title: Impact of obesity on the clinical profile of a population-based sample with chronic obstructive pulmonary disease.
abstract: OBJECTIVE
  To characterize the distribution of BMI in a population-based sample of COPD patients and to evaluate the impact of obesity on their health status, exercise tolerance, systemic inflammation and comorbidity.
  
  
  METHODS
  A population-based sample of 3,797 subjects aged 40-80 years from the EPI-SCAN study was selected. Subjects were categorized according their body mass index (BMI) as underweight (<18.5 kg/m2), normal weight (18.5-24.9 kg/m2), overweight (25.0-29.9 kg/m2) or obese (BMI≥30.0 kg/m2). Subjects were evaluated with post-bronchodilator spirometry and 6-minute walk tests. Smoking habits, respiratory symptoms, generic and specific quality of life, daily physical activities, comorbidities and systemic inflammatory biomarkers were recorded.
  
  
  RESULTS
  The prevalence of obesity or being overweight was higher in the 382 COPD patients than in the subjects without airflow limitation (29.4%, 95%CI 24.8-33.9% vs. 24.3, 95%CI 22.9-25.8; and 44.7%, 95%CI 39.7-49.6% vs. 43.0%, 95%CI 41.3-44.6, respectively; p = 0.020). In the COPD subgroup, obese subjects presented more dyspnea and less chronic cough, chronic bronchitis or chronic phlegm than normal-weight patients, as well as a worse health status. Moreover, reduced exercise tolerance and higher plasmatic C-reactive protein levels were found in the obese patients, who also presented a greater prevalence of cardiovascular disease (adjusted odds ratio 4.796, 95%CI 1.806-12.736, p = 0.002).
  
  
  CONCLUSIONS
  In a population-based sample, obesity is more prevalent in COPD patients than in subjects without airflow limitation. Furthermore, obesity affects the clinical manifestations, quality of life and exercise tolerance of COPD patients, and it may contribute to a phenotype characterized by increased systemic inflammation and greater frequency of cardiovascular comorbidity.
authors.affiliation: Servicio de Neumología, Hospital Universitario La Paz, IdiPAZ, Madrid, Spain, and CIBER de Enfermedades Respiratorias, Madrid, Spain.
authors.forename: Francisco
authors.initials: F
authors.lastname: García-Rio
authors.affiliation: Fundación Caubet-CIMERA Illes Balears, Bunyola, Illes Balears, Spain, and CIBER de Enfermedades Respiratorias, Illes Balears, Spain.
authors.forename: Joan B
authors.initials: JB
authors.lastname: Soriano
authors.affiliation: Pneumology Department, Hospital Universitario Vall d'Hebron, Barcelona, Spain.
authors.forename: Marc
authors.initials: M
authors.lastname: Miravitlles
authors.affiliation: Pneumology Department, Hospital Reina Sofía, Córdoba, Spain.
authors.forename: Luis
authors.initials: L
authors.lastname: Muñoz
authors.affiliation: Centro de Investigación en Epidemiología Ambiental - CREAL, Barcelona, Spain.
authors.forename: Enric
authors.initials: E
authors.lastname: Duran-Tauleria
authors.affiliation: Medical Department, GlaxoSmithkline S.A., Madrid, Spain.
authors.forename: Guadalupe
authors.initials: G
authors.lastname: Sánchez
authors.affiliation: Pneumology Department, Hospital de Cruces, Bilbao, Spain.
authors.forename: Victor
authors.initials: V
authors.lastname: Sobradillo
authors.affiliation: Servicio de Neumología, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria Princesa, Madrid, Spain.
authors.forename: Julio
authors.initials: J
authors.lastname: Ancochea
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000378:metabolism; D015992:Body Mass Index; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications* / Q000453:epidemiology / Q000503:physiopathology; D016017:Odds Ratio; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000503:physiopathology*; D011788:Quality of Life; D012307:Risk Factors
chemical_list: D015415:Biomarkers