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Observational Study
. 2021 May 5;11(1):9548.
doi: 10.1038/s41598-021-87724-8.

Characteristics of chronic obstructive pulmonary disease patients with robust progression of emphysematous change

Akihiro Tsutsumi  1 , Shotaro Chubachi  2 , Hidehiro Irie  1 , Mamoru Sasaki  1 , Yoshitake Yamada  3 , Hiroaki Sugiura  3 , Masahiro Jinzaki  3 , Hidetoshi Nakamura  4 , Koichiro Asano  5 , Tomoko Betsuyaku  1 , Koichi Fukunaga  1
Affiliations
Observational Study

Characteristics of chronic obstructive pulmonary disease patients with robust progression of emphysematous change

Akihiro Tsutsumi et al. Sci Rep. .

Abstract

Emphysema is a major pathological change in chronic obstructive pulmonary disease (COPD). However, the annual changes in the progression of emphysematous have not been investigated. We aimed to determine possible baseline predicting factors of the change in emphysematous progression in a subgroup of COPD patients who demonstrated rapid progression. In this observational study, we analyzed patients with COPD who were followed up by computed tomography (CT) at least two times over a 3-year period (n = 217). We divided the annual change in the low attenuation area percentage (LAA%) into quartiles and defined a rapid progression group (n = 54) and a non-progression group (n = 163). Predictors of future changes in emphysematous progression differed from predictors of high LAA% at baseline. On multivariate logistic regression analysis, low blood eosinophilic count (odds ratio [OR], 3.22; P = 0.04) and having osteoporosis (OR, 2.13; P = 0.03) were related to rapid changes in emphysematous progression. There was no difference in baseline nutritional parameters, but nutritional parameters deteriorated in parallel with changes in emphysematous progression. Herein, we clarified the predictors of changes in emphysematous progression and concomitant deterioration of nutritional status in COPD patients.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Distribution of annual changes in LAA% and time-dependency over 3 years. (A) Distribution of the annual changes in LAA% over the 3-year period. The mean ± SD of ΔLAA%/year was 0.47 ± 2.28. We had arbitrarily defined the cut-off value of ΔLAA%/year, based on the upper quartile value, as 1.48%/year. (B) Overall time-dependent LAA% in the rapid progression and non-progression groups. Data are shown as mean ± SD. LAA low attenuation area.
Figure 2
Figure 2
Comparison of BMI between the rapid progression group and non-progression group. (A) BMI at baseline. (B) Annual change in BMI over 3 years of follow-up. Data are shown as mean ± SD. BMI body mass index.
Figure 3
Figure 3
Relationships between lumbar BMD and changes in emphysematous progression in COPD patients. (A) Frequency of osteopenia and osteoporosis in the non-progression group and rapid progression group. (B) Comparison of baseline T score in the lumbar spine between the two groups. (C) Annual change in BMD in the lumbar spine in the two groups over 3 years of follow-up. Data are shown as mean ± SD. BMD bone mineral density.
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