RT Journal Article SR Electronic T1 Somatotypes trajectories during adulthood and their association with COPD phenotypes JF ERJ Open Research JO erjor FD European Respiratory Society SP 00122-2020 DO 10.1183/23120541.00122-2020 VO 6 IS 3 A1 Miguel J. Divo A1 Marta Marin Oto A1 Ciro Casanova Macario A1 Carlos Cabrera Lopez A1 Juan P. de-Torres A1 Jose Maria Marin Trigo A1 Craig P. Hersh A1 Ana Ezponda Casajús A1 Cherie Maguire A1 Victor M. Pinto-Plata A1 Francesca Polverino A1 James C. Ross A1 Dawn DeMeo A1 Gorka Bastarrika A1 Edwin K. Silverman A1 Bartolome R. Celli YR 2020 UL http://openres.ersjournals.com/content/6/3/00122-2020.abstract AB Rationale Chronic obstructive pulmonary disease (COPD) comprises distinct phenotypes, all characterised by airflow limitation.Objectives We hypothesised that somatotype changes – as a surrogate of adiposity – from early adulthood follow different trajectories to reach distinct phenotypes.Methods Using the validated Stunkard's Pictogram, 356 COPD patients chose the somatotype that best reflects their current body build and those at ages 18, 30, 40 and 50 years. An unbiased group-based trajectory modelling was used to determine somatotype trajectories. We then compared the current COPD-related clinical and phenotypic characteristics of subjects belonging to each trajectory.Measurements and main results At 18 years of age, 88% of the participants described having a lean or medium somatotype (estimated body mass index (BMI) between 19 and 23 kg·m−2) while the other 12% a heavier somatotype (estimated BMI between 25 and 27 kg·m−2). From age 18 onwards, five distinct trajectories were observed. Four of them demonstrating a continuous increase in adiposity throughout adulthood with the exception of one, where the initial increase was followed by loss of adiposity after age 40. Patients with this trajectory were primarily females with low BMI and DLCO (diffusing capacity of the lung for carbon monoxide). A persistently lean trajectory was seen in 14% of the cohort. This group had significantly lower forced expiratory volume in 1 s (FEV1), DLCO, more emphysema and a worse BODE (BMI, airflow obstruction, dyspnoea and exercise capacity) score thus resembling the multiple organ loss of tissue (MOLT) phenotype.Conclusions COPD patients have distinct somatotype trajectories throughout adulthood. Those with the MOLT phenotype maintain a lean trajectory throughout life. Smoking subjects with this lean phenotype in early adulthood deserve particular attention as they seem to develop more severe COPD.In smoking-related COPD, somatotype trajectories are associated with the final COPD phenotype. Specifically, the “pink puffer” or multiorgan loss of tissue (MOLT) phenotype occurs where the patient remains lean. https://bit.ly/2YNhwfu