Dataset Information

BMI is associated with FEV₁ decline in chronic obstructive pulmonary disease: a meta-analysis of clinical trials.

ABSTRACT:

Background

There is considerable heterogeneity in the rate of lung function decline in chronic obstructive pulmonary disease (COPD), the determinants of which are largely unknown. Observational studies in COPD indicate that low body mass index (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 in data from published clinical trials in COPD.

Methods

We performed a systematic review of the literature, and identified 5 randomized controlled trials reporting the association between BMI and FEV₁ decline. Four of these were included in the meta-analyses. We analyzed BMI in 4 categories: BMI-I (2), BMI-II (18.5 or 20 to 2), BMI-III (25 to 2) and BMI-IV (?29 or???30?kg/m²). We then performed a meta-regression of all the estimates against the BMI category.

Results

The estimated rate of FEV₁ decline decreased with increasing BMI. Meta-regression of the estimates showed that BMI was significantly associated with the rate of FEV₁ decline (linear trend p =?1.21?×?10^-?5).

Conclusions

These novel findings support the obesity paradox 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.

SUBMITTER: Sun Y

PROVIDER: S-EPMC6819522 | biostudies-literature | 2019 Oct

REPOSITORIES: biostudies-literature

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Publications

BMI is associated with FEV<sub>1</sub> decline in chronic obstructive pulmonary disease: a meta-analysis of clinical trials.

Sun Yilan Y Milne Stephen S Jaw Jen Erh JE Yang Chen Xi CX Xu Feng F Li Xuan X Obeidat Ma'en M Sin Don D DD

Respiratory research 20191029 1

<h4>Background</h4>There is considerable heterogeneity in the rate of lung function decline in chronic obstructive pulmonary disease (COPD), the determinants of which are largely unknown. Observational studies in COPD indicate that low body mass index (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 FEV<sub>1</sub> decline in data from published clinical tr ...[more]

PMID: 31665000

Similar Datasets

Project description:Rate of FEV1 decline in COPD is heterogeneous and the extent to which inhaled corticosteroids (ICS) influence the rate of decline is unclear. The majority of previous reviews have investigated specific ICS and non-ICS inhalers and have consisted of randomised control trials (RCTs), which have specific inclusion and exclusion criteria and short follow up times. We aimed to investigate the association between change in FEV1 and ICS-containing medications in COPD patients over longer follow up times.MEDLINE and EMBASE were searched and literature comparing change in FEV1 in COPD patients taking ICS-containing medications with patients taking non-ICS-containing medications were identified. Titles, abstract, and full texts were screened and information extracted using the PICO checklist. Risk of bias was assessed using the Cochrane Risk of Bias tool and a descriptive synthesis of the literature was carried out due to high heterogeneity of included studies.Seventeen studies met our inclusion criteria. We found that the difference in change in FEV1 in people using ICS and non-ICS containing medications depended on the study follow-up time. Shorter follow-up studies (1 year or less) were more likely to report an increase in FEV1 from baseline in both patients on ICS and in patients on non-ICS-containing medications, with the majority of these studies showing a greater increase in FEV1 in patients on ICS-containing medications. Longer follow-up studies (greater than 1 year) were more likely to report a decline in FEV1 from baseline in patients on ICS and in patients on non-ICS containing medications but rates of FEV1 decline were similar.Further studies are needed to better understand changes in FEV1 when ICS-containing medications are prescribed and to determine whether ICS-containing medications influence rate of decline in FEV1 in the long term. Results from inclusive trials and observational patient cohorts may provide information more generalisable to a population of COPD patients.

Dataset Information

BMI is associated with FEV₁ decline in chronic obstructive pulmonary disease: a meta-analysis of clinical trials.

Background

Methods

Results

Conclusions

Publications

BMI is associated with FEV<sub>1</sub> decline in chronic obstructive pulmonary disease: a meta-analysis of clinical trials.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets

Dataset Information

BMI is associated with FEV1 decline in chronic obstructive pulmonary disease: a meta-analysis of clinical trials.

Background

Methods

Results

Conclusions

Publications

BMI is associated with FEV<sub>1</sub> decline in chronic obstructive pulmonary disease: a meta-analysis of clinical trials.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets

BMI is associated with FEV₁ decline in chronic obstructive pulmonary disease: a meta-analysis of clinical trials.