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. 2022 Jan-Dec:19:14799731211052305.
doi: 10.1177/14799731211052305.

Adiposity increases weight-bearing exercise-induced dyspnea despite favoring resting lung hyperinflation in COPD

Zewari S  1 , van den Borst B  2 , van den Elshout Fj  1 , Vercoulen Jh  3 , Dekhuijzen Pn  2 , Heijdra Yf  2 , Vos Pj  1
Affiliations

Adiposity increases weight-bearing exercise-induced dyspnea despite favoring resting lung hyperinflation in COPD

Zewari S et al. Chron Respir Dis. 2022 Jan-Dec.

Abstract

Objectives: Our aim was to study the associations between resting lung hyperinflation, weight-bearing exercise-induced dyspnea and adipose distribution in obese and normal-weight COPD patients.

Methods: We performed a comparison between 80 obese COPD patients (COPDOB) with 80 age- and FEV1 matched normal-weight COPD patients (COPDNW). Dyspnea was assessed by the mMRC scale and the Borg dyspnea score before and after a 6 min walk test. Further characterization included spirometry, body plethysmography and metronome paced tachypnea (MPT) to estimate dynamic hyperinflation. Body composition was assessed with bioelectrical impedance analysis. Associations between dyspnea scores and BMI and body composition groups were studied using logistic regression models.

Results: COPDOB patients had attenuated increases in TLC, FRC and RV compared to COPDNW patients (p < 0.01). The groups had comparable 6 min walking distance and ΔFRC upon MPT (p > 0.05). Compared to COPDNW, COPDOB patients reported more often a mMRC ≥ 2 (65 vs 46%; p = 0.02; OR 3.0, 95% CI 1.4-6.2, p < 0.01) and had higher ΔBorg upon 6MWT: 2.0 (SEM 0.20) vs. 1.4 (SEM 0.16), p = 0.01; OR for ΔBorg ≥ 2: 2.4, 95% CI 1.1-5.2, p = 0.03. Additional logistic regression analyses on the associations between body composition and dyspnea indicated that increased body fat percentage, fat mass index and waist-to-hip ratio were associated with higher ORs for mMRC ≥ 2 and ΔBorg upon 6MWT ≥ 2.

Conclusion: Despite its beneficial effect on resting lung hyperinflation, adiposity is associated with increased weight-bearing exercise-induced dyspnea in COPD.

Keywords: COPD; adiposity; dyspnea; obesity.

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Conflict of interest statement

Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Modified medical research council dyspnea scale. Percentage of COPDOB and COPDNW with certain mMRC score. Abbreviations: mMRC, modified medical research council dyspnea scale.
See this image and copyright information in PMC

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