Nutrition and markers of disease severity in patients with bronchiectasis

Katherine A. Despotes, Radmila Choate, Doreen Addrizzo-Harris, Timothy R. Aksamit, Alan Barker, Ashwin Basavaraj, Charles L. Daley, Edward Eden, Angela DiMango, Kevin Fennelly, Julie Philley, Margaret M. Johnson, Pamela J. McShane, Mark L. Metersky, Anne E. O'Donnell, Kenneth N. Olivier, Matthias A. Salathe, Andreas Schmid, Byron Thomashow, Gregory TinoKevin L. Winthrop, Michael R. Knowles, Mary Leigh Anne Daniels, Peadar G. Noone

Research output: Contribution to journalArticlepeer-review

7 Scopus citations

Abstract

Background: Increasing numbers of patients are being diagnosed with bronchiectasis, yet much remains to be elucidated about this heterogeneous patient population. We sought to determine the relationship between nutrition and health outcomes in non-cystic fibrosis (non-CF) bronchiectasis, using data from the U.S. Bronchiectasis Nontuberculous Mycobacterial Research Registry (U.S. BRR). Methods: This was a retrospective, observational, longitudinal study using 5-year follow-up data from the BRR. Bronchiectasis was confirmed on computed tomography (CT). We stratified patients into nutrition categories using body mass index (BMI), and correlated BMI to markers of disease severity. Results: Overall, n = 496 patients (mean age 64.6±13 years; 83.3% female) were included. At baseline 12.3% (n=61) were underweight (BMI<18.5kg/m2), 63.9% (n=317) had normal weight (BMI.18.5kg/m2 and <25.0kg/m2), 17.3% (n=86) were overweight (BMI.25.0kg/m2 and <30.0kg/m2), and 6.5% (n=32) were obese (BMI.30kg/m2). Men were overrepresented in the overweight and obese groups (25.6% and 43.8% respectively, p<0.0001). Underweight patients had lower lung function (forced expiratory volume in 1 second [FEV1] % predicted) than the other weight groups (64.5±22, versus 73.5±21, 68.5±20, and 76.5±21 in normal, overweight, and obese groups respectively, p=0.02). No significant differences were noted between BMI groups for other markers of disease severity at baseline, including exacerbation frequency or hospitalization rates. No significant differences were noted in BMI distribution between patients with and without Pseudomonas, nontuberculous mycobacteria, or by cause of bronchiectasis. The majority of patients demonstrated stable BMI over 5 years. Conclusions: Although underweight patients with bronchiectasis have lower lung function, lower BMI does not appear to relate to other markers of disease severity in this patient population.

Original languageEnglish
Pages (from-to)390-403
Number of pages14
JournalChronic Obstructive Pulmonary Diseases
Volume7
Issue number4
DOIs
StatePublished - 2020

Bibliographical note

Publisher Copyright:
© 2020 JCOPDF.

Funding

The authors would like to acknowledge the COPD Foundation, a 501(c)(3) nonprofit organization, who manages the Bronchiectasis and NTM Research Registry. The Registry is funded by the Richard H. Scarborough Bronchiectasis Research Fund, the Anna-Maria and Stephen Kellen Foundation, and the Bronchiectasis and NTM Industry Advisory Committee. It should also be noted that this work would not have been possible without the comprehensive chart reviews and recording of data by the dedicated research coordinators and principal investigators at each of the participating Registry sites. The authors would also like to acknowledge the staff of the COPD Foundation for their commitment to the success of the Registry. We acknowledge the work of Vira Pravosud who assisted in early data analysis for this project. We acknowledge the editorial assistance of the NC Translational and Clinical Sciences Institute, which is supported by the National Center for Advancing Translational Sciences, National Institutes of Health, through grant award number UL1TR002489. Dr. Addrizzo-Harris reports consultant work from Insmed, advisory board work from AIT, outside the submitted work. Dr. Basavaraj reports grants from the COPD Foundation, personal fees from Hill-Rom, and personal fees from Insmed, outside the submitted work. Dr. Daley reports grants from the COPD Foundation, during the conduct of the study and grants from Insmed, outside the submitted work. Dr. Daniels reports grants and personal fees from Insmed, personal fees from Spark Healthcare, personal fees from International Biophysics Corporation, grants from Zambon, and grants from Parion/Vertex, outside the submitted work. Dr. Noone has received grant support from Aradigm/Grifols, Insmed, Parion/ Vertex and Bayer, and consultancy fees from Bayer, Grifols, and Smartvest. Dr. O’Donnell reports grants from the COPD Foundation/U.S. Bronchiectasis Research Registry, grants and personal fees from Insmed Inc, personal fees from Electromed and Merck, grants and personal fees from Bayer, personal fees from Xellia, and grants from Zambon, Aradigm, and Parion, outside the submitted work. Dr. Olivier reports grants from Beyond Air, Inc, and Matinas Biopharma, outside the submitted work. Dr. Philley reports personal fees from Insmed, Bayer, and Janssen, grants from REPORT trial, outside the submitted work. Dr. Tino reports grants from the U.S. BRR/COPD Foundation, advisory board work from Bayer, Grifols, Aradigm and Cipla, outside the submitted work. Dr. Salathe reports grants from the COPD Foundation (registry), during the conduct of the study; grants and personal fees from the National Institutes of Health, the Flight Attendant Medical Research Institute, and Arrowhead Pharmaceuticals and grants from the James and Esther King Florida Biomedical Research Program, outside the submitted work. Dr. Thomashow reports personal fees from GSK and Astra Zeneca, outside the submitted work. Dr. Winthrop reports grants and personal fees from Insmed, personal fees from Johnson & Johnson, Paratek, Red Hill Biopharma, and Horizon, outside the submitted work. Drs. Aksamit, Barker, Despotes, Choate, DiMango, Eden, Fennelly, Johnson, Knowles, McShane, Metersky, and Schmid have no conflicts of interest to disclose.

FundersFunder number
Anna-Maria and Stephen Kellen Foundation
James and Esther King Florida Biomedical Research Program
Richard H. Scarborough Bronchiectasis Research Fund
National Institutes of Health (NIH)UL1TR002489
Flight Attendant Medical Research Institute
National Center for Advancing Translational Sciences (NCATS)
COPD Foundation
Arrowhead Pharmaceuticals
Bayer Fund

    Keywords

    • BMI
    • Bronchiectasis
    • Nutrition
    • Outcomes
    • U.S. Bronchiectasis research registry

    ASJC Scopus subject areas

    • Pulmonary and Respiratory Medicine

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