S Gu1, R Li2, J K Leader1, B Zheng3, J Bon4, D Gur1, F Sciurba4, C Jin5, J Pu6. 1. Imaging Research Center, Department of Radiology, University of Pittsburgh, PA, USA. 2. Division of Biostatistics, University of Texas School of Public Health, TX, USA. 3. School of Electrical and Computer Engineering, University of Oklahoma, Norman, OK, USA. 4. Department of Medicine, University of Pittsburgh, Pittsburgh, PA, USA. 5. Department of Radiology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China. 6. Imaging Research Center, Department of Radiology, University of Pittsburgh, PA, USA; Department of Bioengineering, University of Pittsburgh, Pittsburgh, PA, USA. Electronic address: jip13@pitt.edu.
Abstract
AIM: To investigate the underlying relationship between obesity and the extent of emphysema depicted at CT. METHODS AND MATERIALS: A dataset of 477 CT examinations was retrospectively collected from a study of chronic obstructive pulmonary disease (COPD). The low attenuation areas (LAAs; ≤950 HU) of the lungs were identified. The extent of emphysema (denoted as %LAA) was defined as the percentage of LAA divided by the lung volume. The association between log-transformed %LAA and body mass index (BMI) adjusted for age, sex, the forced expiratory volume in one second as percent predicted value (FEV1% predicted), and smoking history (pack years) was assessed using multiple linear regression analysis. RESULTS: After adjusting for age, gender, smoking history, and FEV1% predicted, BMI was negatively associated with severe emphysema in patients with COPD. Specifically, one unit increase in BMI is associated with a 0.93-fold change (95% CI: 0.91-0.96, p<0.001) in %LAA; the estimated %LAA for males was 1.75 (95% CI: 1.36-2.26, p<0.001) times that of females; per 10% increase in FEV1% predicated is associated with a 0.72-fold change (95% CI: 0.69-0.76, p<0.001) in %LAA. CONCLUSION: Increasing obesity is negatively associated with severity of emphysema independent of gender, age, and smoking history.
AIM: To investigate the underlying relationship between obesity and the extent of emphysema depicted at CT. METHODS AND MATERIALS: A dataset of 477 CT examinations was retrospectively collected from a study of chronic obstructive pulmonary disease (COPD). The low attenuation areas (LAAs; ≤950 HU) of the lungs were identified. The extent of emphysema (denoted as %LAA) was defined as the percentage of LAA divided by the lung volume. The association between log-transformed %LAA and body mass index (BMI) adjusted for age, sex, the forced expiratory volume in one second as percent predicted value (FEV1% predicted), and smoking history (pack years) was assessed using multiple linear regression analysis. RESULTS: After adjusting for age, gender, smoking history, and FEV1% predicted, BMI was negatively associated with severe emphysema in patients with COPD. Specifically, one unit increase in BMI is associated with a 0.93-fold change (95% CI: 0.91-0.96, p<0.001) in %LAA; the estimated %LAA for males was 1.75 (95% CI: 1.36-2.26, p<0.001) times that of females; per 10% increase in FEV1% predicated is associated with a 0.72-fold change (95% CI: 0.69-0.76, p<0.001) in %LAA. CONCLUSION: Increasing obesity is negatively associated with severity of emphysema independent of gender, age, and smoking history.
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