Evidence map›Paper›PMID 42580774›Full record

Observational studyBMJ open respiratory research2026

Association of body mass index with mortality in COPD through exacerbations and cardiovascular events.

Hyun Woo Lee, Sang Hyuk Kim, Tae-Hyung Kim, Seung Won Ra, Won-Yeon Lee, Min Kwang Byun, Chang-Hoon Lee, Deog Kyeom Kim, Kwang Ha Yoo, Yong Il Hwang

Registry-linked trialAbstract readMulticenter StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in BMJ open respiratory research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02800499 (Domestic COPD Patients Registry Business and COPD Phenotype Research Based by Registry Data - Multi-centered Trial), which is not on this map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02800499 enrolling by invitationnot on this map

Domestic COPD Patients Registry Business and COPD Phenotype Research Based by Registry Data - Multi-centered Trial

Typeobservational_patient_registrySponsorKonkuk University Medical CenterRan2011 to 2042Enrolled2,000ConditionsCOPD
3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Hyun Woo LeeDivision of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, South Korea.ORCID http://orcid.org/0000-0003-4379-0260
Sang Hyuk KimDivision of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, South Korea.
Tae-Hyung KimDivision of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Hanyang University Guri Hospital, Guri, South Korea.
Seung Won RaDivision of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, South Korea.
Won-Yeon LeeDivision of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Yonsei University Wonju Severance Christian Hospital, Wonju, South Korea.
Min Kwang ByunDivision of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea.ORCID http://orcid.org/0000-0003-1525-1745
Chang-Hoon LeeDivision of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Hospital, Seoul, South Korea.ORCID http://orcid.org/0000-0001-9960-1524
Deog Kyeom KimDivision of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University College of Medicine, Seoul Metropolitan Government-Seoul National University Boramae Medical Center, Seoul, South Korea.
Kwang Ha YooDivision of Pulmonary and Allergy and Critical Care Medicine, Department of Internal Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, South Korea.
Yong Il HwangDivision of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang, South Korea hyicyk@gmail.com.ORCID http://orcid.org/0000-0002-3502-5211

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThe mechanisms through which body mass index (BMI) influences the prognosis of chronic obstructive pulmonary disease (COPD) remain poorly understood. This study investigates whether BMI influences all-cause mortality in patients with COPD through mediating effects of exacerbations and cardiovascular events.

methodsData were obtained from a multicentre prospective COPD cohort (NCT02800499). BMI was assessed both continuously and categorically as <23 (low), 23-27 (normal) and >27 kg/m² (high). The primary outcome was all-cause mortality and secondary outcomes were moderate-to-severe exacerbations and cardiovascular events. Mediation analyses were applied to quantify the contribution of these events to the association between BMI and all-cause mortality.

resultsAmong 3314 patients with COPD, those with low BMI had a higher risk of mortality (adjusted OR, 1.46; 95% CI 1.04 to 2.07), whereas no significant difference was observed among those with high BMI. Mediation analyses indicated that exacerbations partially mediated the relationship between BMI and all-cause mortality, explaining 11.9% of the increased mortality among patients with low BMI and 21.9% of the reduced mortality among those with high BMI. Meanwhile, cardiovascular events showed mediating effects in the opposite direction, contributing to 5.2% lower mortality among patients with low BMI and 11.5% higher mortality among those with high BMI.

conclusionsBMI was non-linearly associated with all-cause mortality in COPD. Exacerbations mediated the excess mortality risk among patients with low BMI, whereas the decreasing risk of cardiovascular events in this group contributed to a countervailing effect that tempered the overall association between low BMI and mortality.

Indexed as

Body Mass IndexCardiovascular DiseasesPulmonary Disease, Chronic ObstructiveAgedDisease ProgressionFemaleHumansMaleMiddle AgedPrognosisProspective StudiesRisk FactorsCOPDCOPD Exacerbations

Identifiers

PMID42580774
PMCPMC13475264

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.