A pilot study to examine association of BMI with functional class and 6 min walk distance in idiopathic and heritable PAH: Possible association with estrogen metabolism

Abstract

The hypothesis that a relationship exists between body mass index (BMI), functional class, and 6 min walk distance (6MWD) in Group 1-pulmonary arterial hypertension (PAH) was examined. Analysis of data from the UK National Cohort Study for heritable pulmonary arterial/idiopathic PAH suggests increased BMI is a predictor of worse functional class and shorter 6MWD; increased body-weight in mice and man may be associated with increased estrogen metabolism.

Pulmonary arterial hypertension: Sex matters

“…Given that adipose tissue is actively involved in estrogen synthesis and metabolism (Ellero et al, 2010) it is notable that 30% to 50% of PAH patients are obese (Badesch et al, 2010; Taraseviciute & Voelkel, 2006). Furthermore, retrospective analyses have found that a significant proportion of obese subjects display medial thickening of the pulmonary arteries, consistent with subclinical PH (Blankfield et al, 2000; Haque et al, 2008), and body mass index (BMI) was recently found to be associated with severity (MacLean et al, 2022) and female exercise capacity (Ventetuolo et al, 2023) in PAH cohorts.…”