Zewari S, Hadi L, van den Elshout F, Dekhuijzen R, Heijdra Y, Vos P
a Department of Pulmonary Disease , Rijnstate hospital , Arnhem , Netherlands.
b Department of Pulmonary Disease , Radboud University Nijmegen Medical Centre , Nijmegen , Netherlands.
COPD. 2018 Oct;15(5):464-471. doi: 10.1080/15412555.2018.1509951. Epub 2018 Dec 4.
COPD and obesity often coexist and there is a complex interaction between them. Our aim was to evaluate the prevalence of obesity in a secondary care COPD population. Furthermore, the presence of comorbidities in obese (COPD) and non-obese COPD (COPD) individuals was studied. In 1654 COPD patients (aged ≥18 years) who visited a pulmonologist between January 2015 and December 2015, patient characteristics, pulmonary function tests and comorbidities were obtained from the medical records. Subjects were categorized according their BMI as underweight (<18.5 kg/m), normal weight (18.5-24.9 kg/m), overweight (25.0-29.9 kg/m) or obese (BMI ≥30.0 kg/m). The Charlson comorbidity index and COTE index were used to quantify comorbidities. The prevalence of obesity was 21.8% in our COPD population. Obesity was significantly less common in GOLD stage IV (10.1%) compared to GOLD I (20.5%), II (27.8%) and III (18.9%). COPD had different comorbidities compared with COPD. Hypertension, diabetes mellitus, atrial fibrillation and congestive heart failure were significantly more prevalent in COPD compared with COPD. Osteoporosis and lung cancer were significantly more common in COPD compared with COPD. Obesity is common in patients with COPD and is most prevalent in COPD GOLD I-II and least prevalent in COPD GOLD IV. Obese COPD patients have different comorbidities than non-obese COPD patients. Cardiovascular and metabolic comorbidities, especially hypertension and diabetes mellitus, are highly prevalent in obese COPD patients. Active screening for these conditions should be a priority for physicians treating obese COPD patients.
慢性阻塞性肺疾病（COPD）与肥胖常常并存，且二者之间存在复杂的相互作用。我们的目的是评估二级医疗COPD人群中肥胖的患病率。此外，还研究了肥胖的慢性阻塞性肺疾病（COPD）患者和非肥胖的慢性阻塞性肺疾病（COPD）患者合并症的情况。在2015年1月至2015年12月期间就诊于肺科医生的1654例慢性阻塞性肺疾病患者（年龄≥18岁）中，从病历中获取患者特征、肺功能测试结果及合并症信息。根据体重指数（BMI）将受试者分为体重过轻（<18.5kg/m²）、正常体重（18.5 - 24.9kg/m²）、超重（25.0 - 29.9kg/m²）或肥胖（BMI≥30.0kg/m²）。采用查尔森合并症指数和COTE指数对合并症进行量化。在我们的慢性阻塞性肺疾病人群中，肥胖患病率为21.8%。与全球慢性阻塞性肺疾病倡议（GOLD）I期（20.5%）、II期（27.8%）和III期（18.9%）相比，GOLD IV期肥胖的情况明显较少见。与非肥胖的慢性阻塞性肺疾病患者相比，肥胖的慢性阻塞性肺疾病患者合并症不同。与非肥胖的慢性阻塞性肺疾病患者相比，高血压、糖尿病、心房颤动和充血性心力衰竭在肥胖的慢性阻塞性肺疾病患者中明显更为常见。与非肥胖的慢性阻塞性肺疾病患者相比，骨质疏松症和肺癌在肥胖的慢性阻塞性肺疾病患者中明显更为常见。肥胖在慢性阻塞性肺疾病患者中很常见，在GOLD I-II期的慢性阻塞性肺疾病患者中最为普遍，在GOLD IV期的慢性阻塞性肺疾病患者中最不常见。肥胖的慢性阻塞性肺疾病患者与非肥胖的慢性阻塞性肺疾病患者合并症不同。心血管和代谢合并症，尤其是高血压和糖尿病，在肥胖的慢性阻塞性肺疾病患者中非常普遍。对于治疗肥胖的慢性阻塞性肺疾病患者的医生来说，积极筛查这些疾病应是首要任务。
