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

• Published in: PloS one Vol. 9; no. 8; p. e105220
• Main Authors: García-Rio, Francisco, Soriano, Joan B., Miravitlles, Marc, Muñoz, Luis, Duran-Tauleria, Enric, Sánchez, Guadalupe, Sobradillo, Victor, Ancochea, Julio
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 25.08.2014; Public Library of Science (PLoS)
• Subjects: Adult; Aged; Aged, 80 and over; Air flow; Airflow; Biology and Life Sciences; Biomarkers; Biomarkers - metabolism; Body mass; Body Mass Index; Body size; Body weight; Bronchitis; Bronchodilators; C-reactive protein; Cardiovascular diseases; Chronic obstructive pulmonary disease; Cough; Dyspnea; Female; Humans; Inflammation; Lung diseases; Male; Medicine and Health Sciences; Middle Aged; Mortality; Obesity; Obesity - complications; Obesity - epidemiology; Obesity - physiopathology; Obstructive lung disease; Odds Ratio; Overweight; Patients; Phenotypes; Pulmonary Disease, Chronic Obstructive - complications; Pulmonary Disease, Chronic Obstructive - physiopathology; Quality of Life; Respiration; Risk Factors; Sampling methods; Smoking; Subgroups; Underweight; Weight reduction; Spain
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0105220

To 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. A 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. The 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). In 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.