Obesity in patients with COPD, an undervalued problem?

Bemt, Lisette van den; Wayenburg, C.A.M. van; Smeele, Ivo; Schermer, Tjard

doi:10.1136/thx.2008.111716

Cited by 17 publications

(9 citation statements)

References 6 publications

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Section: Discussionsupporting

confidence: 90%

“…This is similar to the results of numerous studies,33–35 with the exception of a few reports 36. It has been thought that a lower FVC in obese patients is attributed to mechanical restriction of ventilation function 35. Obesity impairs the diaphragm’s ability to descend and decreases the compliance of the thoracic cage, which leads to a decrease in functional residual capacity and total lung capacity, eventually resulting in restrictive extrathoracic ventilation patterns 12.…”

Section: Discussionsupporting

confidence: 86%

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The effect of obesity on patients with mild chronic obstructive pulmonary disease: results from KNHANES 2010 to 2012

Park

Lee

Heo

et al. 2017

COPD

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PurposeA low body mass index has been associated with high mortalities in patients with chronic obstructive pulmonary disease (COPD), and studies reveal that obesity aggravates the clinical effects of COPD. We investigated the impact of obesity on patients newly identified with COPD.Patients and methodsThis population-based, cross-sectional study, used data from the Korea National Health and Nutrition Examination Survey (KNHANES) conducted from 2010 to 2012. Through analyses of data from this survey, we compared concurrent comorbid diseases, symptoms, and lung functions between an obese and nonobese group of patients with COPD.ResultsIn total, 618 participants were diagnosed with COPD and the average forced expired volume in 1 s (FEV1) was 79.47%±0.69%. Of the total, 30.5% of the subjects were categorized into an obese group. Subjects in the obese group were likely to have metabolic syndrome (P<0.001), hypertension (P=0.02), and a higher number of comorbidities compared to the nonobese group (2.3±0.1 vs 2.0±0.1, P=0.02). In addition, subjects in the obese group showed a lower forced vital capacity (FVC) than subjects in the nonobese group, even after adjusting for covariates (average FVC%, 89.32±1.26 vs 92.52%±0.72%, P=0.037). There were no significant differences in the adjusted FEV1% and adjusted FEV1/FVC between the groups.ConclusionsAmong subjects newly identified with mild COPD, participants in the obese group had more comorbid conditions and showed a lower FVC compared with subjects in the nonobese group, even after adjustment of covariates. These findings show that a combination of obesity and COPD may be a severe phenotype; therefore, early attention should be paid to obesity for the management of COPD patients.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 86%

The effect of obesity on patients with mild chronic obstructive pulmonary disease: results from KNHANES 2010 to 2012

Park

Lee

Heo

et al. 2017

COPD

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“…These findings, which have also been identified in other studies [22], [26], coincide with common physiological abnormalities classically associated with simple obesity, such as decreased chest wall and lung compliance, small airway dysfunction and expiratory flow limitation [27]. Contrarily, the lack of differences in inspiratory capacity among our patient groups contradicts with previous information from O'Donnell et al [23], who reported a directly proportional relationship between BMI and resting IC, suggesting that obesity might reduce lung hyperinflation.…”

Section: Discussionsupporting

confidence: 59%

“…In addition to being more frequent, dyspnea is also more intense in obese patients compared with normal-weight patients, even after adjusting for airflow limitation and other variables. Compared with a small clinical series of COPD patients [28] that identified lower baseline dyspnea in obese patients, which was attributed to lower resting hyperinflation, other more extensive clinical series confirm that obese patients with COPD more frequently experience moderate or severe dyspnea than normal-weight patients [22], [26]. A greater perception of the dyspnea associated with obesity may contribute to this finding [29].…”

Section: Discussionmentioning

confidence: 90%

Impact of Obesity on the Clinical Profile of a Population-Based Sample with Chronic Obstructive Pulmonary Disease

García‐Río

Soriano²,

Miravitlles

et al. 2014

PLoS ONE

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AimsTo characterize the distribution of BMI in a population-based sample of COPD patients and to evaluate the impact of obesity on their health status, exercise tolerance, systemic inflammation and comorbidity.MethodsA population-based sample of 3,797 subjects aged 40–80 years from the EPI-SCAN study was selected. Subjects were categorized according their body mass index (BMI) as underweight (<18.5 kg/m2), normal weight (18.5–24.9 kg/m2), overweight (25.0–29.9 kg/m2) or obese (BMI≥30.0 kg/m2). Subjects were evaluated with post-bronchodilator spirometry and 6-minute walk tests. Smoking habits, respiratory symptoms, generic and specific quality of life, daily physical activities, comorbidities and systemic inflammatory biomarkers were recorded.ResultsThe prevalence of obesity or being overweight was higher in the 382 COPD patients than in the subjects without airflow limitation (29.4%, 95%CI 24.8–33.9% vs. 24.3, 95%CI 22.9–25.8; and 44.7%, 95%CI 39.7–49.6% vs. 43.0%, 95%CI 41.3–44.6, respectively; p = 0.020). In the COPD subgroup, obese subjects presented more dyspnea and less chronic cough, chronic bronchitis or chronic phlegm than normal-weight patients, as well as a worse health status. Moreover, reduced exercise tolerance and higher plasmatic C-reactive protein levels were found in the obese patients, who also presented a greater prevalence of cardiovascular disease (adjusted odds ratio 4.796, 95%CI 1.806–12.736, p = 0.002).ConclusionsIn a population-based sample, obesity is more prevalent in COPD patients than in subjects without airflow limitation. Furthermore, obesity affects the clinical manifestations, quality of life and exercise tolerance of COPD patients, and it may contribute to a phenotype characterized by increased systemic inflammation and greater frequency of cardiovascular comorbidity.

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“…Airway epithelium represents a central site for the mechanisms involved in the complex interaction between environmental triggers, airway inflammation and metabolic pathways [12,13,14,19,20]. Regarding peripheral organs, muscle, liver and adipose tissues are a source of a wide range of inflammatory mediators that have systemic effects when released in the systemic compartment.…”

Section: Introductionmentioning

confidence: 99%

Adiponectin: An Attractive Marker for Metabolic Disorders in Chronic Obstructive Pulmonary Disease (COPD)

et al. 2013

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Chronic Obstructive Pulmonary Disease (COPD) is a chronic inflammatory lung disease which may be complicated by development of co-morbidities including metabolic disorders. Metabolic disorders commonly associated with this disease contribute to lung function impairment and mortality. Systemic inflammation appears to be a major factor linking COPD to metabolic alterations. Adipose tissue seems to interfere with systemic inflammation in COPD patients by producing a large number of proteins, known as “adipokines”, involved in various processes such as metabolism, immunity and inflammation. There is evidence that adiponectin is an important modulator of inflammatory processes implicated in airway pathophysiology. Increased serum levels of adiponectin and expression of its receptors on lung tissues of COPD patients have recently highlighted the importance of the adiponectin pathway in this disease. Further, in vitro studies have demonstrated an anti-inflammatory activity for this adipokine at the level of lung epithelium. This review focuses on mechanisms by which adiponectin is implicated in linking COPD with metabolic disorders.

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Obesity in patients with COPD, an undervalued problem?

Cited by 17 publications

References 6 publications

The effect of obesity on patients with mild chronic obstructive pulmonary disease: results from KNHANES 2010 to 2012

The effect of obesity on patients with mild chronic obstructive pulmonary disease: results from KNHANES 2010 to 2012

Impact of Obesity on the Clinical Profile of a Population-Based Sample with Chronic Obstructive Pulmonary Disease

Adiponectin: An Attractive Marker for Metabolic Disorders in Chronic Obstructive Pulmonary Disease (COPD)

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