Longitudinal BMI change and outcomes in Chronic Obstructive Pulmonary Disease: a nationwide population-based cohort study
Abstract Background The association between longitudinal body mass index (BMI) change and clinical outcomes in patients with chronic obstructive pulmonary disease (COPD) has not fully investigated. Methods This retrospective cohort study included 116,463 COPD patients aged ≥ 40, with at least two he...
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| Format: | Article |
| Language: | English |
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BMC
2024-03-01
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| Series: | Respiratory Research |
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| Online Access: | https://doi.org/10.1186/s12931-024-02788-0 |
| _version_ | 1797233391271149568 |
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| author | Taeyun Kim Sun Hye Shin Hyunsoo Kim Yunjoo Im Juhee Cho Danbee Kang Hye Yun Park |
| author_facet | Taeyun Kim Sun Hye Shin Hyunsoo Kim Yunjoo Im Juhee Cho Danbee Kang Hye Yun Park |
| author_sort | Taeyun Kim |
| collection | DOAJ |
| description | Abstract Background The association between longitudinal body mass index (BMI) change and clinical outcomes in patients with chronic obstructive pulmonary disease (COPD) has not fully investigated. Methods This retrospective cohort study included 116,463 COPD patients aged ≥ 40, with at least two health examinations, one within 2 years before and another within 3 years after COPD diagnosis (January 1, 2014, to December 31, 2019). Associations between BMI percentage change with all-cause mortality, primary endpoint, and initial severe exacerbation were assessed. Results BMI decreased > 5% in 14,728 (12.6%), while maintained in 80,689 (69.2%), and increased > 5% in 21,046 (18.1%) after COPD diagnosis. Compared to maintenance group, adjusted hazard ratio (aHR) for all-cause mortality was 1.70 in BMI decrease group (95% CI:1.61, 1.79) and 1.13 in BMI increase group (95% CI:1.07, 1.20). In subgroup analysis, decrease in BMI showed a stronger effect on mortality as baseline BMI was lower, while an increase in BMI was related to an increase in mortality only in obese COPD patients with aHRs of 1.18 (95% CI: 1.03, 1.36). The aHRs for the risk of severe exacerbation (BMI decrease group and increase group vs. maintenance group) were 1.30 (95% CI:1.24, 1.35) and 1.12 (95% CI:1.07, 1.16), respectively. Conclusions A decrease in BMI was associated with an increased risk of all-cause mortality in a dose-dependent manner in patients with COPD. This was most significant in underweight patients. Regular monitoring for weight loss might be an important component for COPD management. |
| first_indexed | 2024-04-24T16:15:25Z |
| format | Article |
| id | doaj.art-5c39b876417d4850af99a25c59b79b44 |
| institution | Directory Open Access Journal |
| issn | 1465-993X |
| language | English |
| last_indexed | 2024-04-24T16:15:25Z |
| publishDate | 2024-03-01 |
| publisher | BMC |
| record_format | Article |
| series | Respiratory Research |
| spelling | doaj.art-5c39b876417d4850af99a25c59b79b442024-03-31T11:29:39ZengBMCRespiratory Research1465-993X2024-03-0125111010.1186/s12931-024-02788-0Longitudinal BMI change and outcomes in Chronic Obstructive Pulmonary Disease: a nationwide population-based cohort studyTaeyun Kim0Sun Hye Shin1Hyunsoo Kim2Yunjoo Im3Juhee Cho4Danbee Kang5Hye Yun Park6Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kosin University Gospel Hospital, Kosin University College of MedicineDivision of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of MedicineCenter for Clinical Epidemiology, Samsung Medical CenterDivision of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of MedicineCenter for Clinical Epidemiology, Samsung Medical CenterCenter for Clinical Epidemiology, Samsung Medical CenterDivision of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of MedicineAbstract Background The association between longitudinal body mass index (BMI) change and clinical outcomes in patients with chronic obstructive pulmonary disease (COPD) has not fully investigated. Methods This retrospective cohort study included 116,463 COPD patients aged ≥ 40, with at least two health examinations, one within 2 years before and another within 3 years after COPD diagnosis (January 1, 2014, to December 31, 2019). Associations between BMI percentage change with all-cause mortality, primary endpoint, and initial severe exacerbation were assessed. Results BMI decreased > 5% in 14,728 (12.6%), while maintained in 80,689 (69.2%), and increased > 5% in 21,046 (18.1%) after COPD diagnosis. Compared to maintenance group, adjusted hazard ratio (aHR) for all-cause mortality was 1.70 in BMI decrease group (95% CI:1.61, 1.79) and 1.13 in BMI increase group (95% CI:1.07, 1.20). In subgroup analysis, decrease in BMI showed a stronger effect on mortality as baseline BMI was lower, while an increase in BMI was related to an increase in mortality only in obese COPD patients with aHRs of 1.18 (95% CI: 1.03, 1.36). The aHRs for the risk of severe exacerbation (BMI decrease group and increase group vs. maintenance group) were 1.30 (95% CI:1.24, 1.35) and 1.12 (95% CI:1.07, 1.16), respectively. Conclusions A decrease in BMI was associated with an increased risk of all-cause mortality in a dose-dependent manner in patients with COPD. This was most significant in underweight patients. Regular monitoring for weight loss might be an important component for COPD management.https://doi.org/10.1186/s12931-024-02788-0COPDBMIMortalityExacerbationK-NHIS |
| spellingShingle | Taeyun Kim Sun Hye Shin Hyunsoo Kim Yunjoo Im Juhee Cho Danbee Kang Hye Yun Park Longitudinal BMI change and outcomes in Chronic Obstructive Pulmonary Disease: a nationwide population-based cohort study Respiratory Research COPD BMI Mortality Exacerbation K-NHIS |
| title | Longitudinal BMI change and outcomes in Chronic Obstructive Pulmonary Disease: a nationwide population-based cohort study |
| title_full | Longitudinal BMI change and outcomes in Chronic Obstructive Pulmonary Disease: a nationwide population-based cohort study |
| title_fullStr | Longitudinal BMI change and outcomes in Chronic Obstructive Pulmonary Disease: a nationwide population-based cohort study |
| title_full_unstemmed | Longitudinal BMI change and outcomes in Chronic Obstructive Pulmonary Disease: a nationwide population-based cohort study |
| title_short | Longitudinal BMI change and outcomes in Chronic Obstructive Pulmonary Disease: a nationwide population-based cohort study |
| title_sort | longitudinal bmi change and outcomes in chronic obstructive pulmonary disease a nationwide population based cohort study |
| topic | COPD BMI Mortality Exacerbation K-NHIS |
| url | https://doi.org/10.1186/s12931-024-02788-0 |
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