COPD: Journal of Chronic Obstructive Pulmonary Disease最新文献

Background: Chronic obstructive pulmonary disease(COPD) hospitalization heightens risks for patients, including mortality, reduced quality of life, and financial strain. Walking pace (WP) and hand grip strength (HGS) are key indicators, their direct connection to COPD hospitalization is uncertain.

Objective: To investigate the relationship between genetic determinants of walking pace, hand grip strength, and the risk of COPD hospitalization as well as lung function.

Methods: The data pertaining to WP (n = 459,915), HGS (n = 922,115), COPD hospitalizations (n = 309,154), and lung function (n = 79,055) were procured from comprehensive large-scale genome-wide association studies. In carrying out the causal inference analysis, robust statistical methods were utilized, encompassing inverse variance weighted (IVW), MR-Egger, weighted median, simple median and Weighted mode. To address issues of heterogeneity, pleiotropy, and outliers, we incorporated sensitivity analyses and Mendelian randomization (MR) techniques.

Results: The IVW analysis suggests that a faster WP reduces the risk of COPD hospitalization (OR = 0.3559, 95% CI: 0.22-0.52; p = 5.197 × 10^-5). It also reveals a potential association between gait speed and the likelihood of developing early-onset COPD (OR = 0.189, 95% CI 0.09 to 0.39; p = 8.89 × 10-6) as well as late-onset COPD (OR = 0.44, 95% CI 0.25 to 0.76; p = 0.0036). The IVW analysis further indicates a potential correlation between an increased WP and enhanced peak expiratory flow (PEF) (OR = 1.699, 95% CI: 1.23 to 2.35; p = 0.0014), forced expiratory volume in 1 s(FEV1, OR = 1.557, 95% CI 1.24 to 1.95; p = 0.0001), and forced vital capacity(FVC, OR = 1.584, 95% CI 1.26 to 1.99; p = 8.89 × 10-5). The IVW analysis suggests a possible causal link between stronger left-hand grip strength and elevated levels of FVC (OR = 1.29, 95% CI: 1.15 to 1.46; p = 1.68 × 10-5), FEV1 (OR = 1.24, 95% CI: 1.11 to 1.39; p = 1.63 × 10-4), and PEF (OR = 1.2, 95% CI: 1.07 to 1.36; p = 2.67 × 10-3). Similarly, right-hand grip strength exhibits a comparable causal relationship with FVC and PEF as left-hand grip strength.

Conclusions: Our research shows a link between slower walking pace and higher COPD hospitalization risk, as well as decreased lung function (PEF, FEV1, FVC). We also found a significant correlation between weaker hand grip and reduced lung function, especially FVC. These findings have the potential to improve risk assessment approaches, intervention strategies, and management methods for COPD patients, while simultaneously enhancing their overall quality of life and health status.

To investigate the clinical effects and application value of self-made disseminating and descending breathing exercises on home rehabilitation of patients with stable chronic obstructive pulmonary disease (COPD). Seeking to generate concepts for creating novel, convenient, and efficient COPD prognosis rehabilitation exercises aimed at enhancing the well-being and rehabilitation confidence of both COPD patients and their families. A total of 70 COPD patients admitted to our outpatient department from July 2019 to September 2021 were randomly divided into the exercise group (n = 35) and the control group (n = 35). The control group received routine breathing training, while the exercise group was treated with self-made disseminating and descending breathing exercises. The respiratory function, including pulmonary function (FVC, FEV1, FEV1/FVC) and respiratory muscle strength (MIP, MEP), exercise tolerance (6-min walking distance, 6MWT), Modified Medical Research Council Dyspnea Scale (mMRC, Borg), COPD quality of life score (CAT, SGRQ), anxiety and depression scores (HAMA, HAMD) were compared between the two groups after 12-week exercise. After 12-week training, the FEV1, MIP, and MEP in the exercise group were significantly higher than those in the control group (p < 0.001), and the 6MWT was significantly increased in the exercise group compared to the control group (p < 0.001); while the mMRC, Borg score, the scores of CAT, SGRQ, HAMA, and HAMD were found significantly lower than those in the control group (p < 0.001). The self-made disseminating and descending breathing exercises can improve respiratory function and reduce symptoms of dyspnea in COPD patients, while enhancing exercise tolerance and relieving anxiety and depression, and are worthy of clinical application.

Chronic Obstructive Pulmonary Disease (COPD) is a complex and heterogeneous condition. Exposure to tobacco smoke and air pollutants are key risk factors for COPD development; however, other risk factors include race/ethnicity, sex of adults, a history of asthma, occupational exposures, and chronic respiratory infections. Data for the current study were from the 2022 Behavioral Risk Factor Surveillance Survey. Chi-squares and multinomial logistic regression analyses, adjusted with the survey's sampling weight, were used to examine how critical health indicators impacted a COPD diagnosis. Participants (N = 311,175) were adults aged 45 years and older. Adjusted multinomial regression analyses showed adults who reported asthma, current and former smoking, poor physical health, depression, less physical activity, and fatigue were more likely to report COPD. Those with COPD were more likely to be male than female. Moreover, those with COPD reported higher rates of health insurance coverage, and yet had lower income and more financial difficulty affording a doctor for health services. In a follow up regression analysis, examining racial differences in COPD for participants, American Indian adults had a higher odds of reporting COPD than the "other" race groups. Because COPD remains a leading cause of death and disability in the U.S., and racial disparities persist in respiratory outcomes, continuing to identify risk factors for vulnerable groups could assist health program planners with development of successful health messaging.

Chronic obstructive pulmonary disease (COPD) is a common chronic disease characterized by airflow obstruction, which seriously threatens people's health. The COPD mouse model was established with cigarette smoke induction. Hematoxylin-eosin staining and Masson staining were carried out to observe the pathological changes of lung tissues in COPD mice. RTEL1 was silenced in COPD mice, and immunohistochemistry was used to detect RTEL1, ki67 and Caspase-3 expression. The role of RTEL1 in inflammation were evaluated by ELISA, and the impacts of RTEL1 on M1 and M2 macrophage markers (iNOS and CD206) were evaluated by qPCR and western blotting. In COPD model, there was an increase in the number of inflammatory cells, with slightly disorganized cell arrangement, unclear hierarchy, condensed and solidified nuclei, while knockdown of RTEL1 improved the inflammatory infiltration. Moreover, knockdown of RTEL1 reduced ki67-positive cells and increased Caspase-3 positive cells in COPD group. The increased inflammatory factors (IL-1β, MMP-9, TNF-α, IL-4, IL-6, and IL-23) in COPD were suppressed by knockdown of RTEL1, while iNOS was raised and CD206 was inhibited. In conclusion, knockdown of RTEL1 promoted M1 and inhibited M2 macrophage polarization and inflammation to alleviate COPD.

Poland is a country with a high burden of COPD and its risk factors. This population-wide and geospatial study on COPD in Poland, aimed to analyze changes in hospitalizations of patients with a diagnosis of COPD between 2006 and 2019 as well as to identify changes in the demographic characteristics of patients hospitalized with COPD. This is a retrospective analysis of hospital discharge records of patients with a diagnosis of COPD (ICD-10 code J44 and age 40 and over), hospitalized in Poland between 2006 and 2019. Data were analyzed separately for all patients hospitalized with COPD (primary and secondary diagnosis), for patients admitted due to COPD (primary diagnosis) and patients hospitalized with COPD as a comorbidity (secondary diagnosis). Between 2006 and 2019, a total of 1,663,420 hospital admissions of patients with COPD were reported. Between 2006 and 2019, the annual number of patients hospitalized due to COPD decreased by 53.8%, including 57.3% among men and 46.6% among women. The number of patients hospitalized with COPD as comorbidity increased by 35.8%. The lowest hospital admissions rate was in north-western Poland and the highest in north-eastern Poland. Among patients admitted due to COPD, the percentage of women increased from 32.6% to 37.7%. The percentage of patients admitted due to COPD and living in rural areas decreased from 51.2% in 2006 to 40.8%in 2019. This study provided data on changes in sociodemographic characteristics of hospitalizations of patients with a diagnosis of COPD, including overall reduction in COPD admissions but an increase in COPD burden among women.