Somatotypes trajectories during adulthood and their association with COPD phenotypes

Area of Science:

• Pulmonary Medicine
• Human Physiology
• Body Composition Analysis

Background:

• Chronic obstructive pulmonary disease (COPD) is characterized by airflow limitation and distinct patient phenotypes.
• Understanding the long-term body composition changes associated with COPD phenotypes is crucial for targeted interventions.

Purpose of the Study:

• To investigate somatotype (body build) trajectories from early adulthood in COPD patients.
• To determine if these somatotype trajectories correlate with distinct COPD phenotypes and clinical characteristics.

Main Methods:

• Utilized Stunkard's Pictogram for somatotype assessment in 356 COPD patients at multiple adult ages.
• Employed group-based trajectory modeling to identify distinct somatotype change patterns.
• Compared clinical and phenotypic COPD characteristics across identified trajectories.

Main Results:

• Five distinct somatotype trajectories were identified from early adulthood.
• A persistently lean somatotype trajectory was observed in 14% of patients, associated with lower FEV1, DLCO, more emphysema, and worse BODE scores, resembling the Multiple Organ Loss of Tissue (MOLT) phenotype.
• Trajectories with increasing adiposity were more common, with one showing initial gain followed by loss after age 40, predominantly in females with low BMI and DLCO.

Conclusions:

• COPD patients exhibit diverse somatotype trajectories throughout adulthood.
• The MOLT phenotype is associated with a lifelong lean somatotype.
• Lean individuals, especially smokers, who maintain a lean phenotype from early adulthood may be at higher risk for developing more severe COPD and warrant closer monitoring.