Frontiers in Physiology (Nov 2023)
The impact of metabolic overweight/obesity phenotypes on unplanned readmission risk in patients with COPD: a retrospective cohort study
- Yang Tian,
- Yang Tian,
- Yang Tian,
- Yang Tian,
- Yang Tian,
- Luna Liu,
- Luna Liu,
- Luna Liu,
- Luna Liu,
- Luna Liu,
- Yuchen Li,
- Yuchen Li,
- Yuchen Li,
- Yuchen Li,
- Yuchen Li,
- Xiude Fan,
- Xiude Fan,
- Xiude Fan,
- Xiude Fan,
- Wanhong Wu,
- Wanhong Wu,
- Wanhong Wu,
- Wanhong Wu,
- Yingzhou Shi,
- Yingzhou Shi,
- Yingzhou Shi,
- Yingzhou Shi,
- Yingzhou Shi,
- Jie Jiang,
- Jie Jiang,
- Jie Jiang,
- Jie Jiang,
- Jie Jiang,
- Zinuo Yuan,
- Zinuo Yuan,
- Zinuo Yuan,
- Zinuo Yuan,
- Zinuo Yuan,
- Hang Dong,
- Hang Dong,
- Hang Dong,
- Hang Dong,
- Hang Dong,
- Huijie Li,
- Qiuhui Xuan,
- Qiuhui Xuan,
- Qiuhui Xuan,
- Qiuhui Xuan,
- Qiuhui Xuan,
- Chao Xu,
- Chao Xu,
- Chao Xu,
- Chao Xu,
- Chao Xu
Affiliations
- Yang Tian
- Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China
- Yang Tian
- Key Laboratory of Endocrine Glucose and Lipids Metabolism and Brain Aging, Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Ministry of Education, Jinan, Shandong, China
- Yang Tian
- Shandong Clinical Research Center of Diabetes and Metabolic Diseases, Jinan, Shandong, China
- Yang Tian
- Shandong Institute of Endocrine and Metabolic Diseases, Jinan, Shandong, China
- Yang Tian
- Shandong Engineering Laboratory of Prevention and Control for Endocrine and Metabolic Diseases, Jinan, Shandong, China
- Luna Liu
- Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China
- Luna Liu
- Key Laboratory of Endocrine Glucose and Lipids Metabolism and Brain Aging, Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Ministry of Education, Jinan, Shandong, China
- Luna Liu
- Shandong Clinical Research Center of Diabetes and Metabolic Diseases, Jinan, Shandong, China
- Luna Liu
- Shandong Institute of Endocrine and Metabolic Diseases, Jinan, Shandong, China
- Luna Liu
- Shandong Engineering Laboratory of Prevention and Control for Endocrine and Metabolic Diseases, Jinan, Shandong, China
- Yuchen Li
- Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China
- Yuchen Li
- Key Laboratory of Endocrine Glucose and Lipids Metabolism and Brain Aging, Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Ministry of Education, Jinan, Shandong, China
- Yuchen Li
- Shandong Clinical Research Center of Diabetes and Metabolic Diseases, Jinan, Shandong, China
- Yuchen Li
- Shandong Institute of Endocrine and Metabolic Diseases, Jinan, Shandong, China
- Yuchen Li
- Shandong Engineering Laboratory of Prevention and Control for Endocrine and Metabolic Diseases, Jinan, Shandong, China
- Xiude Fan
- Key Laboratory of Endocrine Glucose and Lipids Metabolism and Brain Aging, Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Ministry of Education, Jinan, Shandong, China
- Xiude Fan
- Shandong Clinical Research Center of Diabetes and Metabolic Diseases, Jinan, Shandong, China
- Xiude Fan
- Shandong Institute of Endocrine and Metabolic Diseases, Jinan, Shandong, China
- Xiude Fan
- Shandong Engineering Laboratory of Prevention and Control for Endocrine and Metabolic Diseases, Jinan, Shandong, China
- Wanhong Wu
- Key Laboratory of Endocrine Glucose and Lipids Metabolism and Brain Aging, Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Ministry of Education, Jinan, Shandong, China
- Wanhong Wu
- Shandong Clinical Research Center of Diabetes and Metabolic Diseases, Jinan, Shandong, China
- Wanhong Wu
- Shandong Institute of Endocrine and Metabolic Diseases, Jinan, Shandong, China
- Wanhong Wu
- Shandong Engineering Laboratory of Prevention and Control for Endocrine and Metabolic Diseases, Jinan, Shandong, China
- Yingzhou Shi
- Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China
- Yingzhou Shi
- Key Laboratory of Endocrine Glucose and Lipids Metabolism and Brain Aging, Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Ministry of Education, Jinan, Shandong, China
- Yingzhou Shi
- Shandong Clinical Research Center of Diabetes and Metabolic Diseases, Jinan, Shandong, China
- Yingzhou Shi
- Shandong Institute of Endocrine and Metabolic Diseases, Jinan, Shandong, China
- Yingzhou Shi
- Shandong Engineering Laboratory of Prevention and Control for Endocrine and Metabolic Diseases, Jinan, Shandong, China
- Jie Jiang
- Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China
- Jie Jiang
- Key Laboratory of Endocrine Glucose and Lipids Metabolism and Brain Aging, Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Ministry of Education, Jinan, Shandong, China
- Jie Jiang
- Shandong Clinical Research Center of Diabetes and Metabolic Diseases, Jinan, Shandong, China
- Jie Jiang
- Shandong Institute of Endocrine and Metabolic Diseases, Jinan, Shandong, China
- Jie Jiang
- Shandong Engineering Laboratory of Prevention and Control for Endocrine and Metabolic Diseases, Jinan, Shandong, China
- Zinuo Yuan
- Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China
- Zinuo Yuan
- Key Laboratory of Endocrine Glucose and Lipids Metabolism and Brain Aging, Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Ministry of Education, Jinan, Shandong, China
- Zinuo Yuan
- Shandong Clinical Research Center of Diabetes and Metabolic Diseases, Jinan, Shandong, China
- Zinuo Yuan
- Shandong Institute of Endocrine and Metabolic Diseases, Jinan, Shandong, China
- Zinuo Yuan
- Shandong Engineering Laboratory of Prevention and Control for Endocrine and Metabolic Diseases, Jinan, Shandong, China
- Hang Dong
- Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China
- Hang Dong
- Key Laboratory of Endocrine Glucose and Lipids Metabolism and Brain Aging, Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Ministry of Education, Jinan, Shandong, China
- Hang Dong
- Shandong Clinical Research Center of Diabetes and Metabolic Diseases, Jinan, Shandong, China
- Hang Dong
- Shandong Institute of Endocrine and Metabolic Diseases, Jinan, Shandong, China
- Hang Dong
- Shandong Engineering Laboratory of Prevention and Control for Endocrine and Metabolic Diseases, Jinan, Shandong, China
- Huijie Li
- Department of Statistics and Medical Records Management, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
- Qiuhui Xuan
- Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China
- Qiuhui Xuan
- Key Laboratory of Endocrine Glucose and Lipids Metabolism and Brain Aging, Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Ministry of Education, Jinan, Shandong, China
- Qiuhui Xuan
- Shandong Clinical Research Center of Diabetes and Metabolic Diseases, Jinan, Shandong, China
- Qiuhui Xuan
- Shandong Institute of Endocrine and Metabolic Diseases, Jinan, Shandong, China
- Qiuhui Xuan
- Shandong Engineering Laboratory of Prevention and Control for Endocrine and Metabolic Diseases, Jinan, Shandong, China
- Chao Xu
- Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China
- Chao Xu
- Key Laboratory of Endocrine Glucose and Lipids Metabolism and Brain Aging, Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Ministry of Education, Jinan, Shandong, China
- Chao Xu
- Shandong Clinical Research Center of Diabetes and Metabolic Diseases, Jinan, Shandong, China
- Chao Xu
- Shandong Institute of Endocrine and Metabolic Diseases, Jinan, Shandong, China
- Chao Xu
- Shandong Engineering Laboratory of Prevention and Control for Endocrine and Metabolic Diseases, Jinan, Shandong, China
- DOI
- https://doi.org/10.3389/fphys.2023.1290611
- Journal volume & issue
-
Vol. 14
Abstract
Background: There is an inconsistent association between overweight/obesity and chronic obstructive pulmonary disease (COPD). Considering that different metabolic characteristics exist among individuals in the same body mass index (BMI) category, the classification of overweight/obesity based on metabolic status may facilitate the risk assessment of COPD. Our study aimed to explore the relationship between metabolic overweight/obesity phenotypes and unplanned readmission in patients with COPD.Methods: We conducted a retrospective cohort study using the Nationwide Readmissions Database (NRD). According to metabolic overweight/obesity phenotypes, patients were classified into four groups: metabolically healthy non-overweight/obesity (MHNO), metabolically unhealthy non-overweight/obesity (MUNO), metabolically healthy with overweight/obesity (MHO), and metabolically unhealthy with overweight/obesity (MUO). The primary outcome was unplanned readmission to hospital within 30 days of discharge from index hospitalization. Secondary outcomes included in-hospital mortality, length of stay (LOS) and total charges of readmission within 30 days.Results: Among 1,445,890 patients admitted with COPD, 167,156 individuals were unplanned readmitted within 30 days. Patients with the phenotype MUNO [hazard ratio (HR), 1.049; 95%CI, 1.038–1.061; p < 0.001] and MUO (HR, 1.061; 95%CI, 1.045–1.077; p < 0.001) had a higher readmission risk compared with patients with MHNO. But in elders (≥65yr), MHO also had a higher readmission risk (HR, 1.032; 95%CI, 1.002–1.063; p = 0.039). Besides, the readmission risk of COPD patients with hyperglycemia or hypertension regardless of overweight/obesity increased (p < 0.001).Conclusion: In patients with COPD, overweight/obesity alone had little effect on unplanned readmission, whereas metabolic abnormalities regardless of overweight/obesity were associated with an increased risk of unplanned readmission. Among the metabolic abnormalities, particular attention should be paid to hyperglycemia and hypertension. But in elders (≥65yr) overweight/obesity and metabolic abnormalities independently exacerbated the adverse outcomes.
Keywords