Department of Pulmonary Disease, 1321Rijnstate Hospital, Arnhem, The Netherlands.
Department of Pulmonary Disease, 6034Radboud University Medical Center, Nijmegen, The Netherlands.
Chron Respir Dis. 2022 Jan-Dec;19:14799731211052305. doi: 10.1177/14799731211052305.
Our aim was to study the associations between resting lung hyperinflation, weight-bearing exercise-induced dyspnea and adipose distribution in obese and normal-weight COPD patients.
We performed a comparison between 80 obese COPD patients (COPD) with 80 age- and FEV matched normal-weight COPD patients (COPD). Dyspnea was assessed by the mMRC scale and the Borg dyspnea score before and after a 6 min walk test. Further characterization included spirometry, body plethysmography and metronome paced tachypnea (MPT) to estimate dynamic hyperinflation. Body composition was assessed with bioelectrical impedance analysis. Associations between dyspnea scores and BMI and body composition groups were studied using logistic regression models.
COPD patients had attenuated increases in TLC, FRC and RV compared to COPD patients ( < 0.01). The groups had comparable 6 min walking distance and ΔFRC upon MPT ( > 0.05). Compared to COPD, COPD patients reported more often a mMRC ≥ 2 (65 vs 46%; = 0.02; OR 3.0, 95% CI 1.4-6.2, < 0.01) and had higher ΔBorg upon 6MWT: 2.0 (SEM 0.20) vs. 1.4 (SEM 0.16), = 0.01; OR for ΔBorg ≥ 2: 2.4, 95% CI 1.1-5.2, = 0.03. Additional logistic regression analyses on the associations between body composition and dyspnea indicated that increased body fat percentage, fat mass index and waist-to-hip ratio were associated with higher ORs for mMRC ≥ 2 and ΔBorg upon 6MWT ≥ 2.
Despite its beneficial effect on resting lung hyperinflation, adiposity is associated with increased weight-bearing exercise-induced dyspnea in COPD.
我们旨在研究肥胖和正常体重 COPD 患者静息肺过度充气、负重运动诱发的呼吸困难与脂肪分布之间的关系。
我们对 80 例肥胖 COPD 患者（COPD）和 80 例年龄和 FEV1 匹配的正常体重 COPD 患者（COPD）进行了比较。呼吸困难通过 mMRC 量表和 Borg 呼吸困难评分在 6 分钟步行试验前后进行评估。进一步的特征包括肺量计、体描法和节拍呼吸急促度计（MPT）来估计动态过度充气。通过生物电阻抗分析评估身体成分。使用逻辑回归模型研究呼吸困难评分与 BMI 和身体成分组之间的关系。
与 COPD 患者相比，COPD 患者的 TLC、FRC 和 RV 增加幅度较小（<0.01）。两组的 6 分钟步行距离和 MPT 时的ΔFRC 相似（>0.05）。与 COPD 患者相比，COPD 患者报告的 mMRC≥2 更为常见（65%比 46%；=0.02；OR 3.0，95%CI 1.4-6.2，<0.01），且在 6MWT 时ΔBorg 更高：2.0（SEM 0.20）比 1.4（SEM 0.16），=0.01；OR 为ΔBorg≥2：2.4，95%CI 1.1-5.2，=0.03。对呼吸困难与身体成分之间关系的进一步逻辑回归分析表明，体脂百分比、脂肪质量指数和腰围-臀围比增加与 mMRC≥2 和 6MWT 时ΔBorg≥2 的更高 OR 相关。
尽管肥胖对静息肺过度充气有有益影响，但肥胖与 COPD 患者的负重运动诱发的呼吸困难增加有关。
