Association between serum phosphorus and magnesium levels and disease severity/prognosis in elderly patients with acute exacerbation of COPD

doi:10.11958/20253577

Abstract

Abstract:

Objective To investigate the relationship between serum phosphorus and magnesium levels and disease severity/prognosis in elderly patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods A total of 158 elderly AECOPD patients admitted to our hospital from January 2022 to December 2024 were enrolled as the study subjects. Patients were divided into the mild group (n=52), the moderate group (n=46) and the severe group (n=60) based on disease severity. Serum phosphorus and magnesium levels, as well as pulmonary function indices, were compared between the groups. Pearson correlation analysis was performed to assess the relationship between serum phosphorus/magnesium levels and disease-related indicators. According to the prognosis after 6-month follow-up, patients were categorized into the good prognosis group (n=116) and the poor prognosis group (n=42). The general and clinical data of the two groups were collected and compared. Univariate and multivariate Logistic regression analyses were performed to identify prognostic factors. Receiver operating characteristic (ROC) curve analysis was used to evaluate the value of relevant factors in predicting poor prognosis in elderly patients with AECOPD. Results The serum phosphorus and magnesium levels, the percentage of forced expiratory volume in 1 second to the predicted value (FEV1% predicted) and the percentage of forced expiratory volume in one second to forced vital capacity (FEV1/FVC) were lower in the severe group than those in the mild group and the moderate group, but the CURB-65 score was higher in the severe group compared to the mild group and the moderate group (P<0.05). Serum phosphorus and magnesium levels were negatively correlated with the CURB-65 score (r=-0.369 and -0.283, respectively, P<0.05) and positively correlated with FEV1% predicted value and FEV1/FVC (r=0.387, 0.281 for phosphorus; r=0.220, 0.171 for magnesium; P<0.05). Both univariate and multivariate Logistic regression analyses indicated that older age was an independent risk factor for poor prognosis in elderly AECOPD patients, whereas higher FEV1% predicted value, serum phosphorus and serum magnesium levels were independent prediction factors (all P<0.05). ROC curve analysis demonstrated that the area under the curve (AUC) of the combined prediction of age, FEV1% predicted value, serum phosphorus and serum magnesium was higher than that of the individual indicators (Z=4.643, 3.745, 4.411, 4.327, respectively; P<0.05). Conclusion Serum phosphorus and magnesium levels are correlated with the severity of AECOPD in elderly patients. Age, FEV1% predicted value, serum phosphorus and serum magnesium levels possess independent predictive value for prognosis, and their combined assessment enhances predictive efficacy.

Key words: pulmonary disease, chronic obstructive, phosphorus, magnesium, prognosis, aged, acute exacerbation

CLC Number:

R563

Figures/Tables 6

References 21

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组别	n	血磷/（mmol/L）	血镁/（mmol/L）	CURB-65评分/分	FEV1%预计值/%	FEV1/FVC/%
轻度组	52	1.17±0.30	0.91±0.20	1.04±0.21	62.04±8.48	58.64±4.81
中度组	46	1.02±0.27^a	0.88±0.17^a	2.07±0.31^a	50.23±6.20^a	52.43±4.29^a
重度组	60	0.88±0.20^ab	0.78±0.15^ab	2.88±0.43^ab	42.43±7.14^ab	49.68±7.01^ab
F		18.081^＊＊	7.954^＊＊	419.805^＊＊	99.219^＊＊	36.410^＊＊

组别	n	血磷/（mmol/L）	血镁/（mmol/L）	CURB-65评分/分	FEV1%预计值/%	FEV1/FVC/%
轻度组	52	1.17±0.30	0.91±0.20	1.04±0.21	62.04±8.48	58.64±4.81
中度组	46	1.02±0.27^a	0.88±0.17^a	2.07±0.31^a	50.23±6.20^a	52.43±4.29^a
重度组	60	0.88±0.20^ab	0.78±0.15^ab	2.88±0.43^ab	42.43±7.14^ab	49.68±7.01^ab
F		18.081^＊＊	7.954^＊＊	419.805^＊＊	99.219^＊＊	36.410^＊＊

组别	n			年龄/岁	性别（男/女）			体质量指数/（kg/m²）			受教育程度（高中及以下/大专及以上）			居住地（城镇/农村）		吸烟			饮酒		高血压		糖尿病			冠心病
预后良好组	116			71.70±5.35	82/34			22.30±2.64			75/41			68/48		80（68.97）			45（38.79）		52（44.83）		30（25.86）			28（24.14）
预后不良组	42			76.66±5.75	32/10			21.76±2.28			30/12			22/20		32（76.19）			14（33.33）		22（52.38）		14（33.33）			13（30.95）
t或χ²				5.046^＊＊	0.464			1.179			0.635			0.490		0.780			0.393		0.707		0.857			0.745
组别			COPD病程/年				WBC/（×10⁹/L）			LY/（×10⁹/L）			NE/（×10⁹/L）				HGB/（g/L）			PLT/（×10⁹/L）				ALT/（U/L）
预后良好组			8.85±2.30				10.91±2.75			1.11±0.33			8.10±2.50				134.05±16.92			209.86±45.29				27.13（20.36，32.48）
预后不良组			8.80±2.71				11.63±2.89			1.04±0.34			8.55±2.26				131.92±13.26			226.00±50.09				29.83（22.43，36.39）
t或Z			0.109				1.443			1.106			1.019				0.736			1.923				1.019
组别		AST/（U/L）				ALB/（g/L）			TG/（mmol/L）			TC/（mmol/L）			FEV1%预计值/%			FEV1/FVC/%				血磷/（mmol/L）			血镁/（mmol/L）
预后良好组		25.21（20.04，31.22）				35.81±3.40			1.36±0.31			4.20±0.83			45.69±8.36			57.39±9.06				0.90±0.31			0.85±0.20
预后不良组		27.02（25.83，37.32）				35.53±3.85			1.33±0.29			4.10±0.91			36.88±7.15			54.97±9.25				0.68±0.21			0.67±0.20
Z或t		1.622				0.442			0.595			0.615			6.075^＊＊			1.475				4.279^＊＊			4.686^＊＊

组别	n			年龄/岁	性别（男/女）			体质量指数/（kg/m²）			受教育程度（高中及以下/大专及以上）			居住地（城镇/农村）		吸烟			饮酒		高血压		糖尿病			冠心病
预后良好组	116			71.70±5.35	82/34			22.30±2.64			75/41			68/48		80（68.97）			45（38.79）		52（44.83）		30（25.86）			28（24.14）
预后不良组	42			76.66±5.75	32/10			21.76±2.28			30/12			22/20		32（76.19）			14（33.33）		22（52.38）		14（33.33）			13（30.95）
t或χ²				5.046^＊＊	0.464			1.179			0.635			0.490		0.780			0.393		0.707		0.857			0.745
组别			COPD病程/年				WBC/（×10⁹/L）			LY/（×10⁹/L）			NE/（×10⁹/L）				HGB/（g/L）			PLT/（×10⁹/L）				ALT/（U/L）
预后良好组			8.85±2.30				10.91±2.75			1.11±0.33			8.10±2.50				134.05±16.92			209.86±45.29				27.13（20.36，32.48）
预后不良组			8.80±2.71				11.63±2.89			1.04±0.34			8.55±2.26				131.92±13.26			226.00±50.09				29.83（22.43，36.39）
t或Z			0.109				1.443			1.106			1.019				0.736			1.923				1.019
组别		AST/（U/L）				ALB/（g/L）			TG/（mmol/L）			TC/（mmol/L）			FEV1%预计值/%			FEV1/FVC/%				血磷/（mmol/L）			血镁/（mmol/L）
预后良好组		25.21（20.04，31.22）				35.81±3.40			1.36±0.31			4.20±0.83			45.69±8.36			57.39±9.06				0.90±0.31			0.85±0.20
预后不良组		27.02（25.83，37.32）				35.53±3.85			1.33±0.29			4.10±0.91			36.88±7.15			54.97±9.25				0.68±0.21			0.67±0.20
Z或t		1.622				0.442			0.595			0.615			6.075^＊＊			1.475				4.279^＊＊			4.686^＊＊

变量	β	SE	Wald χ²	P	OR	95%CI
年龄	0.121	0.031	14.989	<0.001	1.128	1.061~1.199
FEV1%预计值	-0.147	0.030	24.018	<0.001	0.863	0.814~0.915
血磷	-0.282	0.073	15.032	<0.001	0.754	0.654~0.870
血镁	-0.409	0.100	16.627	<0.001	0.665	0.546~0.809