Diego A Rodríguez1, Judith Garcia-Aymerich2, Jose L Valera3, Jaume Sauleda3, Bernat Togores3, Juan B Galdiz4, Joaquim Gea5, Mauricio Orozco-Levi6, Antoni Ferrer5, Federico P Gomez7, Joan Albert Barberà7, Ignasi Serra8, Josep M Antó9, Josep Roca7. 1. Servei de Pneumologia (ICT), Hospital Clinic, IDIBAPS, Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Universitat de Barcelona, Villaroel 170, 08036 Barcelona, Catalonia, Spain; Muscle and Respiratory System Research Unit and Respiratory Medicine Department, IMIM-Hospital del Mar, Barcelona, Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Health and Experimental Sciences Department (CEXS), Universitat Pompeu Fabra (UPF), Passeig Maritim 25, 08003 Barcelona, Catalonia, Spain. Electronic address: darodriguez@parcdesalutmar.cat. 2. Centre for Research in Environmental Epidemiology (CREAL), Department of Experimental and Health Sciences, Universitat Pompeu Fabra, CIBER EpidemiologÍa y Salud Pública (CIBERESP), Doctor Aiguader 88, 08003 Barcelona, Catalonia, Spain. 3. Hospital Son Espases, Carretera de Valldemossa 79, 07120 Palma de Mallorca, Spain. 4. Hospital Cruces, Universidad del País Vasco, Plaza de Cruces 12, 48903 San Vicente de Barakaldo, Vizcaya, Spain. 5. Muscle and Respiratory System Research Unit and Respiratory Medicine Department, IMIM-Hospital del Mar, Barcelona, Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Health and Experimental Sciences Department (CEXS), Universitat Pompeu Fabra (UPF), Passeig Maritim 25, 08003 Barcelona, Catalonia, Spain. 6. Muscle and Respiratory System Research Unit and Respiratory Medicine Department, IMIM-Hospital del Mar, Barcelona, Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Health and Experimental Sciences Department (CEXS), Universitat Pompeu Fabra (UPF), Passeig Maritim 25, 08003 Barcelona, Catalonia, Spain; Respiratory Department, Fundación Cardiovascular de Colombia, Calle 155A No. 23-58, Urbanización El Bosque Floridablanca, Santander Floridablanca, Santander, Colombia. 7. Servei de Pneumologia (ICT), Hospital Clinic, IDIBAPS, Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Universitat de Barcelona, Villaroel 170, 08036 Barcelona, Catalonia, Spain. 8. Centre for Research in Environmental Epidemiology (CREAL), CIBER EpidemiologÍa y Salud Pública (CIBERESP), Doctor Aiguader 88, 08003 Barcelona, Catalonia, Spain. 9. Centre for Research in Environmental Epidemiology (CREAL), Municipal Institute of Medical Research (IMIM-Hospital del Mar), Department of Experimental and Health Sciences, Universitat Pompeu Fabra, CIBER EpidemiologÍa y Salud Pública (CIBERESP), Doctor Aiguader 88, 08003 Barcelona, Catalonia, Spain.
Abstract
BACKGROUND: The effects of obesity in combination with chronic obstructive pulmonary disease (COPD) on exercise capacity are receiving increased attention. But, a comprehensive analysis of factors associated with aerobic capacity in obese COPD patients has not been performed. METHODS: Six-min walking test (6MWT) was performed in 251 COPD patients, and 159 of those also carried out an incremental cardiopulmonary exercise test (CPET) to evaluate exercise capacity. In all patients, anthropometrics, dyspnea and anxiety-depression scores, lung function, daily physical activity, co-morbidities and circulating inflammatory biomarkers were also assessed. Six-min walking distance (6MWD) and peak oxygen uptake (VO2 peak) during CPET were two primary outcome variables. RESULTS: 57% of the patients showed body mass index (BMI) < 30 kg/m2 (COPDN) and the remaining 43% were obese with a BMI ≥ 30 kg/m2 (COPDO). In patients with COPDN, 6MWD showed independent negative associations with age, dyspnea score, sedentarism, depression scores and a positive relationship with arterial oxygenation; whereas in COPDO, 6MWD showed an inverse relationship with BMI. In COPDN, VO2 peak showed a negative association with age and positive relationships with both FEV1 and DLCO. However, in COPDO the dyspnea score was the strongest determinant of VO2 peak. CONCLUSIONS: Obese and non-obese COPD patients show different determinants of aerobic capacity, including pulmonary and non-pulmonary factors that are also dependent on the type of exercise protocol. These results could be considered in the evaluation of obese patients with COPD.
BACKGROUND: The effects of obesity in combination with chronic obstructive pulmonary disease (COPD) on exercise capacity are receiving increased attention. But, a comprehensive analysis of factors associated with aerobic capacity in obese COPDpatients has not been performed. METHODS: Six-min walking test (6MWT) was performed in 251 COPDpatients, and 159 of those also carried out an incremental cardiopulmonary exercise test (CPET) to evaluate exercise capacity. In all patients, anthropometrics, dyspnea and anxiety-depression scores, lung function, daily physical activity, co-morbidities and circulating inflammatory biomarkers were also assessed. Six-min walking distance (6MWD) and peak oxygen uptake (VO2 peak) during CPET were two primary outcome variables. RESULTS: 57% of the patients showed body mass index (BMI) < 30 kg/m2 (COPDN) and the remaining 43% were obese with a BMI ≥ 30 kg/m2 (COPDO). In patients with COPDN, 6MWD showed independent negative associations with age, dyspnea score, sedentarism, depression scores and a positive relationship with arterial oxygenation; whereas in COPDO, 6MWD showed an inverse relationship with BMI. In COPDN, VO2 peak showed a negative association with age and positive relationships with both FEV1 and DLCO. However, in COPDO the dyspnea score was the strongest determinant of VO2 peak. CONCLUSIONS:Obese and non-obese COPDpatients show different determinants of aerobic capacity, including pulmonary and non-pulmonary factors that are also dependent on the type of exercise protocol. These results could be considered in the evaluation of obesepatients with COPD.
Authors: Allison A Lambert; Nirupama Putcha; M Bradley Drummond; Aladin M Boriek; Nicola A Hanania; Victor Kim; Gregory L Kinney; Merry-Lynn N McDonald; Emily P Brigham; Robert A Wise; Meredith C McCormack; Nadia N Hansel Journal: Chest Date: 2016-08-25 Impact factor: 9.410
Authors: Mingshu Shi; Øyvind Ellingsen; Tone Frost Bathen; Morten A Høydal; Lauren G Koch; Steven L Britton; Ulrik Wisløff; Tomas O Stølen; Morteza Esmaeili Journal: PLoS One Date: 2018-12-11 Impact factor: 3.240
Authors: Peter Hanlon; Barbara I Nicholl; Bhautesh Dinesh Jani; Ross McQueenie; Duncan Lee; Katie I Gallacher; Frances S Mair Journal: BMJ Open Date: 2018-01-14 Impact factor: 2.692
Authors: Jeong Uk Lim; Jae Ha Lee; Ju Sang Kim; Yong Il Hwang; Tae-Hyung Kim; Seong Yong Lim; Kwang Ha Yoo; Ki-Suck Jung; Young Kyoon Kim; Chin Kook Rhee Journal: Int J Chron Obstruct Pulmon Dis Date: 2017-08-21