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Gender modifies the effect of body mass index on lung function decline in mild-to-moderate COPD patients: a pooled analysis Chen, Wenjia; Sadatsafavi, Mohsen; FitzGerald, J. M.; Lynd, Larry D.; Sin, Don

Abstract

Background: Low body weight is associated with poor prognosis in patients with chronic obstructive pulmonary disease (COPD). However, it is not known whether gender modifies this relationship. Methods: We pooled data of 8686 COPD patients from 7 studies with a median length of 36-months of follow up. Using a longitudinal natural cubic spline regression model, we examined the dose–response relationship between body mass index (BMI) and the rate of decline in forced expiratory volume in one second (FEV₁) in patients with GOLD 1 and 2 disease, stratified by gender and adjusted for age, smoking status, and cohort effects. Results: There was an inverse linear relationship between BMI and the rate of FEV1 decline in GOLD Grades 1 and 2, which was modified by gender (p < 0.001). In male patients, an increase of BMI by 1 kg/m² reduced FEV₁ decline by 1.05 mL/year (95% CI 0.96, 1.14). However, in female patients, BMI status did not have a clinically meaningful impact on FEV1 decline: an increase of baseline BMI by 1 kg/m2 reduced FEV₁ decline by 0.16 ml/year (95% CI 0.11, 0.21). These gender-modified relationships were similar between GOLD 1 and 2 patients, and between current and former smokers. Conclusion: 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 females patients. This gender-specific BMI effect was independent of COPD severity and smoking status.

Item Metadata

Title
Gender modifies the effect of body mass index on lung function decline in mild-to-moderate COPD patients: a pooled analysis
Creator
Chen, Wenjia; Sadatsafavi, Mohsen; FitzGerald, J. M.; Lynd, Larry D.; Sin, Don
Contributor
University of British Columbia. Respiratory Evaluation Sciences Program; University of British Columbia. Collaboration for Outcomes Research and Evaluation; University of British Columbia. Centre for Heart Lung Innovation; St. Paul's Hospital (Vancouver, B.C.); Centre for Health Evaluation & Outcome Sciences
Publisher
BioMed Central
Date Issued
2021-02-18
Description
Background: Low body weight is associated with poor prognosis in patients with chronic obstructive pulmonary disease (COPD). However, it is not known whether gender modifies this relationship. Methods: We pooled data of 8686 COPD patients from 7 studies with a median length of 36-months of follow up. Using a longitudinal natural cubic spline regression model, we examined the dose–response relationship between body mass index (BMI) and the rate of decline in forced expiratory volume in one second (FEV₁) in patients with GOLD 1 and 2 disease, stratified by gender and adjusted for age, smoking status, and cohort effects. Results: There was an inverse linear relationship between BMI and the rate of FEV1 decline in GOLD Grades 1 and 2, which was modified by gender (p < 0.001). In male patients, an increase of BMI by 1 kg/m² reduced FEV₁ decline by 1.05 mL/year (95% CI 0.96, 1.14). However, in female patients, BMI status did not have a clinically meaningful impact on FEV1 decline: an increase of baseline BMI by 1 kg/m2 reduced FEV₁ decline by 0.16 ml/year (95% CI 0.11, 0.21). These gender-modified relationships were similar between GOLD 1 and 2 patients, and between current and former smokers. Conclusion: 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 females patients. This gender-specific BMI effect was independent of COPD severity and smoking status.
Subject
Body mass index; FEV1; Lung function decline; COPD
Genre
Article
Type
Text
Language
eng
Date Available
2021-02-18
Provider
Vancouver : University of British Columbia Library
Rights
Attribution 4.0 International (CC BY 4.0)
DOI
10.14288/1.0395916
URI
http://hdl.handle.net/2429/77339
Affiliation
Medicine, Faculty of; Pharmaceutical Sciences, Faculty of; Other UBC; Non UBC; Medicine, Department of
Citation
Respiratory Research. 2021 Feb 18;22(1):59
Publisher DOI
10.1186/s12931-021-01656-5
Peer Review Status
Reviewed
Scholarly Level
Faculty
Copyright Holder
The Author(s)
Rights URI
http://creativecommons.org/licenses/by/4.0/
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Attribution 4.0 International (CC BY 4.0)