Review article

Obesity and Obstructive Pulmonary Diseases

Suzana Mladinov
Dino Ilak

Abstract

The concurrent increase in global prevalence of obesity, COPD and asthma has significant health and economic implications. Obesity is a metabolic disorder that can be associated with systemic inflammation in COPD and asthma. When compared with non-obese patients, obese COPD and asthma patients have more comorbidities, obese COPD patients have greater dyspnea, lower functional capacity and poorer quality of life. Obese asthma patients exacerbate more often, have poorer response to therapy and typical eosinophilic inflammation is less frequent. The “obesity paradox” in COPD refers to the longer survival of obese people which is dependent of total body mass as well as of fat proportion and distribution. It is preferable to provide strategies for body mass reduction with muscle mass preservation. In asthma, there are two different phenotypes associated with obesity: early-onset allergic asthma emerging in young age with the dominant Th2 inflammatory response (Th2-high) and complicated with obesity in later life, and late-onset non-allergic asthma that is more common in adult women as a complication of initially present obesity and characterized by low intensity Th2 inflammatory response (Th2-low). There are several ways in which weight loss positively affects asthma control: improving chest mechanics, reducing gastroesophageal reflux and reducing intensity of inflammation.

Keywords

COPD; asthma; obese patients; comorbidity; dyspnea; obesity paradox; maintaining muscle mass

Hrčak ID:

199418

URI

https://hrcak.srce.hr/199418

Publication date:

26.4.2018.

Article data in other languages: croatian

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