title: Association of body mass index with disease severity and prognosis in patients with non-cystic fibrosis bronchiectasis.
abstract: The objective of this observational, multicenter study was to evaluate the association of body mass index (BMI) with disease severity and prognosis in patients with non-cystic fibrosis bronchiectasis. A total of 339 patients (197 females, 142 males) diagnosed with non-cystic fibrosis bronchiectasis by high-resolution computed tomography were classified into four groups: underweight (BMI<18.5 kg/m2), normal weight (18.5≤BMI<25.0 kg/m2), overweight (25.0≤BMI<30.0 kg/m2), and obese (BMI≥30.0 kg/m2). Clinical variables expressing disease severity were recorded, and acute exacerbations, hospitalizations, and survival rates were estimated during the follow-up period. The mean BMI was 21.90 kg/m2. The underweight group comprised 28.61% of all patients. BMI was negatively correlated with acute exacerbations, C-reactive protein, erythrocyte sedimentation rate, radiographic extent of bronchiectasis, and chronic colonization by P. aeruginosa and positively correlated with pulmonary function indices. BMI was a significant predictor of hospitalization risk independent of relevant covariates. The 1-, 2-, 3-, and 4-year cumulative survival rates were 94%, 86%, 81%, and 73%, respectively. Survival rates decreased with decreasing BMI (χ2=35.16, P<0.001). The arterial carbon dioxide partial pressure, inspiratory capacity, age, BMI, and predicted percentage of forced expiratory volume in 1 s independently predicted survival in the Cox proportional hazard model. In conclusion, an underweight status was highly prevalent among patients with non-cystic fibrosis bronchiectasis. Patients with a lower BMI were prone to developing more acute exacerbations, worse pulmonary function, amplified systemic inflammation, and chronic colonization by P. aeruginosa. BMI was a major determinant of hospitalization and death risks. BMI should be considered in the routine assessment of patients with non-cystic fibrosis bronchiectasis.
authors.affiliation: Department of Respirology, Qilu Hospital, Shandong University, Shandong Province, Jinan, China.
authors.forename: Q
authors.initials: Q
authors.lastname: Qi
authors.affiliation: Department of Respirology, Qilu Hospital, Shandong University, Shandong Province, Jinan, China.
authors.forename: T
authors.initials: T
authors.lastname: Li
authors.affiliation: Neurosurgical Intensive Care Unit, First Affiliated Hospital,, Sun Yat-sen University, Guangdong Province, Guangzhou, China.
authors.forename: J C
authors.initials: JC
authors.lastname: Li
authors.affiliation: Department of Respirology, Qilu Hospital, Shandong University, Shandong Province, Jinan, China.
authors.forename: Y
authors.initials: Y
authors.lastname: Li
mesh_terms: D015992:Body Mass Index; D001987:Bronchiectasis / Q000401:mortality / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012720:Severity of Illness Index; D015996:Survival Rate; D014057:Tomography, X-Ray Computed