P D Loprinzi1, J F Walker2. 1. Department of Health, Exercise Science and Recreation Management, Center for Health Behavior Research, The University of Mississippi, University, MS, USA. 2. Department of Respiratory Therapy, Bellarmine University, Louisville, KY, USA.
Abstract
BACKGROUND: Emerging research demonstrates an interrelationship between systemic inflammation, physical activity and premature all-cause mortality among chronic obstructive pulmonary disease (COPD) patients. Less common in this literature is the use of objective measures of physical activity and representative samples of COPD patients. OBJECTIVE: To examine the association between objectively measured physical activity and all-cause mortality among a national sample of COPD patients, with stratification by inflammatory status. METHODS: Data from the 2003 to 2006 NHANES were employed, with follow-up through 2011. Physical activity was objectively measured via accelerometry; COPD was assessed via physician-diagnosis; and inflammation was assessed via C-reactive protein (CRP) levels from a blood sample. RESULTS: Analysis included 385 adults (20+ years) with COPD. The median follow-up period was 78 months (IQR = 64-90), with 82 COPD patients dying during this period. After adjustment, physical activity was not associated with all-cause mortality among the entire sample (HR = 0.80; 95% CI: 0.61-1.05) or those with no systemic inflammation (HR = 0.89; 95% CI: 0.63-1.24). However, for every 60 min increase in physical activity per day, COPD patients with elevated CRP had a 31% reduced risk of all-cause mortality (HR = 0.69; 95% CI: 0.51-0.93). CONCLUSION: Physical activity may help to promote survival among COPD patients, particularly those with elevated inflammation.
BACKGROUND: Emerging research demonstrates an interrelationship between systemic inflammation, physical activity and premature all-cause mortality among chronic obstructive pulmonary disease (COPD) patients. Less common in this literature is the use of objective measures of physical activity and representative samples of COPDpatients. OBJECTIVE: To examine the association between objectively measured physical activity and all-cause mortality among a national sample of COPDpatients, with stratification by inflammatory status. METHODS: Data from the 2003 to 2006 NHANES were employed, with follow-up through 2011. Physical activity was objectively measured via accelerometry; COPD was assessed via physician-diagnosis; and inflammation was assessed via C-reactive protein (CRP) levels from a blood sample. RESULTS: Analysis included 385 adults (20+ years) with COPD. The median follow-up period was 78 months (IQR = 64-90), with 82 COPDpatients dying during this period. After adjustment, physical activity was not associated with all-cause mortality among the entire sample (HR = 0.80; 95% CI: 0.61-1.05) or those with no systemic inflammation (HR = 0.89; 95% CI: 0.63-1.24). However, for every 60 min increase in physical activity per day, COPDpatients with elevated CRP had a 31% reduced risk of all-cause mortality (HR = 0.69; 95% CI: 0.51-0.93). CONCLUSION: Physical activity may help to promote survival among COPDpatients, particularly those with elevated inflammation.
Authors: Bruna S de Alencar Silva; Fábio S Lira; Fabrício E Rossi; Dionei Ramos; Juliana S Uzeloto; Ana P C F Freire; Fabiano F de Lima; Luís A Gobbo; Ercy M C Ramos Journal: Front Physiol Date: 2018-03-23 Impact factor: 4.566