"Obesity Paradox" in Acute Respiratory Distress Syndrome: Asystematic Review and Meta-Analysis.
"Obesity Paradox" in Acute Respiratory Distress Syndrome: Asystematic Review and Meta-Analysis.
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急性呼吸窘迫综合征中的“肥胖悖论”：Asystematic Resectic和Meta-Analysis。
DOI：
10.1371/journal.pone.0163677
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发表时间：
2016
期刊：
影响因子：
3.7
通讯作者：
Shuying L
中科院分区：
文献类型：
--
作者：
Zhi G;Xin W;Ying W;Guohong X;Shuying L
目前尚不清楚呼吸系统是否存在“肥胖悖论”，特别是在急性呼吸窘迫综合征（ARDS）和急性肺损伤（ALI）中。以前的研究已经假设肥胖和ARDS/ALI之间存在因果关系，但缺乏形成明确结论的能力。探讨肥胖、ARDS/ALI风险和死亡率之间的关系。在Pubmed、EMBASE、Medline、科克伦数据库中进行了截至2016年4月的系统检索，以查找相关研究。所有评估肥胖对ARDS/ALI发病率和死亡率影响的研究均被纳入。共分析了24项研究，包括9，187，248例受试者。来自16项研究的综合结果显示肥胖对ARDS/ALI发病率的影响增加了89%的优势比（合并优势比（OR）1.89，95%可信区间（CI）1.45 - 2.47）。在亚组分析中，与正常体重相比，肥胖与ARDS/ALI风险增加相关（肥胖（BMI 30 -39.9kg/m2）OR 1.57，95% CI 1.30-1.90;肥胖（BMI≥ 30 kg/m2）OR 1.75，95% CI 1.42-2.15;病态肥胖（BMI≥ 40 kg/m2）OR 1.67，95% CI 1.04-2.68）。来自9项研究的合并结果检查了肥胖对ARDS/ALI死亡率的影响，合并优势比（合并OR 0.63，95%CI 0.41 - 0.98）。肥胖与降低ARDS/ALI死亡率的风险显著相关（超重（BMI≤18.5m2）OR 0.88，95%CI 0.78-1.00;肥胖OR 0.74，95%CI 0.64-0.84（BMI 30 -39.9kg/m2）; 60天死亡率OR 0.84，95%CI 0.75-0.94; 90天死亡率OR 0.38，95%CI 0.22-0.66）。我们的数据表明肥胖是发展为ARDS/ALI的重要危险因素;然而，与体重指数正常的个体相比，这一人群的ARDS/ALI结局有所改善。该荟萃分析结果支持ARDS/ALI中的“肥胖悖论”。
It is unclear whether an “obesity paradox” exists in the respiratory system, especially in acute respiratory distress syndrome (ARDS) and acute lung injury (ALI). Previous studies have postulated a causal relation between obesity and ARDS/ALI but have lacked power to form a definitive conclusion. To investigate the relationships between obesity, ARDS/ALIrisk, and mortality. A systematic search current to April 2016 was performed in Pubmed, EMBASE, Medline, Cochrane databases to find relevant studies. All studies that estimate the effect of obesity in the morbidity and mortality of ARDS/ALI were included. A total of 24 studies including 9,187,248 subjects were analyzed. The combined results from 16 studies that examined the effect of obesity in morbidity of ARDS/ALI showed an89% increase in odds ratio(pooled odds ratios (OR) 1.89, 95% confidence intervals (CI) 1.45 to 2.47). In subgroup analysis, compared to normal weight, obesity was associated with an increased risk of ARDS/ALI (OR1.57, 95% CI 1.30–1.90 for obese (BMI30-39.9kg/m2); OR1.75, 95% CI 1.42–2.15 for obese(BMI≥30kg/m2); OR1.67, 95% CI 1.04–2.68 for morbid obese(BMI≥40kg/m2)). The combined results from 9 studies that examined the effect of obesity in mortality of ARDS/ALI had a pooled odds ratio(pooled OR 0.63, 95% CI 0.41 to 0.98). Inversely, obesity was significantly associated with reduced risk of ARDS/ALI mortality(OR0.88, 95% CI 0.78–1.00 for overweight(BMI≤18.5m2); OR0.74, 95% CI 0.64–0.84 for obese (BMI30-39.9kg/m2);OR0.84, 95% CI 0.75–0.94 for 60days mortality; OR0.38, 95% CI 0.22–0.66 for 90days mortality). Our data identify obesity as an important risk factor for the development of ARDS/ALI; however, ARDS/ALI outcomes are improved in this population when compared to individuals with a normal body mass index. This meta-analysis results supported ‘‘obesity paradox” in ARDS/ALI.
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影响因子：
158.5
作者：
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