"Obesity paradox" in chronic obstructive pulmonary disease
Arnon Blum1, Claudia Simsolo, Rizak Sirchan
1Department of Medicine, Padeh Poria Hospital, Lower Galilee, Israel. navablum@hotmail.com
The Israel Medical Association Journal : IMAJ
|January 28, 2012
Summary
The obesity paradox suggests thinner patients with chronic obstructive pulmonary disease (COPD) have worse outcomes. Atherosclerosis and peripheral artery disease (PAD) in COPD patients may explain this paradox, with PAD linked to poorer lung function.
Area of Science:
- Cardiovascular Medicine
- Pulmonary Medicine
- Metabolic Health
Background:
- The "obesity paradox" describes an inverse relationship between obesity and health outcomes, where individuals with higher BMI paradoxically experience better survival in certain conditions.
- In chronic obstructive pulmonary disease (COPD), thinner patients often exhibit more severe cardiovascular complications and higher mortality rates compared to their obese counterparts.
Purpose of the Study:
- To investigate the role of atherosclerosis and peripheral artery disease (PAD) in the increased morbidity and mortality observed in patients with COPD.
- To determine if PAD contributes to the poorer health outcomes in COPD patients.
Main Methods:
- A prospective study enrolled 87 COPD patients, measuring lung function (FEV1%), body mass index (BMI), and ankle-brachial index (ABI).
- The study aimed to identify associations between atherosclerosis (indicated by ABI) and BMI, as well as the severity of lung disease.
Main Results:
- Patients with PAD were older, thinner, had lower abdominal circumference, and more severe lung disease (lower FEV1%) compared to those without PAD.
- A positive correlation was observed between BMI and ABI, and between abdominal circumference and ABI.
- During follow-up, PAD patients experienced mortality from myocardial infarction, while non-PAD patients died from pulmonary causes.
Conclusions:
- COPD patients with PAD are characterized by advanced age, lower BMI, reduced abdominal circumference, and more progressive lung disease.
- The presence of extensive atherosclerosis, particularly PAD, may partially account for the "obesity paradox" observed in COPD patients.
- These findings highlight the significant impact of cardiovascular comorbidities on COPD outcomes.
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