title: Excessive visceral fat accumulation in advanced chronic obstructive pulmonary disease.
abstract: BACKGROUND
  Previous studies have suggested links between chronic obstructive pulmonary disease (COPD), cardiovascular disease, and abdominal obesity. Although abdominal visceral fat is thought to be associated with cardiovascular risk factors, the degree of visceral fat accumulation in patients with COPD has not been directly studied. The aim of this study was to investigate the abdominal visceral fat accumulation and the association between visceral fat and the severity and changes in emphysema in COPD patients.
  
  
  METHODS
  We performed clinical and laboratory tests, including pulmonary function, dyspnea score, and the six-minute walking test in COPD patients (n = 101) and control, which included subjects with a smoking history but without airflow obstruction (n = 62). We used computed tomography to evaluate the abdominal visceral fat area (VFA), subcutaneous fat area (SFA), and the extent of emphysema.
  
  
  RESULTS
  The COPD group had a larger VFA than the control group. The prevalence of non-obese subjects with an increased VFA was greater in the Global Initiative for Chronic Obstructive Lung Disease Stages III and IV than in the other stages of COPD. The extent of emphysema was inversely correlated with waist circumference and SFA. However, VFA did not decrease with the severity of emphysema. VFA was positively correlated with the degree of dyspnea.
  
  
  CONCLUSIONS
  COPD patients have excessive visceral fat, which is retained in patients with more advanced stages of COPD or severe emphysema despite the absence of obesity.
authors.affiliation: Respiratory Care Clinic, Nippon Medical School, Kudan-Minami, Chiyoda-ku, Tokyo, Japan.
authors.forename: Ryuko
authors.initials: R
authors.lastname: Furutate
authors.forename: Takeo
authors.initials: T
authors.lastname: Ishii
authors.forename: Ritsuko
authors.initials: R
authors.lastname: Wakabayashi
authors.forename: Takashi
authors.initials: T
authors.lastname: Motegi
authors.forename: Kouichi
authors.initials: K
authors.lastname: Yamada
authors.forename: Akihiko
authors.initials: A
authors.lastname: Gemma
authors.forename: Kozui
authors.initials: K
authors.lastname: Kida
mesh_terms: D000368:Aged; D015992:Body Mass Index; D015897:Comorbidity; D005260:Female; D006801:Humans; D050152:Intra-Abdominal Fat / Q000000981:diagnostic imaging*; D007564:Japan / Q000453:epidemiology; D008297:Male; D008660:Metabolism; D056128:Obesity, Abdominal / Q000175:diagnosis / Q000453:epidemiology* / Q000378:metabolism / Q000503:physiopathology; D015995:Prevalence; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000453:epidemiology* / Q000378:metabolism / Q000503:physiopathology; D011656:Pulmonary Emphysema / Q000175:diagnosis / Q000503:physiopathology; D012129:Respiratory Function Tests; D012137:Respiratory System / Q000503:physiopathology; D012307:Risk Factors; D012720:Severity of Illness Index; D012907:Smoking / Q000009:adverse effects; D014057:Tomography, X-Ray Computed; D055105:Waist Circumference