WITHDRAWN: The clinical characteristics and treatment response of patients with chronic obstructive pulmonary disease with low body mass index

Abstract

Background This study aimed to analyze the clinical characteristics and treatment response of patients with chronic obstructive pulmonary disease (COPD) with low body mass index (BMI). Methods This cross-sectional study enrolled stable COPD patients from database setup by Second Xiangya Hospital of Central South University. According to the BMI, the patients were classified into three groups: low BMI (BMI < 18.5 kg/m2), normal BMI (18.5 ≤ BMI < 24.0 kg/m2) and high BMI (BMI ≥ 24 kg/m2) groups. Clinically important deterioration (CID) was defined as attaining CAT scores increased ≥ 2, minimum clinically important difference (MCID) was defined as attaining CAT scores decreased ≥ 2 during six months of follow up. Exacerbation and mortality were recorded during one year of follow up. Results A total of 910 stable COPD patients were included and 144 (15.8%) patients in low BMI, 475 (52.2%) patients in normal BMI and 291 (32.0%) patients in high BMI groups. The patients with low BMI had a worse pulmonary function, higher symptoms score and exacerbations in the past year compared with normal and high BMI groups (P < 0.05). Logistic regression analysis revealed that age, Global Initiative for Chronic Obstructive Lung Disease (GOLD) grades 3 and 4, hospitalizations in the past year were the independent risk factors for low BMI (P < 0.05). After followed up for one year, the low BMI patients had higher mortality and number of hospitalizations. Patients with low BMI more likely to attain CID, while less likely to attain MCID compared with high BMI group (P < 0.05). In addition, the low BMI patients treated with long-acting β2-agonist (LABA) + long-acting muscarinic antagonist (LAMA) and LABA + LAMA + inhaled corticosteroid (ICS) more likely attain MCID than treated with LABA + ICS and LAMA (P < 0.05). Conclusion COPD patients with low BMI had worse pulmonary function, higher symptoms scores, higher risk of future hospitalizations and mortality, as well as less likely to attain MCID and more likely to attained CID. It was worth noting that low BMI patients treated with LABA + LAMA and LABA + LAMA + ICS more likely attain MCID than treated with LABA + ICS and LAMA.