Wenjia Chen1, Mohsen Sadatsafavi1,2,3, J Mark FitzGerald3,4, Larry D Lynd1,3,4,5, Don D Sin6,7. 1. Respiratory Evaluation Sciences Program, Collaboration for Outcomes Research and Evaluation, Faculty of Pharmaceutical Sciences, University of British Columbia, 2405 Wesbrook Mall, Vancouver, BC, V6T 1Z3, Canada. 2. UBC Centre for Heart Lung Innovation, St Paul's Hospital, Providence Building, Room 8446, 1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada. 3. Division of Respiratory Medicine, Faculty of Medicine, The University of British Columbia, Vancouver, Canada. 4. Centre for Lung Health, Vancouver Coastal Health Research Institute, University of British Columbia, 7th Floor, 2775 Laurel Street, Vancouver, BC, V5Z 1M9, Canada. 5. Centre for Health Evaluation and Outcome Sciences, The University of British Columbia, Vancouver, Canada. 6. UBC Centre for Heart Lung Innovation, St Paul's Hospital, Providence Building, Room 8446, 1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada. Don.Sin@hli.ubc.ca. 7. Division of Respiratory Medicine, Faculty of Medicine, The University of British Columbia, Vancouver, Canada. Don.Sin@hli.ubc.ca.
Abstract
BACKGROUND: Low body weight is associated with poor prognosis in patients with chronic obstructive pulmonary disease (COPD). However, it is not known whether gender modifies this relationship. METHODS: We pooled data of 8686 COPD patients from 7 studies with a median length of 36-months of follow up. Using a longitudinal natural cubic spline regression model, we examined the dose-response relationship between body mass index (BMI) and the rate of decline in forced expiratory volume in one second (FEV1) in patients with GOLD 1 and 2 disease, stratified by gender and adjusted for age, smoking status, and cohort effects. RESULTS: There was an inverse linear relationship between BMI and the rate of FEV1 decline in GOLD Grades 1 and 2, which was modified by gender (p < 0.001). In male patients, an increase of BMI by 1 kg/m2 reduced FEV1 decline by 1.05 mL/year (95% CI 0.96, 1.14). However, in female patients, BMI status did not have a clinically meaningful impact on FEV1 decline: an increase of baseline BMI by 1 kg/m2 reduced FEV1 decline by 0.16 ml/year (95% CI 0.11, 0.21). These gender-modified relationships were similar between GOLD 1 and 2 patients, and between current and former smokers. CONCLUSION: In mild to moderate COPD, higher BMI was associated with a less rapid decline of FEV1 in male patients whereas this association was minimal in females patients. This gender-specific BMI effect was independent of COPD severity and smoking status.
BACKGROUND: Low body weight is associated with poor prognosis in patients with chronic obstructive pulmonary disease (COPD). However, it is not known whether gender modifies this relationship. METHODS: We pooled data of 8686 COPDpatients from 7 studies with a median length of 36-months of follow up. Using a longitudinal natural cubic spline regression model, we examined the dose-response relationship between body mass index (BMI) and the rate of decline in forced expiratory volume in one second (FEV1) in patients with GOLD 1 and 2 disease, stratified by gender and adjusted for age, smoking status, and cohort effects. RESULTS: There was an inverse linear relationship between BMI and the rate of FEV1 decline in GOLD Grades 1 and 2, which was modified by gender (p < 0.001). In male patients, an increase of BMI by 1 kg/m2 reduced FEV1 decline by 1.05 mL/year (95% CI 0.96, 1.14). However, in female patients, BMI status did not have a clinically meaningful impact on FEV1 decline: an increase of baseline BMI by 1 kg/m2 reduced FEV1 decline by 0.16 ml/year (95% CI 0.11, 0.21). These gender-modified relationships were similar between GOLD 1 and 2 patients, and between current and former smokers. CONCLUSION: In mild to moderate COPD, higher BMI was associated with a less rapid decline of FEV1 in male patients whereas this association was minimal in females patients. This gender-specific BMI effect was independent of COPD severity and smoking status.
Entities:
Keywords:
Body mass index; COPD; FEV1; Lung function decline
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