Association of body mass index with disease severity and prognosis in patients with non-cystic fibrosis bronchiectasis

Abstract

The objective of this observational, multicenter study was to evaluate the association of body mass index (BMI) with disease severity and prognosis in patients with non-cystic fibrosis bronchiectasis. A total of 339 patients (197 females, 142 males) diagnosed with non-cystic fibrosis bronchiectasis by high-resolution computed tomography were classified into four groups: underweight (BMI<18.5 kg/m2), normal weight (18.5≤BMI<25.0 kg/m2), overweight (25.0≤BMI<30.0 kg/m2), and obese (BMI≥30.0 kg/m2). Clinical variables expressing disease severity were recorded, and acute exacerbations, hospitalizations, and survival rates were estimated during the follow-up period. The mean BMI was 21.90 kg/m2. The underweight group comprised 28.61% of all patients. BMI was negatively correlated with acute exacerbations, C-reactive protein, erythrocyte sedimentation rate, radiographic extent of bronchiectasis, and chronic colonization by P. aeruginosa and positively correlated with pulmonary function indices. BMI was a significant predictor of hospitalization risk independent of relevant covariates. The 1-, 2-, 3-, and 4-year cumulative survival rates were 94%, 86%, 81%, and 73%, respectively. Survival rates decreased with decreasing BMI (χ2=35.16, P<0.001). The arterial carbon dioxide partial pressure, inspiratory capacity, age, BMI, and predicted percentage of forced expiratory volume in 1 s independently predicted survival in the Cox proportional hazard model. In conclusion, an underweight status was highly prevalent among patients with non-cystic fibrosis bronchiectasis. Patients with a lower BMI were prone to developing more acute exacerbations, worse pulmonary function, amplified systemic inflammation, and chronic colonization by P. aeruginosa. BMI was a major determinant of hospitalization and death risks. BMI should be considered in the routine assessment of patients with non-cystic fibrosis bronchiectasis.

Phenotyping Adults with Non-Cystic Fibrosis Bronchiectasis: A 10-Year Cohort Study in a French Regional University Hospital Center

“…Thirty [5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34] of the thirty-six reported series [4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39] are smaller than ours. Half of them were retrospective.…”

“…Six cohorts larger than ours have been described [4,35,36,37,38,39]. They were mainly prospective and were designed for epidemiological purposes or for the construction and validation of a severity score and not with the intent to phenotype.…”

Impact of Radiographic Bronchiectasis in COPD

“…Measurement of BMI and albumin is a simple method for screening malnutrition. 39 A meta-regression published recently assessed the role of biomarkers in describing the severity of malnutrition, the investigators concluded that BMI was a useful marker of malnutrition. 40 2,438 Heterogeneity.…”

Is There a Correlation between New Scoring Systems and Systemic Inflammation in Stable Bronchiectasis?

“…In a study performed on patients with last-stage respiratory disorders, including 33 patients with bronchiectasis, a clear relation was demonstrated between decreased BMI and increased mortality [ 18 ]. Similarly, a Turkish study suggested that higher BMI values could be beneficial on expected survival time in patients with bronchiectasis [ 22 ]. BMI was associated with the findings that reflect disease severity.…”

“…Patients with low BMI values were shown to more frequently experience acute exacerbations, have poor lung functions, have increased systemic inflammation, and more commonly have chronic P. aeruginosa colonization. BMI was emphasized to be one of the factors with the most significant effects on the risk of hospitalization and death [ 18 , 22 ]. A positive correlation was demonstrated between high BMI and survival [ 23 ].…”