Park Ju-Hee, Lee Jung-Kyu, Heo Eun Young, Kim Deog Kyeom, Chung Hee Soon
Division of Pulmonary and Critical Care Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, Republic of Korea.
Int J Chron Obstruct Pulmon Dis. 2017 Feb 24;12:757-763. doi: 10.2147/COPD.S126192. eCollection 2017.
A low body mass index has been associated with high mortalities in patients with chronic obstructive pulmonary disease (COPD), and studies reveal that obesity aggravates the clinical effects of COPD. We investigated the impact of obesity on patients newly identified with COPD.
This population-based, cross-sectional study, used data from the Korea National Health and Nutrition Examination Survey (KNHANES) conducted from 2010 to 2012. Through analyses of data from this survey, we compared concurrent comorbid diseases, symptoms, and lung functions between an obese and nonobese group of patients with COPD.
In total, 618 participants were diagnosed with COPD and the average forced expired volume in 1 s (FEV) was 79.47%±0.69%. Of the total, 30.5% of the subjects were categorized into an obese group. Subjects in the obese group were likely to have metabolic syndrome (<0.001), hypertension (=0.02), and a higher number of comorbidities compared to the nonobese group (2.3±0.1 vs 2.0±0.1, =0.02). In addition, subjects in the obese group showed a lower forced vital capacity (FVC) than subjects in the nonobese group, even after adjusting for covariates (average FVC%, 89.32±1.26 vs 92.52%±0.72%, =0.037). There were no significant differences in the adjusted FEV% and adjusted FEV/FVC between the groups.
Among subjects newly identified with mild COPD, participants in the obese group had more comorbid conditions and showed a lower FVC compared with subjects in the nonobese group, even after adjustment of covariates. These findings show that a combination of obesity and COPD may be a severe phenotype; therefore, early attention should be paid to obesity for the management of COPD patients.
低体重指数与慢性阻塞性肺疾病（COPD）患者的高死亡率相关，且研究表明肥胖会加重COPD的临床影响。我们调查了肥胖对新确诊的COPD患者的影响。
这项基于人群的横断面研究使用了2010年至2012年韩国国家健康与营养检查调查（KNHANES）的数据。通过对该调查数据的分析，我们比较了肥胖和非肥胖COPD患者组之间并发的合并症、症状及肺功能。
共有618名参与者被诊断为COPD，1秒用力呼气容积（FEV）的平均值为79.47%±0.69%。其中，30.5%的受试者被归类为肥胖组。与非肥胖组相比，肥胖组受试者更易患代谢综合征（<0.001）、高血压（=0.02），且合并症数量更多（2.3±0.1对2.0±0.1，=0.02）。此外，即使在调整协变量后，肥胖组受试者的用力肺活量（FVC）仍低于非肥胖组受试者（平均FVC%，89.32±1.26对92.52%±0.72%，=0.037）。两组之间调整后的FEV%和调整后的FEV/FVC无显著差异。
在新确诊的轻度COPD受试者中，即使在调整协变量后，肥胖组参与者的合并症仍比非肥胖组更多，且FVC更低。这些发现表明肥胖与COPD并存可能是一种严重的表型；因此，在COPD患者的管理中应尽早关注肥胖问题。
