Abstract
Introduction: In COPD patients a higher BMI is associated with better survival (the obesity paradox). The mechanism of this paradox is not well understood. We explored whether different co-morbidities related to survival in patients with different BMI.
Methods: We followed 1664 COPD patients of the BODE cohort. A total of 80 comorbidities were systematically recorded. Comorbidities prevalence and association with mortality was explored using Cox proportional hazard stratified by BMI in four groups (≤ 21, 22-29, 30-35, ≥ 36 kg/m2).
Results: COPD patients with BMI ≥ 36 had significantly more comorbidities than the other groups but they had lower mortality, better FEV1 and lower BODE.
No specific co-morbidities had an independent association with mortality in this group whereas they did in the other subsets. Patients with a BMI between 22 and 35 had the most number of comorbidities associated with death.
Conclusion: In COPD, obese patients (BMI>36) have a better survival than non-obese patients, in spite of having more co-morbidities. In these obese patients there was no co-morbidity that was significantly and independently associated with mortality.
- © 2011 ERS