Obesity and COPD

Associated symptoms, health-related quality of life, and medication use

Laura M. Cecere, Alyson J. Littman, Christopher G. Slatore, Edmunds M. Udris, Chris L. Bryson, Edward J. Boyko, David J. Pierson, David H. Au

Research output: Contribution to journalArticle

50 Citations (Scopus)

Abstract

Background: There is little data about the combined effects of COPD and obesity. We compared dyspnea, health-related quality of life (HRQoL), exacerbations, and inhaled medication use among patients who are overweight and obese to those of normal weight with COPD. Methods: We performed secondary data analysis on 364 Veterans with COPD. We categorized subjects by body mass index (BMI). We assessed dyspnea using the Medical Research Council (MRC) dyspnea scale and HRQoL using the St. George's Respiratory Questionnaire. We identified treatment for an exacerbation and inhaled medication use in the past year. We used multiple logistic and linear regression models as appropriate, with adjustment for age, COPD severity, smoking status, and co-morbidities. Results: The majority of our population was male (n = 355, 98%) and either overweight (n = 115, 32%) or obese (n = 138, 38%). Obese and overweight subjects had better lung function (obese: mean FEV1 55.4% ±19.9% predicted, overweight: mean FEV1 50.0% ±20.4% predicted) than normal weight subjects (mean FEV1 44.2% ±19.4% predicted), yet obese subjects reported increased dyspnea [adjusted OR of MRC score ≥2 = 4.91 (95% CI 1.80, 13.39], poorer HRQoL, and were prescribed more inhaled medications than normal weight subjects. There was no difference in any outcome between overweight and normal weight patients. Conclusions: Despite having less severe lung disease, obese patients reported increased dyspnea and poorer HRQoL than normal weight patients. The greater number of inhaled medications prescribed for obese patients may represent overuse. Obese patients with COPD likely need alternative strategies for symptom control in addition to those currently recommended.

Original languageEnglish (US)
Pages (from-to)275-284
Number of pages10
JournalCOPD: Journal of Chronic Obstructive Pulmonary Disease
Volume8
Issue number4
DOIs
StatePublished - Aug 2011

Fingerprint

Chronic Obstructive Pulmonary Disease
Dyspnea
Obesity
Quality of Life
Weights and Measures
Biomedical Research
Linear Models
Veterans
Lung Diseases
Body Mass Index
Logistic Models
Smoking
Morbidity
Lung
Population

Keywords

  • COPD
  • Exacerbations
  • Health-related quality of life
  • Inhaled medications
  • Obesity
  • Symptoms

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine

Cite this

Obesity and COPD : Associated symptoms, health-related quality of life, and medication use. / Cecere, Laura M.; Littman, Alyson J.; Slatore, Christopher G.; Udris, Edmunds M.; Bryson, Chris L.; Boyko, Edward J.; Pierson, David J.; Au, David H.

In: COPD: Journal of Chronic Obstructive Pulmonary Disease, Vol. 8, No. 4, 08.2011, p. 275-284.

Research output: Contribution to journalArticle

Cecere, Laura M. ; Littman, Alyson J. ; Slatore, Christopher G. ; Udris, Edmunds M. ; Bryson, Chris L. ; Boyko, Edward J. ; Pierson, David J. ; Au, David H. / Obesity and COPD : Associated symptoms, health-related quality of life, and medication use. In: COPD: Journal of Chronic Obstructive Pulmonary Disease. 2011 ; Vol. 8, No. 4. pp. 275-284.
@article{9d3e91410af94cc68f14915d570f35a4,
title = "Obesity and COPD: Associated symptoms, health-related quality of life, and medication use",
abstract = "Background: There is little data about the combined effects of COPD and obesity. We compared dyspnea, health-related quality of life (HRQoL), exacerbations, and inhaled medication use among patients who are overweight and obese to those of normal weight with COPD. Methods: We performed secondary data analysis on 364 Veterans with COPD. We categorized subjects by body mass index (BMI). We assessed dyspnea using the Medical Research Council (MRC) dyspnea scale and HRQoL using the St. George's Respiratory Questionnaire. We identified treatment for an exacerbation and inhaled medication use in the past year. We used multiple logistic and linear regression models as appropriate, with adjustment for age, COPD severity, smoking status, and co-morbidities. Results: The majority of our population was male (n = 355, 98{\%}) and either overweight (n = 115, 32{\%}) or obese (n = 138, 38{\%}). Obese and overweight subjects had better lung function (obese: mean FEV1 55.4{\%} ±19.9{\%} predicted, overweight: mean FEV1 50.0{\%} ±20.4{\%} predicted) than normal weight subjects (mean FEV1 44.2{\%} ±19.4{\%} predicted), yet obese subjects reported increased dyspnea [adjusted OR of MRC score ≥2 = 4.91 (95{\%} CI 1.80, 13.39], poorer HRQoL, and were prescribed more inhaled medications than normal weight subjects. There was no difference in any outcome between overweight and normal weight patients. Conclusions: Despite having less severe lung disease, obese patients reported increased dyspnea and poorer HRQoL than normal weight patients. The greater number of inhaled medications prescribed for obese patients may represent overuse. Obese patients with COPD likely need alternative strategies for symptom control in addition to those currently recommended.",
keywords = "COPD, Exacerbations, Health-related quality of life, Inhaled medications, Obesity, Symptoms",
author = "Cecere, {Laura M.} and Littman, {Alyson J.} and Slatore, {Christopher G.} and Udris, {Edmunds M.} and Bryson, {Chris L.} and Boyko, {Edward J.} and Pierson, {David J.} and Au, {David H.}",
year = "2011",
month = "8",
doi = "10.3109/15412555.2011.586660",
language = "English (US)",
volume = "8",
pages = "275--284",
journal = "COPD: Journal of Chronic Obstructive Pulmonary Disease",
issn = "1541-2555",
publisher = "Informa Healthcare",
number = "4",

}

TY - JOUR

T1 - Obesity and COPD

T2 - Associated symptoms, health-related quality of life, and medication use

AU - Cecere, Laura M.

AU - Littman, Alyson J.

AU - Slatore, Christopher G.

AU - Udris, Edmunds M.

AU - Bryson, Chris L.

AU - Boyko, Edward J.

AU - Pierson, David J.

AU - Au, David H.

PY - 2011/8

Y1 - 2011/8

N2 - Background: There is little data about the combined effects of COPD and obesity. We compared dyspnea, health-related quality of life (HRQoL), exacerbations, and inhaled medication use among patients who are overweight and obese to those of normal weight with COPD. Methods: We performed secondary data analysis on 364 Veterans with COPD. We categorized subjects by body mass index (BMI). We assessed dyspnea using the Medical Research Council (MRC) dyspnea scale and HRQoL using the St. George's Respiratory Questionnaire. We identified treatment for an exacerbation and inhaled medication use in the past year. We used multiple logistic and linear regression models as appropriate, with adjustment for age, COPD severity, smoking status, and co-morbidities. Results: The majority of our population was male (n = 355, 98%) and either overweight (n = 115, 32%) or obese (n = 138, 38%). Obese and overweight subjects had better lung function (obese: mean FEV1 55.4% ±19.9% predicted, overweight: mean FEV1 50.0% ±20.4% predicted) than normal weight subjects (mean FEV1 44.2% ±19.4% predicted), yet obese subjects reported increased dyspnea [adjusted OR of MRC score ≥2 = 4.91 (95% CI 1.80, 13.39], poorer HRQoL, and were prescribed more inhaled medications than normal weight subjects. There was no difference in any outcome between overweight and normal weight patients. Conclusions: Despite having less severe lung disease, obese patients reported increased dyspnea and poorer HRQoL than normal weight patients. The greater number of inhaled medications prescribed for obese patients may represent overuse. Obese patients with COPD likely need alternative strategies for symptom control in addition to those currently recommended.

AB - Background: There is little data about the combined effects of COPD and obesity. We compared dyspnea, health-related quality of life (HRQoL), exacerbations, and inhaled medication use among patients who are overweight and obese to those of normal weight with COPD. Methods: We performed secondary data analysis on 364 Veterans with COPD. We categorized subjects by body mass index (BMI). We assessed dyspnea using the Medical Research Council (MRC) dyspnea scale and HRQoL using the St. George's Respiratory Questionnaire. We identified treatment for an exacerbation and inhaled medication use in the past year. We used multiple logistic and linear regression models as appropriate, with adjustment for age, COPD severity, smoking status, and co-morbidities. Results: The majority of our population was male (n = 355, 98%) and either overweight (n = 115, 32%) or obese (n = 138, 38%). Obese and overweight subjects had better lung function (obese: mean FEV1 55.4% ±19.9% predicted, overweight: mean FEV1 50.0% ±20.4% predicted) than normal weight subjects (mean FEV1 44.2% ±19.4% predicted), yet obese subjects reported increased dyspnea [adjusted OR of MRC score ≥2 = 4.91 (95% CI 1.80, 13.39], poorer HRQoL, and were prescribed more inhaled medications than normal weight subjects. There was no difference in any outcome between overweight and normal weight patients. Conclusions: Despite having less severe lung disease, obese patients reported increased dyspnea and poorer HRQoL than normal weight patients. The greater number of inhaled medications prescribed for obese patients may represent overuse. Obese patients with COPD likely need alternative strategies for symptom control in addition to those currently recommended.

KW - COPD

KW - Exacerbations

KW - Health-related quality of life

KW - Inhaled medications

KW - Obesity

KW - Symptoms

UR - http://www.scopus.com/inward/record.url?scp=80052053931&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=80052053931&partnerID=8YFLogxK

U2 - 10.3109/15412555.2011.586660

DO - 10.3109/15412555.2011.586660

M3 - Article

VL - 8

SP - 275

EP - 284

JO - COPD: Journal of Chronic Obstructive Pulmonary Disease

JF - COPD: Journal of Chronic Obstructive Pulmonary Disease

SN - 1541-2555

IS - 4

ER -