Subjectively reported unintentional weight loss in patients with COPD was associated with a significantly greater risk of mortality (HR 1.78; 95% CI 1.46-2.16; p < 0.001).
Cohort (n=2,868)
Effect estimate: HR 1.78 (95% CI 1.46-2.16)
p-value: p=< 0.001
Abstract Rationale The presence of various wasting phenotypes has been associated with increased risk of mortality in people with chronic obstructive pulmonary disease (COPD). Subjectively reported unintentional weight loss (UWL) is a simple criterion capturing wasting. In the current report, we aimed to identify characteristics of people with COPD who reported unintentional weight loss and assess its impact on mortality in COPD. Methods Participants in the Genetic Epidemiology of COPD (COPDGene) study with post-bronchodilator forced expiratory volume in one second (FEV1) to forced vital capacity (FVC) ratio 0.7, and 10-pack-year smoking history were included. Participants were asked whether they had experienced unintentional weight loss in the last 12 months at the Phase 2 visit and their answer formed our UWL trait of interest. Chi-squared tests and t-tests were used to assess the relationship between unintentional weight loss with categorical and continuous variables. Survival was modeled using a multivariable Cox proportional hazards model adjusting for age, sex, and BODE index, which includes measures of body mass, obstruction, dyspnea, and exercise capacity. Kaplan-Meier curves of survival were fit by unintentional weight loss group. Results Of 2,868 participants with COPD, 366 (12.8%) reported UWL. Age and sex were not significantly different between COPD participants with and without UWL. Those with UWL were more likely to be current smokers (43% vs 34%, p 0.001) and tended to have worse spirometry, with lower FEV1pp (58.6±23.6% vs 63.9±23.6%, p 0.001) and FEV1/FVC ratio (0.53±0.14 vs 0.56±0.13, p 0.001). Bodyweight (71.6±18.4kg vs 82.1±19.4kg, p 0.001) and body mass index (24.9±5.92kg/m2 vs 28.5±6.08 kg/m2, p 0.001) were both lower in the UWL group. Dyspnea was greater among those with UWL (modified Medical Research Council dyspnea score 2.07±1.49 vs 1.61±1.44, p 0.001), while disease-related quality of life lower (St. George’s Respiratory Questionnaire score: 39.7±23.7 vs 30.2±21.4, p 0.001). Those with UWL also had shorter 6-minute walk distance (1,078±467ft vs 1209±437ft, p 0.001) and greater risk of death (hazard ratio (95% confidence interval) = 1.78 (1.46-2.16), p 0.001, Figure 1). Conclusion In people with COPD, subjectively reported UWL is associated with worse pulmonary function, and impaired quality of life measures as well as substantially increased risk for mortality. Further research is needed to determine whether early detection of UWL in COPD is a treatable trait. This abstract is funded by: This work was supported by NHLBI grants U01 HL089897 and U01 HL089856 and by NIH contract 75N92023D00011
Chiles et al. (2026) conducted a cohort in Chronic obstructive pulmonary disease (COPD) (n=2,868). Subjectively reported unintentional weight loss vs. No unintentional weight loss was evaluated on Mortality (HR 1.78, 95% CI 1.46-2.16, p=< 0.001). Subjectively reported unintentional weight loss in patients with COPD was associated with a significantly greater risk of mortality (HR 1.78; 95% CI 1.46-2.16; p < 0.001).