{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T23:50:22Z","timestamp":1788825022339,"version":"build-2803163510"},"reference-count":43,"publisher":"European Respiratory Society (ERS)","issue":"3","license":[{"start":{"date-parts":[[2020,7,1]],"date-time":"2020-07-01T00:00:00Z","timestamp":1593561600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["U01HL089856"],"award-info":[{"award-number":["U01HL089856"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["U01HL089897"],"award-info":[{"award-number":["U01HL089897"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["publications.ersnet.org"],"crossmark-restriction":true},"short-container-title":["ERJ Open Res"],"accepted":{"date-parts":[[2020,6,15]]},"published-print":{"date-parts":[[2020,7]]},"abstract":"<jats:sec><jats:title>Rationale<\/jats:title><jats:p>Chronic obstructive pulmonary disease (COPD) comprises distinct phenotypes, all characterised by airflow limitation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>We hypothesised that somatotype changes \u2013 as a surrogate of adiposity \u2013 from early adulthood follow different trajectories to reach distinct phenotypes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec><jats:sec><jats:title>Measurements and main results<\/jats:title><jats:p>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\u2005kg\u00b7m<jats:sup>\u22122<\/jats:sup>) while the other 12% a heavier somatotype (estimated BMI between 25 and 27\u2005kg\u00b7m<jats:sup>\u22122<\/jats:sup>). 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<jats:italic>D<\/jats:italic><jats:sub>LCO<\/jats:sub>(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 (FEV<jats:sub>1<\/jats:sub>),<jats:italic>D<\/jats:italic><jats:sub>LCO<\/jats:sub>, more emphysema and a worse BODE (BMI, airflow obstruction, dyspnoea and exercise capacity) score thus resembling the multiple organ loss of tissue (MOLT) phenotype.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec>","DOI":"10.1183\/23120541.00122-2020","type":"journal-article","created":{"date-parts":[[2020,9,14]],"date-time":"2020-09-14T12:55:52Z","timestamp":1600088152000},"page":"00122-2020","update-policy":"https:\/\/doi.org\/10.1183\/ers-crossmark-policy","source":"Crossref","is-referenced-by-count":14,"title":["Somatotypes trajectories during adulthood and their association with COPD phenotypes"],"prefix":"10.1183","volume":"6","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0770-7653","authenticated-orcid":false,"given":"Miguel J.","family":"Divo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Marin Oto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ciro","family":"Casanova 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