Longitudinal association between adiposity changes and lung function deterioration
Youngmok Park, Ji Young Kim, Young Sam Kim, Ah Young Leem, Jinyeon Jo, Kyung Soo Chung, Moo Suk Park, Sungho Won, Ji Ye Jung
Abstract
Abstract Background The longitudinal relationship between adiposity and lung function is controversial. We aimed to investigate the long-term association between adiposity changes and lung function in a middle-aged general Asian population. Methods In total, 5011 participants (average age, 54 years; 45% men) were enrolled from a community-based prospective cohort. During the follow-up period (median 8 years), both spirometry and bio-electrical impedance analysis were performed biannually. Individual slopes of the fat mass index (FMI; fat mass divided by the square of height in meters) and waist-to-hip ratio (WHR) were calculated using linear regression analysis. Multivariate linear mixed regression analysis was used to determine the long-term association between adiposity changes and lung function. Results The FMI was inversely associated with forced vital capacity (FVC) (estimated: − 31.8 mL in men, − 27.8 mL in women) and forced expiratory volume in 1 s (FEV 1 ) (estimated: − 38.2 mL in men, − 17.8 mL in women) after adjusting for baseline age, height, residential area, smoking exposure (pack-years, men only), initial adiposity indices, and baseline lung function. The WHR was also inversely associated with FVC (estimated = − 1242.2 mL) and FEV 1 (estimated = − 849.8 mL) in men. The WHR-increased group showed a more rapid decline in lung function than the WHR-decreased group in both the fat-gain and fat-loss groups. Conclusion Adiposity was associated with the long-term impairment of lung function. Central obesity was the main driver of lung function impairment in the middle-aged general Asian population, regardless of fat mass changes.