Buklioska Ilievska, Daniela and Mickovski, Ivana and Buklioska, Adriana (2024) Cachexia in Chronic Obstructive Pulmonary Disease (COPD). In: XI International Workshop on Lung Health, 18-20 Jan 2024, Seville, Spain.
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Abstract
The prevalence and mortality of chronic obstructive pulmonary disease (COPD) in elderly patients are increasing worldwide. Low body mass index (BMI) is a well-known prognostic factor for COPD. Cachexia and
muscle wasting is well recognized as common and partly reversible features of COPD, adversely affecting disease progression and prognosis. There is considerable heterogenicity in the rate of lung function decline in COPD, the determinants of which are largely unknown. Observational studies in COPD indicate that low BMI is associated with worse outcomes, and overweight/obesity has a protective effect - the so-called "obesity paradox". We aimed to determine the relationship between BMI and the rate of FEV1 decline. The design is a cross-sectional study, including 220 patients with stable COPD as investigated group (IG), aged 40-75 years and 58 non-COPD subjects, matched by gender, age, BMI, smoking-status, as control group (CG).
All study subjects underwent pulmonary evaluation (dyspnea severity assessment, baseline and postbronchodilator spirometry, gas analyses), BMI measurement. We analyzed BMI in 4 categories: BMI-I (< 18.5 or
< 20 kg/m2), BMI-II (18.5 or 20 to < 25 kg/m2), BMI-III (25 to < 29 or < 30 kg/m2) and BMI-IV (≥29 or ≥ 30
kg/m2). The analysis indicated incorrect distribution of frequencies for BMI (kg/m²) values for Shapiro-Wilk
W=0.9746; p=0.00007, which is why appropriate non-parameter statistical tests were applied to the analyses. For p<0.05, no significant difference was established between the four IG subgroups in relation to the
height of the BMI (Kruskal-Wallis H test: p=0.0291). Additional analysis in both groups indicated an average BMI of 25.4±3.8 kg/m² with a min/max of 17.6 /35.5 kg/m² in IG vs. 26.2±2.5 kg/m² with a min/max of 19.4 /33.2 kg/m² in CG. 50% of IG participants were less than 25.3kg/m² for Median IQR=25.3 (22.9-27.4), and in
50% of CG it was Median IQR=29.2. For p<0.05, the analysis indicated a significant association between the
nutrition of subjects and the subgroup (GOLD 1→ GOLD 4) to which they belonged (Fisher Freeman Halton
test: p=0.023). With decline of FEV1, BMI also declined. Analysis between the two (IG/CG) groups indicated that, for p<0.05, there is a significant association between nutrition and the group to which the respondents belong (Pearson Chi-square test: X2=8,691; df=2; p=0.0129). CG respondents were 2,648 times more frequent obese compared to IG [OR=2.65 (1.37–5.13) 95% CI]. In this review, recent insights are presented in the
frequency of cachexia in COPD. In mild to moderate COPD, higher BMI was associated with a less rapid decline of FEV1 in male patients whereas this association was minimal in female patients. This gender-specific BMI
effect was independent of COPD severity and smoking status. These novel findings support the obesity para�dox in COPD: compared to normal BMI, low BMI is a risk factor for accelerated lung function decline, whilst high BMI has a protective effect. The relationship may be due to common but as-of-yet unknown causative factors; further investigation into which may reveal novel endotypes or targets for therapeutic intervention.
| Item Type: | Conference or Workshop Item (Poster) |
|---|---|
| Subjects: | Medical and Health Sciences > Clinical medicine |
| Divisions: | Faculty of Medical Science |
| Depositing User: | Daniela Buklioska Ilievska |
| Date Deposited: | 01 Feb 2024 08:11 |
| Last Modified: | 01 Feb 2024 08:11 |
| URI: | https://eprints.ugd.edu.mk/id/eprint/33328 |
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