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Meta-Analysis
. 2012;7(8):e43892.
doi: 10.1371/journal.pone.0043892. Epub 2012 Aug 24.

Body mass index and mortality in chronic obstructive pulmonary disease: a meta-analysis

Chao Cao  1 , Ran Wang, Jianmiao Wang, Hansvin Bunjhoo, Yongjian Xu, Weining Xiong
Affiliations
Meta-Analysis

Body mass index and mortality in chronic obstructive pulmonary disease: a meta-analysis

Chao Cao et al. PLoS One. 2012.

Abstract

Background: The association between body mass index (BMI) and mortality in patients suffering from chronic obstructive pulmonary disease (COPD) has been a subject of interest for decades. However, the evidence is inadequate to draw robust conclusions because some studies were generally small or with a short follow-up.

Methods: We carried out a search in MEDLINE, Cochrane Central Register of Controlled Trials, and EMBASE database for relevant studies. Relative risks (RRs) with 95% confidence interval (CI) were calculated to assess the association between BMI and mortality in patients with COPD. In addition, a baseline risk-adjusted analysis was performed to investigate the strength of this association.

Results: 22 studies comprising 21,150 participants were included in this analysis. Compared with patients having a normal BMI, underweight individuals were associated with higher mortality (RR = 1.34, 95% CI = 1.01-1.78), whereas overweight (RR = 0.47, 95% CI = 0.33-0.68) and obese (RR = 0.59, 95% CI = 0.38-0.91) patients were associated with lower mortality. We further performed a baseline risk-adjusted analysis and obtained statistically similar results.

Conclusion: Our study showed that for patients with COPD being overweight or obese had a protective effect against mortality. However, the relationship between BMI and mortality in different classes of obesity needed further clarification in well-designed clinical studies.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Flow Diagram of the Literature Search and Trial Selection Process.
Figure 2
Figure 2. Relative risks of Mortality with Body Mass Index among Patients with Chronic Obstruct Pulmonary Disease.
Figure 3
Figure 3. Hazard ratios of Mortality with Body Mass Index among Patients with Chronic Obstruct Pulmonary Disease (HR was adjusted for age, gender, FEV1%pred, smoking and so on.
The HR of Chailleux et al. was extracted by reading off survival curves).
See this image and copyright information in PMC

References

    1. Murray CJL, Lopez AD (1997) Mortality by cause for eight regions of the world: Global Burden of Disease Study. Lancet 349: 1269–1276. - PubMed
    1. Celli BR, MacNee W (2004) ATS/ERS Task Force. Standards for the diagnosis and treatment of patients with COPD: a summary of the ATS/ERS position paper. Eur Respir J 23: 932–946. - PubMed
    1. Waschki B, Kirsten A, Holz O, Müller KC, Meyer T, et al. (2011) Physical activity is the strongest predictor of all-cause mortality in patients with chronic obstructive pulmonary disease: a prospective cohort study. Chest 140: 331–42. - PubMed
    1. Celli BR, Cote CG, Marin JM, Casanova C, Montes de Oca M, et al. (2004) The body-mass index, airflow obstruction, dyspnea, and exercise capacity index in chronic obstructive pulmonary disease. N Engl J Med 350: 1005–1012. - PubMed
    1. Esteban C, Arostegui I, Moraza J, Aburto M, Quintana JM, et al. (2011) Development of a decision tree to assess the severity and prognosis of stable COPD. Eur Respir J In press. - PubMed

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