Determinants of exercise capacity in obese and non-obese COPD patients

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• 作者：Diego A. Rodrí ; guez^a ; ^b ; ^{darodriguez@parcdesalutmar.cat" class="auth_mail} ; Judith Garcia-Aymerich^c ; Jose L. Valera^d ; Jaume Sauleda^d ; Bernat Togores^d ; Juan B. Galdiz^e ; Joaquim Gea^b ; Mauricio Orozco-Levi^b ; ^f ; Antoni Ferrer^b ; Federico P. Gomez^a ; Joan Albert Barber&agrave ; ^a ; Ignasi Serra^g ; Josep M. Antó ; ^h ; Josep Roca^a ; on behalf of the PAC-COPD Study Group
• 关键词：COPD ; Exercise ; Comorbidity ; Obesity
• 刊名：Respiratory Medicine
• 出版年：May 2014
• 年：2014
• 卷：108
• 期：5
• 页码：745-751
• 全文大小：277 K

文摘

The effects of obesity in combination with chronic obstructive pulmonary disease (COPD) on exercise capacity are receiving increased attention. But, a comprehensive analysis of factors associated with aerobic capacity in obese COPD patients has not been performed.

Methods

Six-min walking test (6MWT) was performed in 251 COPD patients, and 159 of those also carried out an incremental cardiopulmonary exercise test (CPET) to evaluate exercise capacity. In all patients, anthropometrics, dyspnea and anxiety–depression scores, lung function, daily physical activity, co-morbidities and circulating inflammatory biomarkers were also assessed. Six-min walking distance (6MWD) and peak oxygen uptake (VO₂ peak) during CPET were two primary outcome variables.

Results

57% of the patients showed body mass index (BMI) < 30 kg/m² (COPD_N) and the remaining 43% were obese with a BMI ≥ 30 kg/m² (COPD_O). In patients with COPD_N, 6MWD showed independent negative associations with age, dyspnea score, sedentarism, depression scores and a positive relationship with arterial oxygenation; whereas in COPD_O, 6MWD showed an inverse relationship with BMI. In COPD_N, VO₂ peak showed a negative association with age and positive relationships with both FEV₁ and DL_CO. However, in COPD_O the dyspnea score was the strongest determinant of VO₂ peak.

Conclusions

Obese and non-obese COPD patients show different determinants of aerobic capacity, including pulmonary and non-pulmonary factors that are also dependent on the type of exercise protocol. These results could be considered in the evaluation of obese patients with COPD.