"Patients with Chronic Obstructive Pulmonary Disease Should Maintain Appropriate Weight for Better Treatment and Management"

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[Asia Economy Reporter Lee Gwan-joo] A study has found that patients with chronic obstructive pulmonary disease (COPD) should be careful not to lose weight below an appropriate level. Losing weight increases the relative risk of disease exacerbation.

The research team led by Professors Park Hye-yoon and Shin Sun-hye from the Department of Pulmonology at Samsung Seoul Hospital, in collaboration with Professor Kim Woo-jin from the Department of Pulmonology at Kangwon National University Hospital and Dr. Kwon Sung-ok from the Institute of Biomedical Research, as well as Professor Yoo Kwang-ha from Konkuk University Hospital who leads the Korean COPD Cohort Study (KOCOSS), announced these findings on the 12th.

COPD is a disease in which abnormal inflammatory responses occur in the bronchi and lung parenchyma due to inhalation of harmful particles or gases, including smoking, causing lung function to decline faster than normal aging. The research team studied the effects of chronic bronchitis and body mass index (BMI) on COPD in 1,264 patients registered in the COPD cohort between 2012 and 2016.

The team classified patients into four types based on the presence of chronic bronchitis symptoms, a risk factor for COPD exacerbation, and obesity defined by a BMI cutoff of 25 (kg/m²).

As a result, the patients who experienced the most frequent COPD exacerbations were those with a BMI below 25 and chronic bronchitis. Among 353 such patients, 184 experienced acute exacerbations within one year, corresponding to 763 cases per 1,000 person-years, the highest rate. Next were patients without chronic bronchitis but with a BMI below 25, with 572 cases per 1,000 person-years, followed by patients with chronic bronchitis but a BMI of 25 or higher at 526 cases per 1,000 person-years. Patients without chronic bronchitis and with a BMI of 25 or higher had the lowest rate at 402 cases per 1,000 person-years.

Based on this, the relative incidence rate of COPD exacerbation was 21% higher in patients with a BMI below 25 compared to those with a BMI of 25 or higher when chronic bronchitis was absent. For patients with chronic bronchitis, the incidence rate jumped to 41% higher when BMI was below 25. This indicates that COPD patients with chronic bronchitis who have low body weight are at a disadvantage in managing their disease.

The reasons for these differences include the likelihood that patients with lower BMI have poorer muscle mass and nutritional status compared to those with higher BMI, a tendency for more severe emphysema that worsens COPD, and limitations in selecting treatments to prevent COPD exacerbations due to low body weight. However, the research team emphasized that indiscriminately gaining weight does not necessarily help in COPD treatment. They added that maintaining an appropriate weight and consistently exercising through pulmonary rehabilitation programs are beneficial for treatment.

Professor Park Hye-yoon said, “Like other diseases, patients with chronic obstructive pulmonary disease need to eat well and exercise diligently to prevent disease exacerbation. Especially for patients who frequently experience bronchitis, it is important to actively manage the condition while being careful not to lose weight.” This study was published in the international journal Respiratory Research.

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