2 research outputs found
Somatotypes trajectories during adulthood and their association with COPD phenotypes
Rationale: Chronic obstructive pulmonary disease (COPD) comprises distinct phenotypes, all
characterised by airflow limitation.
Objectives: We hypothesised that somatotype changes – as a surrogate of adiposity – from early adulthood
follow different trajectories to reach distinct phenotypes.
Methods: Using the validated Stunkard’s Pictogram, 356 COPD patients chose the somatotype that best
reflects their current body build and those at ages 18, 30, 40 and 50 years. An unbiased group-based
trajectory modelling was used to determine somatotype trajectories. We then compared the current
COPD-related clinical and phenotypic characteristics of subjects belonging to each trajectory.
Measurements and main results: At 18 years of age, 88% of the participants described having a lean or
medium somatotype (estimated body mass index (BMI) between 19 and 23 kg·m−2
) while the other 12% a
heavier somatotype (estimated BMI between 25 and 27 kg·m−2
). From age 18 onwards, five distinct
trajectories were observed. Four of them demonstrating a continuous increase in adiposity throughout
adulthood with the exception of one, where the initial increase was followed by loss of adiposity after age
40. Patients with this trajectory were primarily females with low BMI and DLCO (diffusing capacity of the
lung for carbon monoxide). A persistently lean trajectory was seen in 14% of the cohort. This group had
significantly lower forced expiratory volume in 1 s (FEV1), DLCO, more emphysema and a worse BODE
(BMI, airflow obstruction, dyspnoea and exercise capacity) score thus resembling the multiple organ loss
of tissue (MOLT) phenotype.
Conclusions: COPD patients have distinct somatotype trajectories throughout adulthood. Those with the
MOLT phenotype maintain a lean trajectory throughout life. Smoking subjects with this lean phenotype in
early adulthood deserve particular attention as they seem to develop more severe COPD