Body mass index and the incidence of influenza-associated pneumonia in a UK primary care cohort.
Body mass index and the incidence of influenza-associated pneumonia in a UK primary care cohort.
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DOI：
10.1111/j.1750-2659.2011.00262.x
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发表时间：
2012-01
影响因子：
4.4
通讯作者：
Toovey S
中科院分区：
文献类型：
--
作者：
Blumentals WA;Nevitt A;Peng MM;Toovey S
请将本文引用为：Blumentals WA。（2012）在英国初级保健队列中，体重指数和流感相关肺炎的发病率。流感和其他呼吸道病毒6(1),28-36。背景：越来越多的数据表明，2009年H1N1流感大流行患者BMI/肥胖增加与发病率之间存在关联。然而，关于季节性流感患者的代谢状况和预后的信息缺乏。方法采用英国全科医学研究数据库进行回顾性队列研究。在2000年1月1日至2007年12月31日期间，年龄≥18岁且BMI≥1记录在12-58 kg/m2范围内的患者在基线BMI日期后被诊断为流感相关肺炎，包括“流感合并肺炎”或在诊断为“流感”后30天内被诊断为“肺炎”。结果共纳入1 074 315例患者，其中73.2%在参考BMI范围内或超重，2.2%体重不足（< 18.5 kg/m2）。除体重过轻者（98·29/10万）外，所有BMI类别的肺炎发生率均为32.33 ~ 37.48 /10万。相对于体重可接受的患者，体重过轻的患者肺炎发病率增加[校正IRR = 2.32 (95% CI 1.8 - 2·94)]，而超重（BMI = 25.0 - 29.9 kg/m2）或肥胖（BMI≥30.0 kg/m2）与肺炎发病率降低相关[校正IRR = 0.77 （95% CI 0.68 - 0.86）和0.85 (95% CI 0.73 - 1.00)]。另一方面，女性和肥胖女性合并2型糖尿病患者的肺炎发病率增加[调整后的IRR分别为1.37 （95%CI 1.08 - 1.72）和1.47 (95%CI 1.01 - 2.06)]。结论：与来自大流行性流感的初步数据相反，流感肺炎和流感后肺炎在体重过轻者中最为常见，并且随着BMI类别的增加，肺炎的发生率明显降低。患有2型糖尿病的女性患肺炎的几率增加。
Please cite this paper as: Blumentals WA. et al. (2012) Body mass index and the incidence of influenza‐associated pneumonia in a UK primary care cohort. Influenza and Other Respiratory Viruses 6(1), 28–36. Background Accumulating data suggest an association between increased BMI/obesity and morbidity in patients with pandemic (H1N1) 2009 influenza. Information on metabolic status and prognosis in seasonal influenza is lacking, however. Methods A retrospective cohort study was carried out using the UK General Practice Research Database. Patients aged ≥18 with ≥1 recorded BMI in the 12–58 kg/m2 range between January 1, 2000, and December 31, 2007, were observed for an influenza‐associated pneumonia diagnosis after the date of baseline BMI, including ‘influenza with pneumonia’ or a diagnosis of ‘pneumonia’ up to 30 days after a diagnosis of ‘influenza’. Results A total of 1 074 315 patients were included, of whom 73·2% were within the reference BMI range or overweight and 2·2% were underweight (<18·5 kg/m2). Pneumonia rates were 32·33–37·48/100 000 in all BMI categories except the underweight (98·29/100 000). Relative to patients with acceptable weight, those who were underweight had an increased pneumonia rate [adjusted IRR = 2·32 (95% CI 1·80–2·94)], while being overweight (BMI = 25·0–29·9 kg/m2) or obese (BMI ≥ 30·0 kg/m2) was associated with a decreased pneumonia rate [adjusted IRR = 0·77 (95% CI 0·68–0·86) and 0·85 (95% CI 0·73–1·00), respectively]. On the other hand, women and obese women with type 2 diabetes had increased pneumonia rates [adjusted IRR = 1·37 (95% CI 1·08–1·72) and 1·47 (95%CI 1·01–2·06), respectively]. Conclusions In contrast to initial data from pandemic influenza, influenza pneumonia, and pneumonia following influenza were the most common in underweight persons, and an apparent decreased rate of pneumonia was noted with increasing BMI categories. Women with type 2 diabetes had increased rates of pneumonia.