Publications

Authors:

Spelta, Francesco; FRATTA PASINI, Anna Maria; Cazzoletti, Lucia; Ferrari, Marcello

Title:

Body weight and mortality in COPD: focus on the obesity paradox

Year:

2018

Type of item:

Articolo in Rivista

Tipologia ANVUR:

Articolo su rivista

Language:

Inglese

Referee:

No

Name of journal:

EATING AND WEIGHT DISORDERS

ISSN of journal:

1590-1262

N° Volume:

23

Number or Folder:

1

Page numbers:

15-22

Keyword:

COPD; Obesity; Obesity paradox; Overweight; Pulmonary function; Visceral obesity

Short description of contents:

The positive association between overweight, obesity, and cardiovascular and all-cause mortality is well established, even though this relation is typically U shaped with an increased risk also in low-weight subjects. However, being overweight or obese has been associated with a better prognosis in subjects suffering from chronic diseases, id est the "obesity paradox". In both community-dwelling and hospitalized patients with COPD, several studies have reported a significant protective effect of obesity on all-cause mortality, indicating that also in obstructive pulmonary diseases, an obesity paradox may be present. Interestingly, the "paradox" is more evident for subjects with severe bronchial obstruction (i.e., a lower FEV1), while in mild-moderate conditions, the weight-related mortality shows a behavior similar to that observed in the general population. Several factors may confound the relation between COPD, obesity and mortality. The lower FEV1 found in obese people may be linked to a restrictive defect rather than to an obstructive one. Due to the modified chest wall mechanical properties-related to increased fat mass-obese COPD patients may present, respect to their lean counterpart, a lower lung hyperinflation which is associated with higher mortality. The traditional classification of COPD attributes to obese "blue bloaters" a low-grade emphysema in opposition to lean "pink puffers"; the fact that emphysema extent is related to mortality may bias the relationship between weight and survival. It is also to underline that the majority of the studies, consider BMI rather than body composition (a better predictor of mortality) when studying the intriguing relation between weight, COPD, and mortality. Reverse bias has also to be taken into account, hypothesizing that an unintentional weight loss may be the deleterious factor related to mortality, rather than considering obesity a protective one. Further prospective studies are needed to shed light on the complexity of this emerging issue.

Product ID:

99185

Handle IRIS:

11562/969670

Last Modified:

November 15, 2022

Bibliographic citation:

Spelta, Francesco; FRATTA PASINI, Anna Maria; Cazzoletti, Lucia; Ferrari, Marcello, Body weight and mortality in COPD: focus on the obesity paradox «EATING AND WEIGHT DISORDERS» , vol. 23 , n. 1 , 2018 , pp. 15-22

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