Qi Q, Li T, Li JC, Li Y. Association of body mass index with disease severity and prognosis in patients with non-cystic fibrosis bronchiectasis.
ACTA ACUST UNITED AC 2015;
48:715-24. [PMID:
26176309 PMCID:
PMC4541691 DOI:
10.1590/1414-431x20154135]
[Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2014] [Accepted: 03/18/2015] [Indexed: 01/22/2023]
Abstract
The objective of this observational, multicenter study was to evaluate the
association of body mass index (BMI) with disease severity and prognosis in patients
with non-cystic fibrosis bronchiectasis. A total of 339 patients (197 females, 142
males) diagnosed with non-cystic fibrosis bronchiectasis by high-resolution computed
tomography were classified into four groups: underweight (BMI<18.5
kg/m2), normal weight (18.5≤BMI<25.0 kg/m2), overweight
(25.0≤BMI<30.0 kg/m2), and obese (BMI≥30.0 kg/m2). Clinical
variables expressing disease severity were recorded, and acute exacerbations,
hospitalizations, and survival rates were estimated during the follow-up period. The
mean BMI was 21.90 kg/m2. The underweight group comprised 28.61% of all
patients. BMI was negatively correlated with acute exacerbations, C-reactive protein,
erythrocyte sedimentation rate, radiographic extent of bronchiectasis, and chronic
colonization by P. aeruginosa and positively correlated with
pulmonary function indices. BMI was a significant predictor of hospitalization risk
independent of relevant covariates. The 1-, 2-, 3-, and 4-year cumulative survival
rates were 94%, 86%, 81%, and 73%, respectively. Survival rates decreased with
decreasing BMI (χ2=35.16, P<0.001). The arterial carbon dioxide partial
pressure, inspiratory capacity, age, BMI, and predicted percentage of forced
expiratory volume in 1 s independently predicted survival in the Cox proportional
hazard model. In conclusion, an underweight status was highly prevalent among
patients with non-cystic fibrosis bronchiectasis. Patients with a lower BMI were
prone to developing more acute exacerbations, worse pulmonary function, amplified
systemic inflammation, and chronic colonization by P. aeruginosa.
BMI was a major determinant of hospitalization and death risks. BMI should be
considered in the routine assessment of patients with non-cystic fibrosis
bronchiectasis.
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