Chronic obstructive pulmonary disease and body mass index in five Latin America cities: The PLATINO study

Summary

Background

The body mass index (BMI) is a prognostic factor for chronic obstructive pulmonary disease (COPD). Despite its importance, little information is available regarding BMI alteration in COPD from a population-based study. We examined characteristics by BMI categories in the total and COPD populations in five Latin-American cities, and explored the factors influencing BMI in COPD.

Methods

COPD was defined as a postbronchodilator forced expiratory volume in the first second/forced vital capacity (FEV₁/FVC) <0.70. BMI was categorized as underweight (<20 kg/m²), normal weight (20–24.9 kg/m²), overweight (25.0–29.9 kg/m²), and obese (⩾30.0 kg/m²).

Results

Interviews were completed in 5571 subjects from 6711 eligible individuals, and spirometry was performed in 5314 subjects. There were 759 subjects with COPD and 4555 without COPD. Compared with the non-COPD group, there was a higher proportion of COPD subjects in the underweight and normal weight categories, and a lower proportion in the obese category. Over one-half COPD subjects had BMI over 25 kg/m². No differences in BMI strata among countries were found in COPD subjects. Factors associated with lower BMI in males with COPD were aging, current smoking, and global initiative for chronic obstructive lung disease (GOLD) stages III–IV, whereas wheeze and residing in Santiago and Montevideo were associated with higher BMI. In females with COPD, current smoking, lower education, and GOLD stages II–IV were associated with lower BMI, while dyspnea and wheeze were associated with higher BMI.

Conclusions

BMI alterations are common in COPD with no significant differences among countries. Current smoking, age, GOLD stages, education level, residing in Santiago and Montevideo, dyspnea and wheeze were independently associated with BMI in COPD.