ArticleAmerican journal of epidemiology2019
Investigation of the Obesity Paradox in Chronic Obstructive Pulmonary Disease, According to Smoking Status, in the United States.
Article in American journal of epidemiology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers, 2 of them syntheses that pooled it.
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Who cites it
37 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- The impact of body mass index on mortality in COPD: an updated dose-response meta-analysis.European respiratory review : an official journal of the European Respiratory Society · 2024Pooled it
- Guideline
- Respiratory Effects of Treatment with a Glucagon-Like Peptide-1 Receptor Agonist in Patients Suffering from Obesity and Chronic Obstructive Pulmonary Disease.International journal of chronic obstructive pulmonary diseaseTrial
- Observational
- Development and validation of a clinical factor-based nomogram for predicting imaging-defined cardiopulmonary abnormality risk in an asymptomatic screening population.World journal of radiology · 2026Article
- Association Between Phase Angle, Muscle Mass Distribution, and Quality of Life in Patients with Chronic Obstructive Pulmonary Disease.Journal of clinical medicine · 2026Article
- Relationship between the advanced lung cancer inflammation index (ALI) and all-cause and cause-specific mortality among patients with chronic obstructive pulmonary disease (COPD): a population-based study.BMC pulmonary medicine · 2026Article
- A 3-year prospective study to assess clinical characteristics and risk factors for exacerbations in patients with asthma-COPD overlap based on the GINA guideline compared with patients with asthma and COPD.Respiratory research · 2026Article
- Medical nutrition therapy in chronic obstructive pulmonary disease: A narrative review.Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition · 2025Review
- High BMI and COPD Outcomes in Alpha-1 Antitrypsin Deficiency.CHEST pulmonary · 2025Article
- Association between lipid accumulation product and chronic obstructive pulmonary disease: a cross-sectional analysis.BMC pulmonary medicine · 2025Observational
- Body Mass Index and Lung Function in Hospitalized Severe AECOPD Patients: Investigating Nonlinear Associations and the Role of Hemoglobin.International journal of chronic obstructive pulmonary disease · 2025Article
- The Role of Computed Tomography and Artificial Intelligence in Evaluating the Comorbidities of Chronic Obstructive Pulmonary Disease: A One-Stop CT Scanning for Lung Cancer Screening.International journal of chronic obstructive pulmonary disease · 2025Review
- Impact of zinc deficiency on mortality risk in patients with chronic obstructive pulmonary disease: a retrospective analysis.Frontiers in nutrition · 2025Article
- Canonical correlation analysis on the association between pulmonary function and obesity in early-onset COPD: CT-based body composition analysis.Frontiers in medicine · 2025Article
- Relationship between advanced lung cancer inflammation index and all-cause and cause-specific mortality among chronic inflammatory airway diseases patients: a population-based study.Frontiers in immunology · 2025Article
- Spirometric pattern and cardiovascular risk: a prospective study of 0.3 million Chinese never-smokers.The Lancet regional health. Western Pacific · 2025Article
- Longitudinal analysis of adiponectin to leptin and apolipoprotein B to A1 ratios as markers of future airflow obstruction and lung function decline.Scientific reports · 2024Observational
- Genetically Predicted Body Mass Index and Mortality in Chronic Obstructive Pulmonary Disease.American journal of respiratory and critical care medicine · 2024Article
- Associations of obesity with chronic inflammatory airway diseases and mortality in adults: a population-based investigation.BMC public health · 2024Article
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Abstract
An obesity paradox in chronic obstructive pulmonary disease (COPD), whereby overweight/obese individuals have improved survival, has been well-described. These studies have generally included smokers. It is unknown whether the paradox exists in individuals with COPD arising from factors other than smoking. Nonsmoking COPD is understudied yet represents some 25%-45% of the disease worldwide. To determine whether the obesity paradox differs between ever- and never-smokers with COPD, 1,723 adult participants with this condition were examined from 2 iterations of the National Health and Nutrition Examination Survey (1988-1994, 2007-2010), with mortality outcomes followed through December 2011. Using Cox proportional hazards models, adjusted for sociodemographic factors, lung function, and survey cycle, ever/never-smoking was found to modify the association between body mass index and hazard of death. Compared with normal-weight participants, overweight/obese participants had lower hazard of death among ever-smokers (for overweight, adjusted hazard ratio (aHR) = 0.56, 95% confidence interval (CI): 0.43, 0.74; for obesity, aHR = 0.66, 95% CI: 0.48, 0.92), but never-smokers did not (overweight, aHR = 1.41, 95% CI: 0.66, 3.03; obesity, aHR = 1.29, 95% CI: 0.48, 3.48). An obesity paradox appeared to be absent among never-smokers with COPD. This, to our knowledge, novel finding might be explained by pathophysiological differences between smoking-related and nonsmoking COPD or by smoking-associated methodological biases.
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