{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T07:01:25Z","timestamp":1790146885369,"version":"4.0.1"},"reference-count":30,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T00:00:00Z","timestamp":1790121600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to investigate the interrelationships among pulmonary rehabilitation outcomes, systemic inflammation, and nutritional status in patients with chronic respiratory diseases, and to provide evidence supporting\u2014but not establishing causality for\u2014multidimensional clinical intervention strategies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A real-world retrospective cohort analysis was performed on clinical records of 100 patients with chronic respiratory diseases hospitalized in the Department of Respiratory Medicine of a tertiary respiratory center in China between January 2018 and December 2022. Pre- and post-comprehensive rehabilitation (pharmacotherapy, pulmonary rehabilitation exercise, individualized nutritional support, and health education) data were collected, including pulmonary function parameters (FEV1, FVC, FEV1\/FVC, TLC, and RV), six-minute walk distance (6MWD), inflammatory markers (C-reactive protein, white blood cell count, and neutrophil percentage), and nutritional indicators (body mass index, serum albumin, and total protein). Cases with &amp;gt;20% missing data were excluded; remaining missing values were handled by complete case analysis. Paired t-tests were used to evaluate pre-post differences, multiple linear regression to identify independent predictors of pulmonary function improvement, and Pearson correlation analysis to examine inter-variable associations. Regression covariates were selected by univariate screening at\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.20.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The mean patient age was 57.74\u202f\u00b1\u202f8.81\u202fyears, with 41 males (41%). Following intervention, FEV1 increased from 1.47\u202f\u00b1\u202f0.43\u202fL to 1.65\u202f\u00b1\u202f0.44\u202fL (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001), 6MWD improved from 428.97\u202f\u00b1\u202f88.59\u202fm to 470.40\u202f\u00b1\u202f92.99\u202fm (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001), and BMI rose from 18.15\u202f\u00b1\u202f2.40 to 18.59\u202f\u00b1\u202f2.47\u202fkg\/m\n                      <jats:sup>2<\/jats:sup>\n                      (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001). CRP decreased from 6.85\u202f\u00b1\u202f4.50 to 4.95\u202f\u00b1\u202f4.71\u202fmg\/L (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001). Seventy-six percent of patients exceeded the FEV1 minimal clinically important difference (MCID, \u2265100\u202fmL), and 63% exceeded the 6MWD MCID (\u226530\u202fm). Correlation analysis demonstrated a moderate positive association between \u0394FEV1 and \u03946MWD (\n                      <jats:italic>r<\/jats:italic>\n                      \u202f=\u202f0.41,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001) and a significant negative association between \u0394FEV1 and \u0394CRP (\n                      <jats:italic>r<\/jats:italic>\n                      =\u202f\u22120.21,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.039). Multiple linear regression showed that no variable independently predicted \u0394FEV1 after full adjustment (overall model\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.297); the nutritional adequacy score showed only a non-significant trend (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      \u202f=\u202f0.024,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.093), interpreted as an exploratory finding.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Comprehensive intervention was associated with significant improvements in pulmonary function, exercise tolerance, and nutritional status alongside reductions in systemic inflammation in patients with chronic respiratory diseases. The observed correlations between changes in FEV1, 6MWD, and CRP highlight potentially interrelated mechanisms, though causality cannot be established from this retrospective, uncontrolled design. These findings support multidimensional management strategies, pending validation in prospective controlled trials.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1876212","type":"journal-article","created":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T06:17:21Z","timestamp":1790144241000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Association of pulmonary rehabilitation outcomes with inflammatory and nutritional status in patients with chronic respiratory diseases: a real-world retrospective cohort study"],"prefix":"10.3389","volume":"13","author":[{"given":"Jingcheng","family":"Dong","sequence":"first","affiliation":[{"name":"Department of Integrative Medicine, Huashan Hospital, Fudan University","place":["Jing'an, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shan","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Integrative Medicine, Huashan Hospital, Fudan University","place":["Jing'an, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maimaititusun","family":"Yalikun","sequence":"additional","affiliation":[{"name":"Department of Integrative Medicine, Huashan Hospital, Fudan University","place":["Jing'an, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,23]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"29","DOI":"10.1097\/01.NPR.0000000000000180","article-title":"An update on COPD prevention, diagnosis, and management: the 2024 GOLD report","volume":"49","author":"Patel","year":"2024","journal-title":"Nurse Pract"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"e18","DOI":"10.1164\/rccm.202202-0399ST","article-title":"Idiopathic pulmonary fibrosis (an update) and progressive pulmonary fibrosis in adults: an official ATS\/ERS\/JRS\/ALAT clinical practice 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