Obesity in COPD: Comorbidities with Practical Consequences?

Abstract

COPD and obesity often coexist and there is a complex interaction between them. Our aim was to evaluate the prevalence of obesity in a secondary care COPD population. Furthermore, the presence of comorbidities in obese (COPDOB) and non-obese COPD (COPDNO) individuals was studied. In 1654 COPD patients (aged ≥18 years) who visited a pulmonologist between January 2015 and December 2015, patient characteristics, pulmonary function tests and comorbidities were obtained from the medical records. Subjects were categorized according their BMI as underweight (<18.5 kg/m2), normal weight (18.5–24.9 kg/m2), overweight (25.0–29.9 kg/m2) or obese (BMI ≥30.0 kg/m2). The Charlson comorbidity index and COTE index were used to quantify comorbidities. The prevalence of obesity was 21.8% in our COPD population. Obesity was significantly less common in GOLD stage IV (10.1%) compared to GOLD I (20.5%), II (27.8%) and III (18.9%). COPDOB had different comorbidities compared with COPDNO. Hypertension, diabetes mellitus, atrial fibrillation and congestive heart failure were significantly more prevalent in COPDOB compared with COPDNO. Osteoporosis and lung cancer were significantly more common in COPDNO compared with COPDOB. Obesity is common in patients with COPD and is most prevalent in COPD GOLD I-II and least prevalent in COPD GOLD IV. Obese COPD patients have different comorbidities than non-obese COPD patients. Cardiovascular and metabolic comorbidities, especially hypertension and diabetes mellitus, are highly prevalent in obese COPD patients. Active screening for these conditions should be a priority for physicians treating obese COPD patients.