Obesity and Overweight Linked to Lower Risk of Exacerbations in COPD Patients

Alison Rodriguez

Obesity and overweight in individuals were associated with a lower risk and frequency of chronic pulmonary obstructive disease (COPD) exacerbations in Taiwan.
A study recently published by the International Journal of Chronic Obstructive Pulmonary Disease assessed the link between a high body mass index (BMI) and COPD-related outcomes. Data was collected from the Taiwan Obstructive Lung Disease (TOLD) study—an observational nationwide survey of COPD patients conducted at 12 hospitals from December 2011 through November 2013 in Taiwan.
“COPD is a significant health burden worldwide and, currently, the seventh leading cause of death in Taiwan. The natural history of COPD is punctuated by exacerbations, defined as acute worsening of symptoms,” explained the study. “COPD exacerbations have been shown to be associated with an accelerated decline in pulmonary function, poorer health-related quality of life (HRQL), and higher mortality rate.”
The researchers considered demographic and clinical data that are often related to COPD, such as age, gender, smoking history, concomitant diseases, and wheezing presence.  The individuals’ BMI was calculated as weight in kilograms divided by the participants square height in meters. A frequent exacerbator phenotype was considered if 2 or more exacerbations occurred in the course of 1 year.
Of the 1096 COPD patients included in the TOLD study, 9.2% were underweight, 49.5% had a normal BMI, 23.4% were overweight, and 17.9% were obese. Patients with a higher BMI demonstrated fewer exacerbations than those with the frequent exacerbator phenotype, the study found.
Additionally, patients with a BMI of 24 or greater had fewer COPD exacerbations that those with a BMI less than 24.  However, those with a higher BMI faced a greater rate of comorbidities, including cardiovascular disease, hypertension, diabetes mellitus, ischemic heart disease, and dyslipidemia.
“The prediction and prevention of COPD exacerbations are important goals in the management of COPD. BMI is an easily accessible parameter for patient assessment and risk stratification,” the researchers stated. “It is well known that underweight increases the risk of mortality in patients with COPD. However, the impact of increased body weight on the outcomes of COPD was not conclusive.”
The researchers acknowledge the need for further studies to investigate anthropometric parameters and to determine their clinical relevance among patients with COPD.
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