Features of Functional Indicators in Chronic Obstructive Pulmonary Disease Patients with Obesity

The review article examines the question of the dependence of some functional parameters in chronic obstructive pulmonary disease patients depending from obesity. The low body mass index was considered an independent risk factor for mortality in chronic obstructive pulmonary disease patients, however, several studies showed a significant aggravation of the respiratory symptoms, limiting physical activity and aggravation the quality of life when chronic obstructive pulmonary disease combine with obesity. Today, the problem of obesity effects on the severity of chronic obstructive pulmonary disease remains unclear, which may be due to differences in research methodology, cohort groups selection, statistical analysis methodology and requires further research for final responses. According to the last recommendations, five clinical phenotypes of chronic obstructive pulmonary disease were identified. One of them is the phenotype of chronic obstructive pulmonary disease with obesity, which develops due to chronic inflammation of low intensity, due to the presence of hormones, neurotransmitters, adipocytokines, pro- and anti-inflammatory interleukins in the adipose tissue, which contribute to the progression of chronic obstructive pulmonary disease, pulmonary insufficiency due to chronic hypoxia. Obesity has a direct effect on the physiology of respiration due to increased chest resistance, limitation of diaphragmatic excursion, dysfunction of the contractile ability of the respiratory muscles. Thus, increase the body weight in chronic obstructive pulmonary disease patients leads to the decrease of FEV1, FVC, FEV1/FVC, residual and total exhalation rates, which confirmed by a number of studies. In addition to the decrease of spirometric indicators, obesity in chronic obstructive pulmonary disease patients significantly reduces tolerance to physical activity and increase the degree of breathlessness. The difference in the physiological response to various loads, the weakness of skeletal muscles and the presence of concomitant diseases is the reason for reducing tolerance to physical activity in chronic obstructive pulmonary disease patients with obesity. For today the question of mechanisms of obesity influence on the functional state of chronic obstructive pulmonary disease patients remains discursive. Possibly, the relationship between diseases is affected by several factors, such as the chronic obstructive pulmonary disease phenotype and the distribution of adipose tissue.