Symptom profile in obese COPD (Chronic Obstructive Pulmonary Disease) patients compared with non-obese patients: retrospective evaluation in the French overseas department of Reunion Island (period 2015-2020).

Abstract

Background: It has been proposed that in COPD patients with obesity, it is more difficult to achieve control when compared with non – obese patients.

The aim of this study was to establish a symptom profile in our outpatient COPD comparing obese with non - obese subjects.

Methods: We included patients with confirmed COPD, who had filled prescriptions for at least one year. They should not have other respiratory illness or systemic uncontrolled disease. Subjects answered the COPD assessment test (CAT®). Obesity was defined as BMI > 30 (body mass index BMI > 30 kg/m2).

Results: 110 patients were included (50 obese and 60 non-obese), with FEV1 70±10%, and COPD for 5±2years. Obese group was older (60.4±5.6) vs (48.2±4.4 years old; p=0.004), had more men (65vs59%, p=0.001), more obstructive sleep apnea (OSA) and worse symptom control CAT. Symptom profiled showed in obese subjects more activity impairment (3.4±1.3 vs 2.9±1.2; p=0.01), nocturnal dyspnoea (3.4±1.4 vs 2.1±1.5; p< 0.002) and use of rescue inhaler. We found no differences in FEV1, diurnal dyspnoea, self-evaluation of control, smoking status, and COPD duration. Controller treatment included Long-acting beta agonist (LABA) only in 29% of obese vs 24% in non-obese, LABA/LAMA (muscarinic antagonist) in 61% vs 59% and two controller drugs in 19% vs 7% (p=0.001).

Conclusion: In this group of COPD patients, we found that obese subjects had worse control than non-obese, with a different symptom profile, despite receiving more treatment.