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Respiration

Title:		Impact of Body Mass Index Change on the Prognosis of Chronic Obstructive Pulmonary Disease
Author(s):		Kim EK; Singh D; Park JH; Park YB; Kim SI; Park B; Park J; Kim JH; Kim MA; Lee JH; Kim TH; Yoon HK; Oh YM;
Address:		"Department of Pulmonology, Allergy and Critical Care Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea. Division of Infection, Immunity and Respiratory Medicine, The University of Manchester and Manchester University NHS Foundation Trust, Manchester, United Kingdom. Department of Pulmonary and Critical Care Medicine, Ajou University School of Medicine, Suwon, Republic of Korea, jhpamc@hanmail.net. Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Hallym University Kangdong Sacred Heart Hospital, Seoul, Republic of Korea. Department of Biomedical Informatics, Ajou University School of Medicine, Suwon, Republic of Korea. Division of Pulmonology, Department of Internal Medicine, Hanyang University College of Medicine, Guri, Republic of Korea. Division of Pulmonary, allergy and Critical Care Medicine, Department of Internal Medicine, Seoul Saint Mary's hospital, Catholic University of Korea, Seoul, Republic of Korea. Department of Pulmonary and Critical Care Medicine and Clinical Research Center for Chronic Obstructive Airway Diseases, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea"
Journal Title:		Respiration
Year:		2020
Volume:		20201202
Issue:		11
Page Number:		943 - 953
DOI:		10.1159/000511022
ISSN/ISBN:		1423-0356 (Electronic) 0025-7931 (Linking)
Abstract:		"BACKGROUND: Low body mass index (BMI) is an important prognostic factor in chronic obstructive pulmonary disease (COPD). However, the prognostic value of longitudinal BMI change in COPD has not been well studied. OBJECTIVE: We aimed to evaluate the association between longitudinal change of BMI and prognosis of COPD in Korean COPD cohort. METHODS: This study was conducted in a prospective Korean Obstructive Lung Disease (KOLD) cohort where COPD patients were recruited on an outpatient basis at 17 hospitals in South Korea. Annual BMI was measured over a period of 3 years or more. All patients were categorized into underweight (UW), normal weight (NW), and overweight (OW) groups by BMI. Clinical characteristics and outcomes including exacerbation and mortality were compared based on initial BMI grade and longitudinal change of BMI. RESULTS: This analysis included 537 COPD patients (mean age = 67.4 +/- 7.9 years, male = 97.0%, mean BMI = 23.0 +/- 3.1) of KOLD cohort. The proportions of UW, NW, and OW groups were 6.9% (n = 37), 68.9% (n = 370), and 24.2% (n = 130) respectively. The UW group showed lower forced expiratory volume in 1 s (FEV1) (p < 0.001), shorter 6-minute walk distance (p < 0.001), higher modified Medical Research Council score (p = 0.002), higher St. George Respiratory Questionnaire score (p < 0.001), higher emphysema index (p < 0.001) and air-trapping index (p < 0.001), and more frequent (p < 0.001) and severe exacerbations (p = 0.003). Multivariable analyses demonstrated that decrease of BMI (hazard ratio [HR] = 0.786, p = 0.038) and the descent of BMI group (HR = 3.167, p = 0.016) at 3-year follow-up along with age, initial BMI, post-bronchodilator FEV1, and severe exacerbations were significantly associated with mortality. CONCLUSIONS: This study demonstrated that BMI decrease during follow-up was independently associated with exacerbation and higher mortality of COPD, suggesting BMI reduction in COPD should be carefully managed"
Keywords:		"Aged Asian People *Body Mass Index Female Forced Expiratory Volume Humans Male Middle Aged Prognosis Prospective Studies Pulmonary Disease, Chronic Obstructive/mortality/*physiopathology Republic of Korea Severity of Illness Index Survival Analysis Thinne;"
Notes:		"MedlineKim, Eun Kyung Singh, Dave Park, Joo Hun Park, Yong Bum Kim, Seung-Il Park, Bumhee Park, Jisoo Kim, Jung-Hyun Kim, Mi-Ae Lee, Ji-Hyun Kim, Tae-Hyung Yoon, Hyoung Kyu Oh, Yeon-Mok eng Switzerland 2020/12/03 Respiration. 2020; 99(11):943-953. doi: 10.1159/000511022. Epub 2020 Dec 2"