ABSTRACT
PURPOSE OF THE STUDY: Larger proportions of chronic obstructive pulmonary disease (COPD) patients are currently overweight or with obesity than underweight, and the combination of COPD and obesity is increasing. The purpose of this study was to investigate differences in the body composition, pulmonary function tests, exercise capacity, and health-related quality of life among normal weight, overweight, and obese patients with COPD. STUDY DESIGN: A total of 514 patients with COPD were included in the study. According to the World Health Organization criteria for body mass index, the patients were classified as normal weight, overweight, and obese. Evaluations included fat-free mass, fat-free mass index, phase angle, pulmonary function tests, and 6-minute walk test. Dyspnea was assessed using the modified Medical Research Council dyspnea scale, and the health-related quality of life was evaluated using COPD Assessment Test and St. George's Respiratory Questionnaire. Values were compared among the three groups. RESULTS: There were 315 male and 199 female patients, with a mean age of 66.7 ± 8.4 years. Fat-free mass, fat-free mass index, and phase angle values were significantly higher in COPD patients with obesity than in other patients (P < .001, P < .001, P < .001). Forced expiratory volume in 1 s, forced expiratory volume in 1 s/forced vital capacity, and diffusing capacity of lung for carbon monoxide value in pulmonary function tests were significantly higher in COPD patients with obesity than in other patients (P = .046, P < .001, P < .001), while the forced vital capacity values were similar in all groups. Exercise capacity (6-min walk test distance), dyspnea symptoms (modified Medical Research Council scale), and health-related quality of life (COPD Assessment Test and St. George's Respiratory Questionnaire) did not differ significantly between groups. CONCLUSIONS: According to our study, obesity has no negative effect on pulmonary function tests, dyspnea perception, exercise capacity, and health-related quality of life.
Subject(s)
Body Composition , Body Mass Index , Exercise Tolerance , Obesity , Pulmonary Disease, Chronic Obstructive , Quality of Life , Respiratory Function Tests , Humans , Pulmonary Disease, Chronic Obstructive/physiopathology , Pulmonary Disease, Chronic Obstructive/psychology , Pulmonary Disease, Chronic Obstructive/complications , Male , Female , Aged , Obesity/physiopathology , Obesity/complications , Obesity/psychology , Exercise Tolerance/physiology , Middle Aged , Walk Test , Dyspnea/physiopathology , Dyspnea/etiologyABSTRACT
AIM: To assess the proportion of patients with asthma or chronic obstructive pulmonary disease (COPD) with significant bronchoobstruction who do not have inspiratory flows necessary for the adequate use of dry powder inhaler (DPI) devices Diskus and Turbuhaler. PATIENTS AND METHODS: multicentre cross-sectional study that included 400 patients with asthma or COPD (with FEV1 < 60%) aged 5-91 years tested during exacerbation or usual control visit. All patients underwent lung function testing and measurement of inspiratory flows using In-check Dial. RESULTS: Significantly lower proportion of patients didn't have inspiratory flows necessary for the regular adequate use of Diskus than for Turbuhaler (21.0% vs 87.0%, chi2 = 350.72, p < 0.0001). In patients tested during exacerbation these proportions were marginally greater. Regression analysis showed a weak association of inspiratory flows measured with different resistance settings with parameters of lung function (best association was seen between resistance setting for Diskus and PEF [%], r2 = 0.104). CONCLUSIONS: Significant proportion of patients with asthma or COPD with significant bronchoobstruction do not exhibit satisfactory inspiratory flows for the use of dry powder inhaler (DPI) devices (Diskus < Turbuhaler). Spirometry is not to be used for selection of the device for drug application and In-check Dial should be used instead.
