title: Maximal exercise in obese patients with COPD: the role of fat free mass.
abstract: BACKGROUND
  Obese patients (OB) with COPD may better tolerate exercise as compared to normal weight (NW) COPD patients, even if the reason for this is not yet fully understood. We investigated the interactions between obesity, lung hyperinflation, fat-free mass (FFM) and exercise capacity in COPD.
  
  
  METHODS
  Forty-four patients (16 females; age 65 ± 8 yrs) were assessed by resting lung function and body composition and exercised on a cycle-ergometer to exhaustion.
  
  
  RESULTS
  Twenty-two OB and 22 NW patients did not differ in age, gender and airflow obstruction degree, but in FFM (p < 0.05). OB had significantly higher values in inspiratory capacity/total lung capacity ratio (IC/TLC) at rest (p < 0.01), but not at peak of exercise and showed significantly higher values in peak workload (p < 0.05) and in peak oxygen uptake (VO2), when expressed as absolute value (p < 0.05), but not when corrected by FFM. OB compared to NW experienced lower leg fatigue (p < 0.05), but similar dyspnea on exertion. In all patients, the regression equation by stepwise multiple regression analysis for peak workload and VO2, as dependent variables included both FFM and IC/TLC at rest, as independent variables (r(2) = 0.43 and 0.37, respectively).
  
  
  CONCLUSIONS
  OB with COPD, as compared to NW patients matched for age, gender and airflow obstruction, had greater FFM and less resting lung hyperinflation and showed greater maximal exercise capacity. Pulmonary and non-pulmonary factors may explain the preservation of exercise tolerance in patients with COPD associated with obesity.
authors.forename: Marina
authors.initials: M
authors.lastname: Aiello
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Teopompi
authors.forename: Panagiota
authors.initials: P
authors.lastname: Tzani
authors.forename: Sara
authors.initials: S
authors.lastname: Ramponi
authors.forename: Maria Rosaria
authors.initials: MR
authors.lastname: Gioia
authors.forename: Emilio
authors.initials: E
authors.lastname: Marangio
authors.affiliation: Dept of Clinical & Experimental Medicine, Respiratory Disease and Lung Function Unit, University of Parma, Strada dell'Università 12, Parma 43100, Italy. chetta@unipr.it.
authors.forename: Alfredo
authors.initials: A
authors.lastname: Chetta
mesh_terms: D000368:Aged; D001823:Body Composition; D015992:Body Mass Index; D001835:Body Weight; D016022:Case-Control Studies; D004417:Dyspnea / Q000503:physiopathology; D005080:Exercise Test / Q000379:methods*; D017079:Exercise Tolerance / Q000502:physiology*; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D018763:Muscle Fatigue / Q000502:physiology; D009765:Obesity / Q000150:complications / Q000175:diagnosis*; D005082:Physical Exertion / Q000502:physiology*; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000175:diagnosis*; D012016:Reference Values; D012129:Respiratory Function Tests