MD Conference Express ATS 2013 - (Page 22)
CLINICAL TRIAL HIGHLIGHTS
than normal-weight patients, even though lung function
was better for obese and overweight patients [Cecere LM
et al. COPD 2011]. In another study, researchers found that
absolute peak workload increased in obese patients during
cycling (compared with normal-weight patients matched
for age and degree of airway obstruction), but these patients
reported less dyspnea during all levels of ventilation during
cycling [Ora J et al. Am J Respir Crit Care Med 2009].
Obesity appears to be a substantial contributor to
systemic inflammation in COPD. Adipose tissue is a source
of inflammation in obesity, and obesity (high body mass
index [BMI]) has been associated with highly elevated levels
of C-reactive protein in patients with COPD; the highest levels
have been found in patients with abdominal obesity [Breyer MK
et al. Clin Nutr 2009]. In addition, persistent inflammation
in COPD has been associated with a high BMI but not with
the fat-free mass index, which suggests a role for adipose
tissue in the inflammatory process [Agusti A et al. PloS
One 2012; van den Borst B et al. Am J Respir Crit Care Med
2013]. Prof. Franssen said that increasing evidence suggests
a relationship between visceral adipose tissue dysfunction
and the pathophysiology of COPD, and he proposed several
links between COPD, adipose tissue dysfunction, and
systemic inflammation, noting that several questions remain
unanswered (Figure 1) [Franssen FME et al. Thorax 2008].
Figure 1. Obesity and Chronic Obstructive Pulmonary Disease: Unanswered Questions
COPD
?
Inactivity
Systemic inflammation
?
Reduced oxidative capacity
Loss of fat-free mass
Insulin resistance
Absolute or relative
increase in fat mass
?
Tissue hypoxia
?
Adipose tissue
dysfunction
Altered adipokine
secretion
Reproduced from Franssen FME et al.
Obesity and the Lung: 5 • Obesity and COPD. Thorax 2008;23(12):1110-1117. With permission from The BMJ Publishing Group.
22
July 2013
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Table of Contents for the Digital Edition of MD Conference Express ATS 2013
MD Conference Express ATS 2013
Contents
Prevention and Early Treatment of Acute Lung Injury
Nocturnal Noninvasive Ventilation Improves Outcomes in Multiple Disorders
Hospital Readmissions: Challenges and Opportunities
EBUS-TBNA: Accurate and Safe for Detecting Sarcoidosis
Data Link Obstructive Sleep Apnea and Type 2 Diabetes
Statin Use Improves Respiratory-Related Mortality in Patients With COPD
Addition of Spironolactone to Ambrisentan May Be a Novel Treatment Strategy to Improve Outcome in Patients With PAH
Haloperidol Does Not Prevent Delirium in Ventilated ICU Patients
Beraprost Plus Sildenafil Effective in Pulmonary Arterial Hypertension
Dupilumab Is Safe and Effective for Controlling Asthma Attacks
Once-Daily QVA149 Improves Breathlessness in COPD Patients
CPAP in CVD and OSA Does Not Significantly Improve Cardiovascular Biomarkers
CPAP Reduces BP in Patients With Resistant Hypertension and Obstructive Sleep Apnea
Effects of Obesity on COPD
Pulmonary Embolism
Ventilator-Associated Pneumonia
Lung Cancer Screening
Idiopathic Pulmonary Fibrosis
Non-Small-Cell Lung Cancer
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