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FEV1 decline across BMI gradient in COPD patients who were part of large randomized controlled trial over at least 3 years.

FEV1 decline across BMI gradient in COPD patients who were part of large randomized controlled trial over at least 3 years.

Don D Sin

Centre for Heart Lung Innovation, St Paul's Hospital and Division of Respiratory Medicine, University of British Columbia,Vancouver, BC V6Z 1Y6, Canada

13 June 2019

Chronic obstructive pulmonary disease (COPD) is a preventable and treatable respiratory disease characterized by persistent and progressive airflow limitation in the lungs. Airflow limitation is commonly caused by lung inflammation, the lungs' response to noxious particles or gases, particularly cigarette smoke. COPD is a leading cause of death worldwide and its prevalence is increasing due to continuous exposure to risk factors and aging of the population. It leads to enormous social and economic burdens on individuals and society. Therefore, COPD is a major public health issue that requires great attention.Weight loss and muscle wasting are common in patients with COPD, especially in severe cases. Body mass index (BMI), a measurement of weight to height, is generally recognized as the most useful indicator of health risk among people who are over- or underweight. It is well known that low BMI is predictive of greater risk of death in patients with COPD. However it is unclear whether BMI is a predictor of COPD disease progression. It is widely accepted that COPD disease progression can be assessed using the rate of decline in FEV1 (a measurement of the amount of air a patient can exhale in one second). Some studies suggested that COPD patients with greater BMI showed slower rates of decline in FEV1. In another study, COPD patients with normal BMI had the slowest decline in FEV1, patients with low BMI had the fastest decline in FEV1, and patients with high BMI had the slower decline in FEV1. Another study showed BMI had no relation with the rate of decline in FEV1 in COPD patients. Therefore, the relationship between BMI and the rate of decline in FEV1 in patients with COPD is still uncertain. The objective of the proposed research is to determine whether BMI is a predictor of FEV1 decline and explore the relationship between them.    We hypothesize that BMI is a predictor of the decline in FEV1 and that patients with a lower BMI will show a faster decline in lung function. It may be helpful to identify COPD patients with rapid progression who require more intensive treatment, and also provide more theoretical basis for nutritional support treatment for COPD patients.

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Statistical Analysis Plan

Sun, Y., Milne, S., Jaw, J.E. et al. BMI is associated with FEV1 decline in chronic obstructive pulmonary disease: a meta-analysis of clinical trials. Respir Res 20, 236 (2019).