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Impact of overweight and obesity on acute exacerbations of COPD – subgroup analysis of the Taiwan Obstructive Lung Disease cohort

Authors Wei YF, Tsai YH, Wang CC, Kuo PH

Received 1 April 2017

Accepted for publication 30 May 2017

Published 12 September 2017 Volume 2017:12 Pages 2723—2729

DOI https://doi.org/10.2147/COPD.S138571

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Charles Downs

Peer reviewer comments 3

Editor who approved publication: Dr Richard Russell

Yu-Feng Wei,1,2 Ying-Huang Tsai,3 Chin-Chou Wang,4 Ping-Hung Kuo5

On behalf of the TOLD Study Group

1Department of Internal Medicine, E-Da Hospital, I-Shou University, Kaohsiung, 2Institute of Biotechnology and Chemical Engineering, I-Shou University, Kaohsiung, 3Department of Internal Medicine, Chang Gung Memorial Hospital, Chiayi, 4Division of Pulmonary and Critical Care Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, 5Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan, Republic of China

Purpose: A low body mass index (BMI) is a poor prognostic marker of acute exacerbations and mortality in patients with COPD. However, the impact of overweight and obesity on COPD-related outcomes is uncertain. The aim of this study was to examine whether a high BMI is associated with the frequent exacerbator phenotype (≥2/year) in Taiwanese patients with COPD.
Patients and methods: Data were obtained from the Taiwan Obstructive Lung Disease study, a retrospective, observational nationwide survey of COPD patients conducted at 12 hospitals in Taiwan. Multivariate logistic regression models were used to explore the association between BMI and other factors with the frequency of COPD exacerbations in these patients.
Results: Among the whole study cohort (n=1,096), 735 (67.1%) had no exacerbations and 148 (13.5%) were frequent exacerbators in the previous year. The BMI values of the patients with 0, 1, and ≥2 exacerbations were 23.6, 23.5, and 22.6 kg/m2, respectively. In all, 256 (23.4%) and 196 (17.9%) patients were overweight (27 kg/m2 > BMI ≥24 kg/m2) and obese (BMI ≥27 kg/m2), respectively. Even after adjusting for multiple factors, overweight and obesity were associated with the frequency of exacerbations (odds ratio [95% confidence interval] 0.49 [0.28–0.87, P=0.015] and 0.49 [0.26–0.94, P=0.033], respectively).
Conclusion: Our results suggest that overweight and obesity are associated with a lower frequency of COPD exacerbations in Taiwan.

Keywords: acute exacerbation, COPD, obesity, overweight

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