Related Experiment Video
Updated: Aug 5, 2026

Generation of a Chronic Obstructive Pulmonary Disease Model in Mice by Repeated Ozone Exposure
Published on: August 25, 2017
High BMI and COPD Outcomes in Alpha-1 Antitrypsin Deficiency
Michael A Campos1, Leonard Riley2, Jorge Lascano3
1Department of Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, University of Miami, Miami, FL.
Background:
Elevations in BMI impact morbidity in patients with COPD in general, but little is known about its impact in patients with COPD due to alpha-1 antitrypsin deficiency (AATD-COPD).
Research Question:
What is the prevalence and clinical impact of high BMI in AATD-COPD?
Study Design And Methods:
A total of 646 patients completed clinical and health-related quality of life (HRQoL) questionnaires for 2 years. Patients were grouped by baseline BMI categories (underweight, normal, overweight, obese, and morbidly obese) to compare symptoms, exacerbations, HRQoL, and 5- and 10-year survival. Relation between changes in BMI over time on HRQoL was assessed.
Results:
The cohort's mean age ± SD (55 ± 9.2 years), sex distribution (50.1% male), and mean % FEV1 ± SD (36.6% ± 17.0%) was similar across all BMI categories. One-third (31.6%) had normal BMI, 5.6% were underweight, and 62% had a high BMI (37.3% overweight, 16.1% obese, and 9.4% morbidly obese). Patients with a high BMI had significantly worse St. George's Respiratory questionnaire (SGRQ) and 36-Item Short Form Survey (SF-36) physical composite scores than patients with normal weight. Patients with morbid obesity had the highest odds of being in the worst SGRQ (OR, 3.8; 95% CI, 1.9-7.8) and SF-36 physical composite (OR, 4.2; 95% CI, 2.1-8.1) quartiles and experienced more emergency department visits and hospitalizations than patients with normal weight (P < .05). Patients who transitioned to a higher BMI category over time reported worsening of SGRQ and SF-36 physical composite scores (P < .05) and vice versa. Despite their higher morbidity, no difference in survival was observed between patients with high BMI and normal BMI after a mean follow-up of 9 years.
Interpretation:
BMI above normal is prevalent in patients with AATD-COPD and is associated with greater comorbidity and poor HRQoL but does not impact survival. HRQoL is inversely affected by BMI changes over time.
Related Concept Videos
Chronic Obstructive Pulmonary Disease II: Emphysema
Chronic Obstructive Pulmonary Disease III: Chronic Bronchitis Features
Chronic Obstructive Pulmonary Disease-II: Pathophysiology
Chronic Inflammation
COPD: Management Using Bronchodilators and Corticosteroids
Chronic Obstructive Pulmonary Disease
Smoking is a primary risk factor for COPD, with over 80% of patients having a history of it. Patients typically experience progressive dyspnea or labored breathing, frequent coughing, and recurrent pulmonary infections. Many eventually succumb to respiratory failure, characterized by...
Chronic Obstructive Pulmonary Disease-IV: Assessement and Diagnostic Studies
Medical History