Body Mass Index and Mortality in Chronic Obstructive Pulmonary Disease: A Meta-Analysis

Abstract

BackgroundThe association between body mass index (BMI) and mortality in patients suffering from chronic obstructive pulmonary disease (COPD) has been a subject of interest for decades. However, the evidence is inadequate to draw robust conclusions because some studies were generally small or with a short follow-up.MethodsWe carried out a search in MEDLINE, Cochrane Central Register of Controlled Trials, and EMBASE database for relevant studies. Relative risks (RRs) with 95% confidence interval (CI) were calculated to assess the association between BMI and mortality in patients with COPD. In addition, a baseline risk-adjusted analysis was performed to investigate the strength of this association.Results22 studies comprising 21,150 participants were included in this analysis. Compared with patients having a normal BMI, underweight individuals were associated with higher mortality (RR = 1.34, 95% CI = 1.01–1.78), whereas overweight (RR = 0.47, 95% CI = 0.33–0.68) and obese (RR = 0.59, 95% CI = 0.38–0.91) patients were associated with lower mortality. We further performed a baseline risk-adjusted analysis and obtained statistically similar results.ConclusionOur study showed that for patients with COPD being overweight or obese had a protective effect against mortality. However, the relationship between BMI and mortality in different classes of obesity needed further clarification in well-designed clinical studies.

Spirometry and Health Status Worsen with Weight Gain in Obese Smokers but Improve in Normal-Weight Smokers

“…bias from linear modeling and inadequate stratified analyses separating overweight and obese categories or different classes of obesity (9)(10)(11)44). If BMI associations with respiratory outcomes are U-shaped, bias from linear modeling would be particularly manifest in analyses of study populations with limited numbers of obese subjects.…”

The impact of overweight and obesity on acute exacerbations of COPD - subgroup analysis of the Taiwan obstructive lung disease cohort

“…3 A low body mass index (BMI) and cachexia have been associated with negative outcomes in these patients, independent of the degree of airflow limitation. [4][5][6][7] Lin et al 8 reported that a cross-sectional study in Taiwan indicated that lower BMI is associated with osteoporosis in patients with COPD. However, the impact of overweight and obesity on outcomes in patients with COPD remains controversial.…”

“…However, the impact of overweight and obesity on outcomes in patients with COPD remains controversial. Some studies have reported that overweight or obesity had a protective effect against mortality in patients with COPD, 6,7,9 while others have reported a worse HRQL, increased severity of dyspnea and frequency of severe exacerbations in obese patients with COPD. [10][11][12] To the best of our knowledge, few studies have explored the relationship between overweight or obesity and the frequency of COPD exacerbations.…”

Independência Funcional E Tolerância Ao Exercício Físico Em Portadores De Dpoc

“…Há evidências de que o baixo IMC está relacionado à baixa sobrevida nesta população e está associado principalmente à fraqueza muscular diafragmática, diminuição da função pulmonar e inflamação sistêmica. No entanto, apesar de pouco elucidado, o excesso de peso ou obesidade tem sido demonstrado como fator de proteção contra a mortalidade nessa população (CAO et al, 2012).…”