https://orcid.org/0000-0002-2124-6793
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Abstract
Purpose
Low body mass index (BMI) has been reported to be associated with poor prognosis in patients with chronic obstructive pulmonary disease (COPD). In contrast, a detailed analysis of the association between body weight change over time and prognosis is not sufficient, particularly in Japanese patients with COPD who have been reported to be much thinner compared to Westerners. This study aimed to investigate the relationship between annual body weight change and long-term prognosis in Japanese patients with COPD in two independent cohorts.
Patients and Methods
We analyzed 279 patients with COPD who participated in the Hokkaido COPD cohort study as a discovery cohort. We divided participants into three groups according to quartiles of annual body weight change calculated by the data from the first 5 years: weight loss group (<-0.17 kg/year), no change group (−0.17 to ≤0.20 kg/year), and weight gain group (>0.20 kg/year). The association between annual body weight change and prognosis was replicated in the Kyoto University cohort (n = 247).
Results
In the Hokkaido COPD cohort study, the weight loss group had significantly worse mortality than the other groups, whereas there was no difference in BMI at baseline. In the multivariate analysis, annual body weight change was an independent risk factor for all-cause mortality, which was confirmed in the Kyoto University cohort.
Conclusion
Annual body weight loss is associated with poor prognosis in Japanese patients with COPD, independent of baseline BMI. Longitudinal assessment of body weight is important for the management of COPD.
Abbreviations
COPD, chronic obstructive pulmonary disease; BMI, body mass index; GOLD, Global Initiative for Chronic Obstructive Lung Disease; CT, computed tomography; LAV, low attenuation volume; FEV1, forced expiratory volume in 1 second; FVC, forced vital capacity; DLCO, carbon monoxide diffusion capacity; FFM, fat-free mass.
Data Sharing Statement
The data sets analyzed during the current study are available from the corresponding author upon reasonable request.
Ethics Approval and Informed Consent
This study was conducted in accordance with the Declaration of Helsinki and approved by the ethics committee of Hokkaido University School of Medicine (med02-001) and the ethics committee of Kyoto University (E182 and R0311-2). All participants provided written informed consent.
Author Contributions
All authors made substantial contributions to conception and design, acquisition of data, or analysis and interpretation of data; took part in drafting the article or revising it critically for important intellectual content; agreed to submit to the current journal; gave final approval of the version to be published; and agree to be accountable for all aspects of the work.
Disclosure
MS, KS, HM, SK, and MN have received grants from Boehringer-Ingelheim and Pfizer during the conduct of the study. MS has received grants from Boehringer-Ingelheim, Novartis, GlaxoSmithKline, and AstraZeneca outside the submitted work. MN has received personal fees from Nippon Boehringer-Ingelheim, Pfizer, Novartis, and AstraZeneca outside the submitted work. NT, SS, and TH report a grant from Fujifilm Medical outside the current work. YA, HS, YS, and HK declare that they have no conflicts of interest in this work.