Source: Annual Congress 2009 - Prognosis and comorbidities in COPD
Disease area: Airway diseases

Abstract

Malnutrition in COPD is associated with higher mortality. Obesity has been associated with COPD through a "systemic inflammatory syndrome". The relationship between obesity, clinical outcomes and survival in COPD remain unknown.
We investigated prevalence and associations of obesity with clinical outcomes in 1,084 COPD patients followed for 58 ± 33 months. Patients were classified as underweight (BMI ≤ 21 Kg/m²), normal (22-29 Kg/m²), and obese (≥ 30 Kg/m²). We compared demographic and physiological characteristics, patient centered outcomes and survival. Obesity was present in 29 %, and malnutrition in 18% of the patients. Obese patients had lower MRC dyspnea scale (2.4 vs. 2.9 points; p =0.004), higher 6MWD (338 vs. 275 meters; p <0.0001), less hyperinflation (IC/TLC= 0.33 vs. 0.22, p<0.0001) and better survival (64% vs. 32 %; p <0.001) than underweight patients. They had similar if not better outcomes than normal weight patients. In regression models, low and not high BMI independently predicted worse dyspnea, IC/TLC, exercise capacity and survival.
In COPD patients, obesity prevalence was high and had no association with worsened outcomes, including mortality. Obesity appears to be protective for those outcomes. Further work is required to evaluate the effect of obesity and associated co-morbidities in COPD patients.

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Citations should be made in the following way:
C. Cote, V. Pinto-Plata, B. Celli (Bay Pines, Boston, United States Of America). Paradoxical beneficial effect of obesity in patient centered outcomes and survival in COPD. Eur Respir J 2009; 34: Suppl. 53, 509

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