Katherine A Despotes1, Radmila Choate2,3, Doreen Addrizzo-Harris4, Timothy R Aksamit5, Alan Barker6, Ashwin Basavaraj4, Charles L Daley7, Edward Eden8, Angela DiMango9, Kevin Fennelly10, Julie Philley11, Margaret M Johnson12, Pamela J McShane13, Mark L Metersky14, Anne E O'Donnell15, Kenneth N Olivier10, Matthias A Salathe16, Andreas Schmid16, Byron Thomashow9, Gregory Tino17, Kevin L Winthrop6,18, Michael R Knowles1, Mary Leigh Anne Daniels1, Peadar G Noone1. 1. Department of Medicine, University of North Carolina at Chapel Hill. 2. Research, COPD Foundation, Washington, DC. 3. College of Public Health, University of Kentucky, Lexington. 4. School of Medicine, New York University, New York, New York. 5. Pulmonary Disease and Critical Care Medicine, Mayo Clinic, Rochester, Minnesota. 6. Department of Pulmonary and Critical Care, School of Medicine, Oregon Health and Science University, Portland. 7. Division of Mycobacterial and Respiratory Infections, National Jewish Health, Denver, Colorado. 8. Icahn School of Medicine, Mt. Sinai West and Mt. Sinai St Luke's Hospitals, Mt. Sinai, New York. 9. Center for Chest Disease, Columbia College of Physicians and Surgeons, New York, New York. 10. National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland. 11. University of Texas at Tyler. 12. Center for Chest Disease, Mayo Clinic Florida, Jacksonville. 13. Department of Medicine, University of Chicago, Chicago, Illinois. 14. Division of Pulmonary and Critical Care Medicine, School of Medicine, University of Connecticut, Farmington. 15. Georgetown University Medical Center, Washington, DC. 16. University of Kansas Medical Center, Kansas City. 17. Perelman School of Medicine, University of Pennsylvania, Philadelphia. 18. Department of Infectious Disease, School of Medicine, Oregon Health and Science University School of Medicine, Portland.
Abstract
BACKGROUND: Increasing numbers of patients are being diagnosed with bronchiectasis, yet much remains to be elucidated about this heterogeneous patient population. We sought to determine the relationship between nutrition and health outcomes in non-cystic fibrosis (non-CF) bronchiectasis, using data from the U.S. Bronchiectasis Nontuberculous Mycobacterial Research Registry (U.S. BRR). METHODS: This was a retrospective, observational, longitudinal study using 5-year follow-up data from the BRR. Bronchiectasis was confirmed on computed tomography (CT). We stratified patients into nutrition categories using body mass index (BMI), and correlated BMI to markers of disease severity. RESULTS: Overall, n = 496 patients (mean age 64.6- ± 13 years; 83.3% female) were included. At baseline 12.3% (n = 61) were underweight (BMI < 18.5kg/m2), 63.9% (n = 317) had normal weight (BMI ≥ 18.5kg/m2 and <25.0kg/m2), 17.3% (n = 86) were overweight (BMI ≥ 25.0kg/m2 and < 30.0kg/m2), and 6.5% (n= 32) were obese (BMI ≥ 30kg/m2). Men were overrepresented in the overweight and obese groups (25.6% and 43.8% respectively, p < 0.0001). Underweight patients had lower lung function (forced expiratory volume in 1 second [FEV1] % predicted) than the other weight groups (64.5 ± 22, versus 73.5 ± 21, 68.5 ± 20, and 76.5 ± 21 in normal, overweight, and obese groups respectively, p = 0.02). No significant differences were noted between BMI groups for other markers of disease severity at baseline, including exacerbation frequency or hospitalization rates. No significant differences were noted in BMI distribution between patients with and without Pseudomonas, non-tuberculous mycobacteria, or by cause of bronchiectasis. The majority of patients demonstrated stable BMI over 5 years. CONCLUSIONS: Although underweight patients with bronchiectasis have lower lung function, lower BMI does not appear to relate to other markers of disease severity in this patient population. JCOPDF
BACKGROUND: Increasing numbers of patients are being diagnosed with bronchiectasis, yet much remains to be elucidated about this heterogeneous patient population. We sought to determine the relationship between nutrition and health outcomes in non-cystic fibrosis (non-CF) bronchiectasis, using data from the U.S. Bronchiectasis Nontuberculous Mycobacterial Research Registry (U.S. BRR). METHODS: This was a retrospective, observational, longitudinal study using 5-year follow-up data from the BRR. Bronchiectasis was confirmed on computed tomography (CT). We stratified patients into nutrition categories using body mass index (BMI), and correlated BMI to markers of disease severity. RESULTS: Overall, n = 496 patients (mean age 64.6- ± 13 years; 83.3% female) were included. At baseline 12.3% (n = 61) were underweight (BMI < 18.5kg/m2), 63.9% (n = 317) had normal weight (BMI ≥ 18.5kg/m2 and <25.0kg/m2), 17.3% (n = 86) were overweight (BMI ≥ 25.0kg/m2 and < 30.0kg/m2), and 6.5% (n= 32) were obese (BMI ≥ 30kg/m2). Men were overrepresented in the overweight and obese groups (25.6% and 43.8% respectively, p < 0.0001). Underweight patients had lower lung function (forced expiratory volume in 1 second [FEV1] % predicted) than the other weight groups (64.5 ± 22, versus 73.5 ± 21, 68.5 ± 20, and 76.5 ± 21 in normal, overweight, and obese groups respectively, p = 0.02). No significant differences were noted between BMI groups for other markers of disease severity at baseline, including exacerbation frequency or hospitalization rates. No significant differences were noted in BMI distribution between patients with and without Pseudomonas, non-tuberculous mycobacteria, or by cause of bronchiectasis. The majority of patients demonstrated stable BMI over 5 years. CONCLUSIONS: Although underweight patients with bronchiectasis have lower lung function, lower BMI does not appear to relate to other markers of disease severity in this patient population. JCOPDF
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