中国全科医学 ›› 2026, Vol. 29 ›› Issue (34): 5051-5060.DOI: 10.12114/j.issn.1007-9572.2026.0056

• 论著 • 上一篇    

甘油三酯-总胆固醇-体重指数与老年人筛查定义慢性阻塞性肺疾病和肺功能的关联:一项基于青岛市老年人的横断面调查

马慧琳1, 王瑶瑶1, 李赞1, 杨晨2, 于新娟3, 韩伟4,*()   

  1. 1.266071 山东省青岛市,青岛大学青岛医学院
    2.261053 山东省潍坊市,山东第二医科大学临床医学院
    3.266071 山东省青岛市,康复大学青岛医院(青岛市市立医院)临床研究中心
    4.266071 山东省青岛市,康复大学青岛医院(青岛市市立医院)呼吸与危重症医学科
  • 收稿日期:2026-06-22 修回日期:2026-09-02 出版日期:2026-12-05 发布日期:2026-10-26
  • 通讯作者: 韩伟

  • 作者贡献:

    马慧琳确定研究目标,并负责研究的设计、实施及论文撰写;王瑶瑶、李赞负责数据收集、整理、统计分析及图表绘制;杨晨参与论文修订;于新娟、韩伟负责文章的质量把控、审查及整体监督管理。

  • 基金资助:
    国家科技重大专项(2026ZD0557903); 青岛市呼吸共病重构与精准防控重点实验室

Association between Nutritional Index TCBI, Screening-defined Chronic Obstructive Pulmonary Disease, and Lung Function: a Cross-sectional Study of the Elderly in Qingdao

MA Huilin1, WANG Yaoyao1, LI Zan1, YANG Chen2, YU Xinjuan3, HAN Wei4,*()   

  1. 1. Qingdao Medical College, Qingdao University, Qingdao 266071, China
    2. School of Clinical Medicine, Shandong Second Medical University, Weifang 261053, China
    3. Clinical Research Center, Qingdao Hospital, University of Health and Rehabilitation Sciences (Qingdao Municipal Hospital), Qingdao 266071, China
    4. Department of Respiratory and Critical Care Medicine, Qingdao Hospital, University of Health and Rehabilitation Sciences (Qingdao Municipal Hospital), Qingdao 266071, China
  • Received:2026-06-22 Revised:2026-09-02 Published:2026-12-05 Online:2026-10-26
  • Contact: HAN Wei

摘要: 背景 慢性阻塞性肺疾病(COPD)是全球及我国老年人群面临的重大公共卫生挑战,具有高致残率和高致死率。营养状况是影响COPD患者预后及社区老年人健康管理的可改变的关键因素。甘油三酯-总胆固醇-体重指数(TCBI)是一种整合脂质代谢与体质量的简易营养相关指标,但在社区老年人群COPD筛查及肺功能评估中的应用价值尚不明确。 目的 本研究旨在利用2023年青岛市慢性阻塞性肺疾病高风险人群筛查项目的大规模社区普查数据,探讨TCBI与社区老年人群筛查定义的COPD患病风险及肺功能指标的关联。 方法 本研究为横断面设计,纳入2023年青岛市COPD高风险人群筛查项目的89 368名60岁及以上居民,收集其人口学信息、既往史及生化指标。以"筛查定义的COPD[吸入支气管舒张剂前第1秒用力呼气容积(FEV1)与用力肺活量(FVC)比值(FEV1/FVC)<0.70或既往经医师明确诊断为COPD]"为主要结局指标。采用多因素Logistic回归分析TCBI与筛查定义的COPD患病风险的关联,多元线性回归分析探讨TCBI与肺功能指标[FEV1、FVC、FEV1/FVC、FEV1实测值占预计值的百分比(FEV1%pred)、呼气峰流量(PEF)]的关系,并进行敏感性分析与亚组分析。 结果 研究人群平均年龄为(72.1±5.9)岁,筛查定义的COPD患病率为23.4%(20 912/89 368)。在调整年龄、性别、吸烟状况、腰围、高血压、糖尿病、哮喘、心血管疾病及空腹血糖后,Logistic回归显示Log TCBI每增加1个单位,筛查定义的COPD患病风险降低16%(OR=0.84, 95%CI=0.79~0.89, P<0.001)。多元线性回归显示,Log TCBI与FEV1(β=0.08)、FVC(β=0.07)、FEV1/FVC(β=0.83)及PEF(β=0.21)均呈正相关(P<0.001)。敏感性分析证实上述结果在排除极端消瘦或肥胖、哮喘及严重心血管疾病或糖尿病人群后依然稳健。 结论 在青岛市高龄社区人群中,较高的TCBI水平与较低的筛查定义的COPD风险及较好的肺功能相关。TCBI作为一个整合脂质代谢与能量储备的简易指标,可能为社区老年人群COPD评估及健康管理提供新思路。

关键词: 肺疾病,慢性阻塞性, 甘油三酯-总胆固醇-体重指数, 肺功能, 社区筛查, 横断面研究

Abstract:

Background

Chronic obstructive pulmonary disease (COPD) is a major public health challenge worldwide and in China, particularly among older adults, and is associated with substantial disability and mortality. Nutritional status is a modifiable factor related to the prognosis of patients with COPD and to health management in community-dwelling older adults. The triglyceride-total cholesterol-body weight index (TCBI) is a simple composite indicator reflecting lipid metabolism and body weight; however, its value in COPD screening and lung function assessment in community-dwelling older adults remains unclear.

Objective

This study aimed to examine the associations of TCBI with screening-defined COPD and lung function parameters among community-dwelling older adults, using large-scale data from the 2023 Qingdao COPD high-risk population screening project.

Methods

This cross-sectional study included 89 368 residents aged 60 years or older who participated in the 2023 Qingdao COPD high-risk population screening project. Demographic characteristics, medical history, and biochemical indicators were collected. The primary outcome was screening-defined COPD, defined as a pre-bronchodilator FEV1/FVC ratio <0.70 or a previous physician-confirmed diagnosis of COPD. Multivariable Logistic regression was used to assess the association between TCBI and screening-defined COPD, and multivariable linear regression was used to examine the associations between TCBI and lung function parameters, including FEV1, FVC, FEV1/FVC, FEV1%pred, and PEF. Sensitivity analyses and subgroup analyses were also performed.

Results

The mean age of the participants was (72.1±5.9) years, and the prevalence of screening-defined COPD was 23.4% (20 912/89 368). After adjustment for age, sex, smoking status, waist circumference, hypertension, diabetes mellitus, asthma, cardiovascular disease, and fasting blood glucose, each 1-unit increase in log-transformed TCBI was associated with 16% lower odds of screening-defined COPD (OR=0.84, 95%CI=0.79-0.89, P<0.001). Log-transformed TCBI was positively associated with FEV1 (β=0.08), FVC (β=0.07), FEV1/FVC (β=0.83), and PEF (β=0.21) (all P<0.001). These associations remained robust in sensitivity analyses after excluding participants with extreme underweight or obesity, asthma, or severe cardiovascular disease or diabetes mellitus.

Conclusion

Among community-dwelling older adults in Qingdao, higher TCBI was associated with lower odds of screening-defined COPD and better lung function. As a simple indicator integrating lipid metabolism and body weight, TCBI may serve as a practical marker for COPD assessment and health management in community settings.

Key words: Pulmonary disease, chronic obstructive, Triglycerides-total cholesterol-body weight index, Pulmonary function, Community screening, Cross-sectional study