Obesity and chronic obstructive pulmonary disease

Abstract

Introduction. Nutritional abnormalities have one of the most important systematic effects on chronic obstructive pulmonary disease (COPD). A relationship between COPD and obesity has been observed and recognized. In COPD patients, beside changes in the total body weight, changes in body composition are also possible with the loss of fat-free mass (FFM). Objective. This study was undertaken to evaluate the impact of obesity and the change of body composition on the pulmonary function, dyspnoea level and the quality of life in COPD patients. Methods. Seventy-nine patients in the stable state of COPD were evaluated. Pulmonary function and arterial blood gas analysis were assessed. Nutritional status was analyzed according to Body Mass Index (BMI). Body composition was evaluated by using anthropometric measurement by fat free mass index (FFMI). Quality of life was assessed using the St. George Respiratory Questionnaire (SGRQ). The Visual Analogue Scale (VAS) was used to evaluate dyspnoea. Results. The highest prevalence of obesity (50.0%) was found in patients with mild COPD, while the lowest prevalence was detected in very severe COPD patients (10.0%). The loss of FFM occurred in 22.2% patients with normal body weight and in 9.0% of overweight COPD patients. The quality of life was lower in obese patients compared to other COPD patients. A higher dyspnoea level was also present in obese patients. The lowest airflow obstruction was in obese patients (p=0.023). We found a significant positive correlation between forced expiratory volume in the first second (FEV1%) and BMI (r=0.326, p=0.003), FEV1% and FFMI (r=0.321, p=0.004). Conclusion. The highest prevalence of obesity was in patients with mild COPD. Obese patients with COPD had the lowest level of airflow obstruction, higher dyspnoea level and lower quality of life in comparison to other COPD patients.