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Body Mass Index and Mortality in Patients with Idiopathic Pulmonary Fibrosis

Mazen Alakhras, MD^*; Paul A Decker, MS; Hassan F. Nadrous, MD^*; Maria Collazo-Clavell, MD and Jay H. Ryu, MD^*

^*Division of Pulmonary and Critical Care Medicine Division of Biostatistics Division of Endocrinology, Diabetes, Metabolism, Nutrition, Mayo Clinic, Rochester, MN

ryu.jay{at}mayo.edu

Abstract

BackgroundTo examine the relationship between body mass index BMI and mortality in patients with idiopathic pulmonary fibrosis IPF.

MethodsWe studied a cohort of patients with IPF seen at the Mayo Clinic Rochester during 1994 through 1996. These patients met the current consensus definition of IPF. We excluded patients with prior treatment for IPF, no follow-up data, or no pulmonary function results available at the index visit.

ResultsOf the 197 patients fulfilling the inclusion criteria the mean age ± SD was 71.4 yrs ± 8.9, 137 70% were men, and the mean BMI was 28.2 ± 4.6. These patients were categorized by BMI into three groups: <25, 25-30, and 30. There were 46 patients 23% with a BMI <25 with a median survival of 3.6 yrs 1-yr survival 76% [95% CI, 65%-90%], 3-yr survival 54% [95% CI, 41%-70%]. The second group consisted of 85 patients 43% with a BMI between 25-30 and had a median survival of 3.8 years 1-year survival 84% [95% CI, 76%-92%], 3-year survival 58% [95% CI, 48%-70%]. The final group consisted of 66 patients 34% with a BMI 30 and had a median survival of 5.8 years 1-year survival 91% [95% CI, 84%-98%], 3-year survival of 69% [95% CI, 58%-81%]. Using a proportional hazards regression model, survival was significantly associated with BMI hazard ratio=0.93 for each 1 unit increase in BMI; 95% CI: 0.89-0.97; p=0.002 with increased BMI being associated with better survival.

ConclusionHigher BMI was associated with better survival in patients with IPF.

Key Words: Pulmonary fibrosis • Nutrition • Interstitial lung disease • Body mass index • Prognosis • Mortality