COPD: Body Weight and Composition (2019)

Assessment
What effect does body weight have on mortality outcomes in adults with COPD?
- Conclusion
  Evidence suggests an association between body weight status and mortality in adults with COPD. The lowest body mass index (BMI) groups had higher mortality rates when compared to higher BMI groups. A BMI classification of approximately 25.0-29.99kg/m² appeared to lower the risk of mortality when compared to both higher and lower BMI classifications.
- Grade: I
  - Grade I means there is Good/Strong evidence supporting the statement;
  - Grade II is Fair;
  - Grade III is Limited/Weak;
  - Grade IV is Expert Opinion Only;
  - Grade V is Not Assignable.
  - High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
  - Moderate (B) means we are moderately confident in the effect estimate;
  - Low (C) means our confidence in the effect estimate is limited;
  - Very Low (D) means we have very little confidence in the effect estimate.
  - Ungraded means a grade is not assignable.
- Evidence Summary: What effect does body weight have on mortality outcomes in adults with COPD?
- Search Plan and Results: COPD: Body Weight and Composition 2017
What effect does body composition have on mortality outcomes in adults with COPD?
- Conclusion
  Limited evidence suggests that a lower fat-free mass index (FFMI) and "muscle atrophy" [defined as (kg/m²) BMI ≥21 and FFMI <16 (men) or <15 (women)], but not fat mass index, is associated with higher mortality in both underweight and overweight adults with COPD. Higher mortality risk was also seen in groups of patients with "muscle atrophy" (as previously defined).
- Grade: III
  - Grade I means there is Good/Strong evidence supporting the statement;
  - Grade II is Fair;
  - Grade III is Limited/Weak;
  - Grade IV is Expert Opinion Only;
  - Grade V is Not Assignable.
  - High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
  - Moderate (B) means we are moderately confident in the effect estimate;
  - Low (C) means our confidence in the effect estimate is limited;
  - Very Low (D) means we have very little confidence in the effect estimate.
  - Ungraded means a grade is not assignable.
- Evidence Summary: What effect does body composition have on mortality outcomes in adults with COPD?
- Search Plan and Results: COPD: Body Weight and Composition 2017
What effect does body weight have on lung function outcomes in adults with COPD?
- Conclusion
  Evidence suggests a positive association between body mass index (BMI) and forced expiratory volume in 1 minute % predicted (FEV₁% predicted) and FEV₁/forced vital capacity (FVC) in adults with COPD. In addition, a longitudinal study showed that increasing BMI reduced the decline of these measures over time. However, most results did not include adjustment for relevant confounders and should be interpreted with caution. Results were either mixed or not significant for other lung function measures [FEV₁, FVC, FVC % predicted].
- Grade: II
  - Grade I means there is Good/Strong evidence supporting the statement;
  - Grade II is Fair;
  - Grade III is Limited/Weak;
  - Grade IV is Expert Opinion Only;
  - Grade V is Not Assignable.
  - High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
  - Moderate (B) means we are moderately confident in the effect estimate;
  - Low (C) means our confidence in the effect estimate is limited;
  - Very Low (D) means we have very little confidence in the effect estimate.
  - Ungraded means a grade is not assignable.
- Evidence Summary: What effect does body weight have on lung function outcomes in adults with COPD?
- Search Plan and Results: COPD: Body Weight and Composition 2017
What effect does body composition have on lung function outcomes in adults with COPD?
- Conclusion
  Very limited evidence from a single study showed that underweight COPD subjects with muscle and fat store depletions had lower forced expiratory volume in one minute (FEV₁) and FEV₁ to forced vital capacity ratio (FEV₁/FVC), compared to normal and overweight COPD subjects with or without muscle or fat store depletion. No differences were found for other lung function measures (FEV₁ percentage predicted, FVC or FVC percentage predicted).
- Grade: III
  - Grade I means there is Good/Strong evidence supporting the statement;
  - Grade II is Fair;
  - Grade III is Limited/Weak;
  - Grade IV is Expert Opinion Only;
  - Grade V is Not Assignable.
  - High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
  - Moderate (B) means we are moderately confident in the effect estimate;
  - Low (C) means our confidence in the effect estimate is limited;
  - Very Low (D) means we have very little confidence in the effect estimate.
  - Ungraded means a grade is not assignable.
- Evidence Summary: What effect does body composition have on lung function outcomes in adults with COPD?
  - Detail
  - Quality Rating Summary
    For a summary of the Quality Rating results, click here.
  - Worksheets
    
    Baccioglu A, Gulbay B, Acican T. Body composition in patients with stable chronic obstructive pulmonary disease: comparison with malnutrition in healthy smokers. The Eurasian Journal of Medicine 2014; 46:169-175
- Search Plan and Results: COPD: Body Weight and Composition 2017