Values of Body Mass Index and Chest CT Features in the Assessment of Chronic Obstructive Pulmonary Disease / 中国医学科学院学报

ABSTRACT

To investigate the clinical values of nutritional status and chest CT phenotypes in the assessment of chronic obstructive pulmonary disease(COPD). A total of 256 patients with stable COPD were enrolled from Peking Union Medical College Hospital and Civil Aviation General Hospital from June 2017 to June 2018.Demographic data,height,weight,smoking history,and number of exacerbations were collected.Pulmonary function tests and COPD assessment test(CAT)questionnaire-based survey were performed.The correlations of Goddard score with pulmonary function,CAT score,and number of exacerbations were analyzed.The clinical features of COPD patients with different body mass index(BMI)grades and CT phenotype were analyzed. The forced expiratory volume in one second as percentage of predicted value(FEV%pred)was significantly higher in normal body mass group(=-2.701,=0.0080),overweight group(=-3.506,=0.001),and obese group(=-4.323,=0.000)than in low body mass group and was significantly higher in obese group than in normal body mass group(=-3.096,=0.002).The forced vital capacity as percentage of predicted value(FVC%pred)of normal body mass group(=-3.081,=0.002)and overweight group(=-2.766,=0.006)were significantly higher than that of low body mass group.The forced expiratory volume in one second(FEV)/forced vital capacity(FVC)was significantly higher in overweight group than in normal body mass group(=-3.702,=0.001)and significantly higher in obese group than in low body mass group(=-4.742,=0.000),normal body mass group(=-5.785,=0.000),and overweight group(=-2.984,=0.003).In addition,the carbon monoxide diffusing capacity as percentage of predicted value(DLco%pred)was significantly higher in overweight group than in underweight(=-3.042,=0.003)and normal body mass groups(=-3.128,=0.002)and significantly higher in obese group than in underweight group(=-4.742,=0.000)and normal body mass group(=-5.785,=0.000).The Goddard scores of overweight(=4.535,=0.000)and obese groups(=5.422,=0.000)were significantly lower than that of normal body mass group.Partial correlation analysis showed that Goddard score was negatively correlated with FEV/FVC( =-0.230, = 0.022)and DLco%pred( =-0.531, = 0.000)and positively correlated with CAT score( = 0.244, = 0.021).BMI of phenotype E(=3.467,=0.001)and M(=3.031,=0.003),FEV/FVC of phenotype E(=2.484,=0.015)and M(=2.969,=0.004)as well as DLco%pred of phenotype E(=4.928,=0.000)and M(=2.489,=0.0163)were significantly lower than those of phenotype A.Patients with phenotype M had worse FEV%pred,FVC%pred,residual volume/total lung capacity and number of acute exacerbations than patients with phenotypes A and E,but the differences were not statistically significant(all >0.05). The nutritional status is closely related to lung function,severity of emphysema,and number of exacerbations in COPD patients.Chest CT phenotype is clinically valuable in the assessment of COPD.