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

Wei, Yufeng; Tsai, Ying‐Huang; Lin, Ming‐Shyan; Wang, Chin‐Chou; Cheng, Shih-Lung; Hsu, Wu‐Huei; Wu, Yao‐Kuang; Chen, Ning‐Hung; Lee, Chao-Hsien; Hsu, Jeng-Yuan; Tao, Chi‐Wei; Kuo, Ping-Hung

doi:10.1183/1393003.congress-2017.pa953

Cited by 9 publications

(10 citation statements)

References 21 publications

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“…Sleep apnea and metabolic syndrome are associated with obesity and we observed a higher prevalence of obesity in individuals with sleep apnea and elevated plasma glucose. Nevertheless, our results remained similar after adjustment for BMI categories and, in fact, overweight and obesity per se associated with reduced risk of severe exacerbations requiring hospital admissions, which is in line with previous findings [29], and in line with our observation that hypertension was associated with reduced risk of exacerbations [30], but future studies on the associations between BMI, hypertension, sleep apnea, and COPD exacerbations are warranted.…”

Section: Discussionsupporting

confidence: 92%

Witnessed sleep apneas together with elevated plasma glucose are predictors of COPD exacerbations

Ingebrigtsen

Marott

Lange

2020

European Clinical Respiratory Journal

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Objective Sleep apnea and elevated plasma glucose associates with inflammation which associates with the risk of COPD exacerbations. We investigated the risk of exacerbations in individuals with COPD, witnessed sleep apneas, and elevated plasma glucose. Methods From the Copenhagen City Heart Study cohort, we identified 564 individuals with COPD (forced expiratory volume in 1 sec divided by forced vital capacity, FEV 1 /FVC<0.70), no asthma, above 40 years of age, and more than 10 pack-years of smoking history, with information on witnessed apneas and levels of plasma glucose. We prospectively recorded hospital admissions with COPD exacerbations during maximum available follow-up (26.3 years; mean 10.7 years). Cox-regression analyses were used to analyze the risk of COPD exacerbations. Results We identified 74 (13%) individuals with sleep apnea without elevated plasma glucose, 70 (12%) had elevated plasma glucose (above 6.9 mM (>125 mg/dL)) without sleep apnea and 11 individuals had the presence of both conditions. In univariable analysis, witnessed apneas together with elevated plasma glucose had a high risk of exacerbations, hazard ratio (HR) = 5.81 (2.34–14.4, p = 0.0001) compared to those without sleep apnea and without elevated plasma glucose. Multivariable analysis, adjusting for several risk factors of exacerbations, showed a similar result, HR = 3.45 (1.13–10.5, p = 0.03). Both presence of sleep apnea without elevated plasma glucose and the presence of elevated plasma glucose without sleep apnea showed no associations with the risk of exacerbations. Conclusions Witnessed sleep apneas in COPD are associated with increased risk of exacerbations, but only among those with elevated plasma glucose.

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Section: Discussionsupporting

confidence: 92%

Witnessed sleep apneas together with elevated plasma glucose are predictors of COPD exacerbations

Ingebrigtsen

Marott

Lange

2020

European Clinical Respiratory Journal

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“…In addition, while increased body mass index, as expected, associated with increased risk of both coronary heart disease and heart failure, previous research has shown that an increased body mass index is, in fact, associated with a lower risk of exacerbations in COPD 41. This seems like a paradox as several studies have shown a strong association between increased risk of exacerbations in COPD and increased risk of cardiovascular events 42.…”

Section: Discussionmentioning

confidence: 87%

Coronary heart disease and heart failure in asthma, COPD and asthma-COPD overlap

Ingebrigtsen¹,

Marott

Vestbo

et al. 2020

BMJ Open Resp Res

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IntroductionWe investigated risk of coronary heart disease and heart failure in phenotypes of obstructive airway disease.MethodsAmong 91 692 participants in the Copenhagen General Population Study, 42 058 individuals were classified with no respiratory disease, and 11 988 individuals had different phenotypes of obstructive airways disease: asthma with early onset or late-onset, chronic obstructive pulmonary disease (COPD) with forced expiratory volume in one second (FEV1) above or below 50% of predicted value (%p) or asthma-COPD overlap (ACO).ResultsDuring a mean follow-up of 5.7 years we registered 3584 admissions for coronary heart disease and 1590 admissions for heart failure. Multivariable Cox regression analyses of time to first admission were used with a two-sided p value of 0.05 as significance level. Compared with no respiratory disease the highest risks of coronary heart disease and heart failure were observed in ACO with late-onset asthma and FEV1 <50% p, HR=2.2 (95% CI 1.6 to 3.0), and HR=2.9 (95% CI 2.0 to 4.3), respectively. In COPD with FEV1 above 50% p the HRs were 1.3 (95% CI 1.2 to 1.5) for coronary heart disease and 1.9 (95% CI 1.6 to 2.3) for heart failure. Asthma associated with increased risks of coronary heart disease and heart failure, however, in asthma without allergy the HR was 1.1 (95% CI 0.7 to 1.6) for coronary heart disease while individuals with allergy had an HR of 1.4 (95% CI 1.1 to 1.6).ConclusionsRisks of coronary heart disease and heart failure were increased in asthma, COPD and ACO. In asthma, the risk of coronary heart disease depended on presence of allergy. We suggest that cardiovascular risk factors should be assessed systematically in individuals with obstructive airway disease with the potential to facilitate targeted treatments.

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“…For example, in COPD data from the COPDGene study suggests that obesity is linked to worse dyspnoea, increased risk of acute exacerbations and poorer quality of life [26]. On the contrary, other studies suggest that obese patients in fact have lower acute exacerbation frequency [27]. The study by Landbo et al investigated the relationship between weight status, disease severity and survival, in mild to moderate COPD a normal body weight or being overweight was favourable for improved prognosis.…”

Section: Discussionmentioning

confidence: 99%

Nutritional status and quality of life in interstitial lung disease: a prospective cohort study

et al. 2021

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Background Malnutrition and altered body composition are well-documented in chronic pulmonary diseases; however, investigation of nutritional status in interstitial lung disease (ILD) is limited. This study aimed to describe the nutritional status of ILD patients within three diagnostic groups and explore the relationship between nutritional status and quality of life (QoL). Methods Consecutive patients attending an ILD clinic within a tertiary referral hospital in Sydney, Australia were studied. Weight, body-mass-index, anthropometrics, handgrip strength (HGS), subjective global assessment and QoL questionnaires (EQ-5D-5L and King’s-Brief Interstitial-Lung-Disease ‘K-BILD’) were collected. Associations between nutritional status and QoL were analysed. Results Ninety participants were recruited and categorised: (1) Idiopathic Pulmonary Fibrosis (IPF) (2) Connective-Tissue Disease associated-ILD (CTD-ILD) or (3) Other (non-IPF/non-CTD ILD). Median age was 66.5 (18) years. Four-percent of patients were underweight and 50% were overweight or obese. Median HGS was 71%-(25.3) of predicted and was correlated to all measures of QoL including EQ-5D health-state index (r = 0.376, p < 0.0001), patient-reported EQ-5D-5L Visual Analogue Score (r = 0.367, p < 0.0001) and K-BILD total score (r = 0.346, p = 0.001). Twenty-three percent of the variance in K-BILD total score (F = 12.888, p < 0.0001) was explained by HGS (ß = 0.273, p = 0.006) and forced vital capacity % predicted (ß = 0.331, p = 0.001). Conclusions Although a small number of ILD patients were malnourished, a large proportion of the cohort were overweight or obese. Handgrip strength was compromised and correlated to QoL. Future research with a larger cohort is required to explore the role of HGS as a predictor of QoL.

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

Cited by 9 publications

References 21 publications

Witnessed sleep apneas together with elevated plasma glucose are predictors of COPD exacerbations

Witnessed sleep apneas together with elevated plasma glucose are predictors of COPD exacerbations

Coronary heart disease and heart failure in asthma, COPD and asthma-COPD overlap

Nutritional status and quality of life in interstitial lung disease: a prospective cohort study

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