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. 2015 May;70(5):e14-9.
doi: 10.1016/j.crad.2015.01.007. Epub 2015 Feb 19.

Obesity and extent of emphysema depicted at CT

S Gu  1 , R Li  2 , J K Leader  1 , B Zheng  3 , J Bon  4 , D Gur  1 , F Sciurba  4 , C Jin  5 , J Pu  6
Affiliations

Obesity and extent of emphysema depicted at CT

S Gu et al. Clin Radiol. 2015 May.

Abstract

Aim: To investigate the underlying relationship between obesity and the extent of emphysema depicted at CT.

Methods and materials: A dataset of 477 CT examinations was retrospectively collected from a study of chronic obstructive pulmonary disease (COPD). The low attenuation areas (LAAs; ≤950 HU) of the lungs were identified. The extent of emphysema (denoted as %LAA) was defined as the percentage of LAA divided by the lung volume. The association between log-transformed %LAA and body mass index (BMI) adjusted for age, sex, the forced expiratory volume in one second as percent predicted value (FEV1% predicted), and smoking history (pack years) was assessed using multiple linear regression analysis.

Results: After adjusting for age, gender, smoking history, and FEV1% predicted, BMI was negatively associated with severe emphysema in patients with COPD. Specifically, one unit increase in BMI is associated with a 0.93-fold change (95% CI: 0.91-0.96, p<0.001) in %LAA; the estimated %LAA for males was 1.75 (95% CI: 1.36-2.26, p<0.001) times that of females; per 10% increase in FEV1% predicated is associated with a 0.72-fold change (95% CI: 0.69-0.76, p<0.001) in %LAA.

Conclusion: Increasing obesity is negatively associated with severity of emphysema independent of gender, age, and smoking history.

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Figures

Figure 1
Figure 1
The distribution of BMI across all patients (n = 477).
Figure 2
Figure 2
The emphysema extent quantified by CT in terms of GOLD.
Figure 3
Figure 3
The percent of low attenuation areas (%LAA) stratified by BMI. (a) Patients with airflow obstruction based on GOLD. (b) Patients without airflow obstruction.
See this image and copyright information in PMC

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