Effects of BMI on Static Lung Volumes in Patients With Airway Obstruction

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Background: Both chronic airway obstruction and obesity are increasing in prevalence but the effect of their combination on pulmonary function parameters across the range of airway obstruction is unknown.

Methods: We studied the impact of increasing BMI on static lung volumes and airway function in a cohort of 2,265 subjects from a large pulmonary function laboratory database who were 40 to 80 years of age and met GOLD (Global Initiative for Chronic Obstructive Lung Disease) spirometric criteria for COPD (postbronchodilator FEV j/FVC < 0.7). We also evaluated the influence of severity of airway obstruction (by GOLD criteria) on these relationships.

Results: With increasing BMI in the group as a whole, functional residual capacity, residual volume, expiratory reserve volume, and specific airway resistance (sRaw) decreased exponentially (all P < .001); total lung capacity (TLC) decreased linearly (P < .001); and inspiratory capacity (IC) and IC/TLC increased linearly (P < .001). However, vital capacity was not influenced significantly. The effects of increasing BMI on FEV/FVC and sRaw were greatest in GOLD stage III/IV (P < .05), whereas increasing BMI had greater effects on IC in GOLD stage I (P < .001). Conclusions: With increasing BMI, subjects with airway obstruction had consistent reductions in lung hyperinflation, with significant improvements in IC and the FEV1/FVC ratio; this effect was greatest in patients with the most severe airway obstruction.

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