Characteristics of chronic obstructive pulmonary disease patients with robust progression of emphysematous change

Hidetoshi Nakamura,Akihiro Tsutsumi,Shotaro Chubachi,Masahiro Jinzaki,Yoshitake Yamada,Koichi Fukunaga,Koichiro Asano,Hidehiro Irie,Tomoko Betsuyaku,Mamoru Sasaki,Hiroaki Sugiura

doi:10.1038/s41598-021-87724-8

Hidetoshi Nakamura, Akihiro Tsutsumi + Show 9 more

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https://doi.org/10.1038/s41598-021-87724-8

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Abstract

Emphysema is a major pathological change in chronic obstructive pulmonary disease (COPD). However, the annual changes in the progression of emphysematous have not been investigated. We aimed to determine possible baseline predicting factors of the change in emphysematous progression in a subgroup of COPD patients who demonstrated rapid progression. In this observational study, we analyzed patients with COPD who were followed up by computed tomography (CT) at least two times over a 3-year period (n = 217). We divided the annual change in the low attenuation area percentage (LAA%) into quartiles and defined a rapid progression group (n = 54) and a non-progression group (n = 163). Predictors of future changes in emphysematous progression differed from predictors of high LAA% at baseline. On multivariate logistic regression analysis, low blood eosinophilic count (odds ratio [OR], 3.22; P = 0.04) and having osteoporosis (OR, 2.13; P = 0.03) were related to rapid changes in emphysematous progression. There was no difference in baseline nutritional parameters, but nutritional parameters deteriorated in parallel with changes in emphysematous progression. Herein, we clarified the predictors of changes in emphysematous progression and concomitant deterioration of nutritional status in COPD patients.

Highlights

Emphysema is a major pathological change in chronic obstructive pulmonary disease (COPD)
We demonstrated that having osteoporosis and low blood eosinophilia were predictors of future rapid changes in emphysematous progression; cachexia and health status deteriorated with changes in emphysematous progression
The present study showed that having osteoporosis is an important predictor of baseline emphysema presence, and of future changes in emphysematous progression in COPD patients

Summary

Introduction

Emphysema is a major pathological change in chronic obstructive pulmonary disease (COPD). We aimed to determine possible baseline predicting factors of the change in emphysematous progression in a subgroup of COPD patients who demonstrated rapid progression. In this observational study, we analyzed patients with COPD who were followed up by computed tomography (CT) at least two times over a 3-year period (n = 217). Abbreviations LAA Low attenuation area ΔLAA%/year Annual changes in LAA% BMI Body mass index BMD Bone mineral density COPD Chronic obstructive pulmonary disease CI Confidence interval CT Computed tomography CAT COPD assessment test CRP C-reactive protein DXA Dual X-ray absorptiometry FFM Fat-free mass FFMI FFM index FEV1 Forced expiratory volume in 1 s %FEV1 Forced expiratory volume in 1 s as a percentage of predicted forced expiratory volume in 1 s GOLD Global Initiative for Chronic Obstructive Lung Disease ICS Inhaled corticosteroids K-CCR Keio COPD Comorbidity Research. The annual changes in emphysematous progression on chest CT have not been assessed in COPD patients

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