- •Increasing BMI is associated with worse pulmonary function, functional capacity, dyspnea, and quality of life in ILD.
- •Mass loading of the thorax in higher BMI categories could exacerbate the restrictive pulmonary defect characteristic of ILD.
- •Intentional weight-loss in overweight and obese patients may improve pulmonary function in addition to functional capacity.
Obesity is a health epidemic associated with greater morbidity and mortality in the general population. Mass loading of the thorax from obesity leads to a restrictive pulmonary defect that reduces lung capacity in obese individuals without pulmonary disease, and may exacerbate the restrictive pulmonary physiology that is characteristic of interstitial lung disease (ILD). The purpose of this study was to test the association of body mass index (BMI) with pulmonary function, functional capacity, and patient-reported outcomes (dyspnea and quality of life) in patients with ILD. We analyzed 3169 patients with fibrotic ILD from the Canadian Registry for Pulmonary Fibrosis. Patients were subcategorized as underweight (BMI<18.5 kg/m2), normal weight (18.5≤BMI<25), overweight (25≤BMI<30), obese I (30≤BMI<35), obese II (35≤BMI<40), and obese III (BMI>40). Analysis was performed using a linear regression with adjustment for common prognostic variables. Overweight and obese BMI categories were associated with worse pulmonary function, functional capacity, dyspnea, and quality of life compared to normal weight. This is likely a result of mass loading on the thorax, and we speculate that intentional weight-loss may improve lung function and functional capacity in obese patients with fibrotic ILD. The underweight BMI category was also associated with worse functional capacity compared to normal weight, which may reflect greater disease severity or the presence of other comorbidities. Future work should explore the clinical utility of BMI to improve patient outcomes.
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to Respiratory Medicine
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- The incidence of co-morbidities related to obesity and overweight: a systematic review and meta-analysis.BMC Publ. Health. 2009; 9: 88
- Body mass index and mortality in chronic obstructive pulmonary disease: a dose-response meta-analysis.Medicine (Baltim.). 2016; 95: e4225
- Decrements of body mass index are associated with poor outcomes of idiopathic pulmonary fibrosis patients.PLoS One. 2019; 14e0221905
- Body mass index and mortality in patients with idiopathic pulmonary fibrosis.Chest. 2007; 131: 1448-1453
- Association of body mass index and change in weight with mortality in patients with fibrotic interstitial lung disease.Chest. 2021;
- The CAnadian REgistry for Pulmonary Fibrosis (CARE-PF): design and rationale of a national pulmonary fibrosis registry.Cancer Res. J. 2015;
- Trends and projections of obesity among Canadians.Health Promot Chronic. Dis. Prev. Can: Res, Policy, Pract. 2015; 35: 109-112
- The effects of body mass index on lung volumes.Chest. 2006; 130: 827-833
- Combined effects of obesity and chronic obstructive pulmonary disease on dyspnea and exercise tolerance.Am. J. Respir. Crit. Care Med. 2009; 180: 964-971
- The impact of bariatric surgery on pulmonary function: a meta-analysis.Surg. Obes. Relat. Dis. 2018; 14: 225-236
Published online: March 05, 2022
Accepted: February 22, 2022
Received in revised form: February 21, 2022
Received: January 11, 2022
© 2022 Elsevier Ltd. All rights reserved.