Exploration Of Independent Risk Factors For Sarcopenia In Stable COPD And Establishment Of Risk Prediction Mode

Purpose:1.To study the independent risk factors of COPD combined with hypomyosia syndrome,and to provide directions for the prevention of hypomyosia syndrome in subsequent COPD patients;2.To establish the risk prediction model of chronic obstructive pulmonary disease complicated with myosthenia syndrome by logistic regression analysis,so as to provide reference for clinical diagnosis and treatment.3.The reliability of this model was tested to provide evidence for screening high-risk groups of COPD complicated with hypomyosia syndrome.Material and method:1.According to the diagnostic criteria for chronic obstructive pulmonary disease,275 outpatient and inpatient patients with stable COPD meeting the criteria were selected from January 2021 to January 2023,and 55 patients meeting the diagnosis of hypomuscular syndrome were screened out;2.Fully communicate with outpatients and inpatients,formulate questionnaires and clinical tests to collect patients’ personal information,diet,6-minute walking speed,lung function index,physical examination,diet,GOLD grading,emotion,lung CT,cultural and educational level,etc.;Consult senior TCM physicians to verify their TCM syndrome elements;3.The data were summarized and univariate analysis was carried out for the hypomuscular syndrome group and the non-hypomuscular syndrome group,and independent risk factors for secondary hypomuscular syndrome were screened.4.The risk prediction model of chronic obstructive pulmonary disease combined with hypomyosia syndrome based on Logistic regression was established by using spss.5.ROC curve,goodness of fit and AUC were used to evaluate the accuracy of the risk prediction model of COPD combined with hypomyosia syndrome.Results:A total of 275 stable COPD patients were included in this study,including 152 males and123 females.The male-female ratio was 1.24:1,P value was 0.903,and the education level was 0.182(p > 0.005).BMI was 18.5 as the boundary,which was low,normal or high,P=0.500(> 0.005).Age was 64.5(±12.12),p value was 0,731;bmi was 22.22(±3.19),P value was 0.192;Through the analysis of life behaviors,the P values of tobacco exposure(smoking,second-hand smoke),drinking history,exercise,staying up late,regular diet,pollution exposure(industrial pollution,residential pollution,working environment pollution,etc.)were 0.224,0.6.5,< 0.001,0.574,< 0.001,0.050,respectively.Analyze emotional states;For the analysis of emotional states,the P values of irritability,anxiety,depression and tension were 0.903,0.624,0.798 and < 0.001 respectively.Seven disease sites were included:spleen,liver,kidney,heart,heart,heart,meridians and muscles and bones,and P values were< 0.001,0.566,0.411,0.259,0.063,0.008,0.522,respectively.11 diseases: dampness,fire,phlegm,Yin,blood stasis,qi stagnation,qi deficiency,Yin deficiency,Yang deficiency,food accumulation,blood deficiency,P values were 0.021,0.053,0.871,0.095,0.806,0.256,<0.001,0.277,0.004,0.627,0.053,respectively.The analysis of disease grade showed that there were 169 patients with GOLD2 grade,106 patients with GOLD3 grade.The P values of GOLD grade and disease > 15 years were < 0.001 and < 0.001,respectively.In summary,the independent risk factors of COPD combined with hypomyosia syndrome are COLD3 grade,the onset > 15 years,lack of exercise,disease location in the spleen,qi deficiency,depression,Yang deficiency,and irregular diet.The above factors were analyzed by SPSS software,and the forward method(α in =0.05,α out =0.1)was selected for screening.A total of 5variables related to hypomuscular syndrome were selected,namely,years of onset greater than 15 years,GOLD3 grade,qi deficiency,spleen,and lack of exercise.Among them,Qi deficiency is most closely related to the occurrence of muscle deficiency syndrome.Five independent risk factors of COPD combined with myosthenia syndrome: GOLD3 grade,years > 15 years,exercise,spleen,qi deficiency after parameter statistics with maximum likelihood value,the risk prediction model of COPD combined with myosthenia syndrome was established as follows:Ln(p/(1-p))=-3.594+1.546X1+1.961X2+1.624X3+1.358X4+3.167X5Among them,X1 is GOLD3,X2 is years > 15 years,X3 is lack of exercise,X4 is disease in the spleen,X5 is qi deficiency.Hosmer-Lemeshow goodness of fit test results P=0.711 > 0.05(x2=4.581)suggested that the classification model had a good effect,and the predicted value was in good agreement with the observed value.The receiver operating characteristic curve(ROC curve)was used to evaluate the prediction effect of the risk prediction model of COPD combined with hypomyosis syndrome.areaunder the ROC curve(AUC)was 0.931(P < 0.001),indicating that the risk factor model of COPD combined with hypomyelia syndrome was reliable.Conclusion:The independent risk factors of COPD combined with hypomyosia syndrome are COLD3 grade,onset > 15 years,lack of exercise,disease location in spleen,qi deficiency,depression,Yang deficiency,irregular diet.The above factors were analyzed by SPSS software,and the forward method(α in =0.05,α out =0.1)was selected for screening.A total of 5 variables related to hypomuscular syndrome were selected,namely,years of onset greater than 15 years,GOLD3 grade,qi deficiency,spleen,and lack of exercise.Among them,Qi deficiency is most closely related to the occurrence of muscle deficiency syndrome.Five independent risk factors of COPD combined with myosthenia syndrome: GOLD3 grade,years > 15 years,exercise,spleen,qi deficiency after parameter statistics with maximum likelihood value,the risk prediction model of COPD combined with myosthenia syndrome was established as follows:Ln(p/(1-p))=-3.594+1.546X1+1.961X2+1.624X3+1.358X4+3.167X5Among them,X1 is GOLD3,X2 is years > 15 years,X3 is lack of exercise,X4 is disease in the spleen,X5 is qi deficiency.Hosmer-Lemeshow goodness of fit test results P=0.711 > 0.05(x2=4.581)suggested that the classification model had a good effect,and the predicted value was in good agreement with the observed value.The receiver operating characteristic curve(ROC curve)was used to evaluate the prediction effect of the risk prediction model of COPD combined with hypomyosis syndrome.areaunder the ROC curve(AUC)was 0.931(P < 0.001),indicating that the risk factor model of COPD combined with hypomyelia syndrome was reliable.