{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,21]],"date-time":"2026-03-21T22:37:21Z","timestamp":1774132641803,"version":"3.50.1"},"reference-count":35,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,2,9]],"date-time":"2025-02-09T00:00:00Z","timestamp":1739059200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82360662"],"award-info":[{"award-number":["82360662"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82160640"],"award-info":[{"award-number":["82160640"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Respirology"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background and Objective<\/jats:title><jats:p>An imbalanced fat and muscle mass ratio might impact exacerbation of chronic obstructive pulmonary disease (COPD). We investigated the association of visceral fat\u2010to\u2010muscle ratio (VMR) with severe COPD exacerbation requiring hospitalisation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This prospective cohort study in COPD patients was performed along with the Xinjiang Multi\u2010Ethnic Cohort study between May 2018 and December 2023. Baseline VMR was calculated from visceral fat area and muscle mass measured by bioelectrical impedance analysis. Numbers of COPD exacerbation hospitalizations were monitored. Associations between various variables and exacerbation were assessed by logistics regression and Zero\u2010inflated Poisson regression analyses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 631 COPD patients were included, with 186 (29.48%) and 304 (48.18%) severe COPD exacerbation within 1 and 5\u2009years, respectively. Compared with body mass index and other obesity indicators, VMR had stronger associations with severe exacerbation. A higher VMR was associated with increased risks of 1\u2010year and 5\u2010year exacerbation (odds ratio [OR]\u2009=\u20091.34 and 1.44, respectively). The subgroup female and overweight individuals showed a strong association (female OR\u2009=\u20091.89 and 1.99, overweight OR\u2009=\u20091.80 and 1.88, for 1 and 5\u2010year exacerbation, respectively). The number of COPD exacerbation increased by 46% for each one\u2010point VMR increase. These results remained unchanged in the sensitivity analyses after removing underweight patients or smoke influence, as well as in the competing risk analysis when considering other causes for death.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>VMR was a risk factors of severe COPD exacerbation. Proactive assessment of VMR might be helpful to guide management of COPD patients.<\/jats:p><\/jats:sec>","DOI":"10.1111\/resp.14883","type":"journal-article","created":{"date-parts":[[2025,2,11]],"date-time":"2025-02-11T06:56:45Z","timestamp":1739257005000},"page":"398-407","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Association Between the Visceral Fat\u2010to\u2010Muscle Ratio and Severe Exacerbation of <scp>COPD<\/scp>: A Prospective Cohort Study"],"prefix":"10.1111","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7055-782X","authenticated-orcid":false,"given":"Yuanyuan","family":"Li","sequence":"first","affiliation":[{"name":"School of Public Health Xinjiang Medical University  Urumqi China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lu","family":"Wang","sequence":"additional","affiliation":[{"name":"School of Public Health Xinjiang Medical University  Urumqi China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhen","family":"Li","sequence":"additional","affiliation":[{"name":"COPD Research Department National TCM Clinical Research Base in Xinjiang  Urumqi China"},{"name":"Department of Pulmonology Traditional Chinese Medicine Hospital Affiliated to Xinjiang Medical University  Urumqi China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tao","family":"Luo","sequence":"additional","affiliation":[{"name":"School of Public Health Xinjiang Medical University  Urumqi China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qi","family":"Sun","sequence":"additional","affiliation":[{"name":"Medical Research Design and Data Analysis Center Traditional Chinese Medicine Affiliated Hospital of Xinjiang Medical University  Urumqi China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Henry S.","family":"Lynn","sequence":"additional","affiliation":[{"name":"School of Public Health Xinjiang Medical University  Urumqi China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jianghong","family":"Dai","sequence":"additional","affiliation":[{"name":"School of Public Health Xinjiang Medical University  Urumqi China"},{"name":"Key Laboratory of Special Environment and Health Research in Xinjiang  Urumqi China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,2,9]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.00239-2023"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0909883"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa021322"},{"key":"e_1_2_12_5_1","unstructured":"Global Initiative for chronic obstructive lung disease \u201cGlobal Strategy for the Diagnosis Management and Prevention of Chronic Obstructive Pulmonary Disease (2024 REPORT)[EB\/OL] \u201dhttps:\/\/goldcopd.org\/2024\u2010gold\u2010reports\/."},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.5694\/mja2.50138"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1183\/16000617.0061-2016"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-2600(19)30397-2"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/00008483-200507000-00010"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.01899-2019"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12931-021-01751-7"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/jcsm.12600"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2020-048242"},{"key":"e_1_2_12_14_1","unstructured":"Tanita Corporation \u201cBody Composition Analyzer DC\u2010430MA III Instruction Manual EN. 2015 \u201dhttps:\/\/tanita.eu\/media\/pdf\/products\u2010tanita\/professional\/DC\u2010430\/DC\u2010430MA%20Instruction%20Manual%20EN%20%281%29.pdf. 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