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The longitudinal relationship of changes of adiposity to changes in pulmonary function and risk of asthma in a general adult population.

Fenger RV, Gonzalez-Quintela A, Vidal C, Husemoen LL, Skaaby T, Thuesen BH, Aadahl M, Madsen F, Linneberg A - BMC Pulm Med (2014)

Bottom Line: Atopy did not modify these associations.Over a five-year period, increasing adiposity was associated with decreasing lung function, whereas decreasing adiposity was associated with increasing lung function.This effect was significantly greater in males than in females and increased with pre-existing adiposity, but was independent of atopy.

View Article: PubMed Central - PubMed

Affiliation: Research Centre for Prevention and Health, The Capital Region of Denmark, Building 84-85, Nordre Ringvej 57, DK-2600 Glostrup, Denmark. Runa.vavia.fenger@regionh.dk.

ABSTRACT

Background: Adiposity has been linked to both higher risk of asthma and reduced lung function. The effects of adiposity on asthma may depend on both atopic status and gender, while the relationship is less clear with respect to lung function. This study aimed to explore longitudinal weight changes to changes in forced expiratory volume in first second (FEV1) and forced vital capacity (FVC), as well as to incident cases of asthma and wheezing, according to atopy and gender.

Methods: A general population sample aged 19-72 years was examined with the same methodology five years apart. Longitudinal changes in weight, body mass index, waist circumference, and fat percentage (bio-impedance) were analyzed with respect to changes of FEV1 and FVC (spirometry), and incidence of asthma and wheezing (questionnaire). Gender, atopy (serum specific IgE-positivity to inhalant allergens) and adipose tissue mass prior to adiposity changes were examined as potential effect modifiers.

Results: A total of 2,308 persons participated in both baseline and five-year follow-up examinations. Over the entire span of adiposity changes, adiposity gain was associated with decreasing levels of lung function, whereas adiposity loss was associated with increasing levels of lung function. All associations were dependent on gender (p-interactions < 0.0001). For one standard deviation weight gain or weight loss, FEV1 changed with (+/-)72 ml (66-78 ml) and FVC with (+/-)103 ml (94-112 ml) in males. In females FEV1 changed with (+/-) 27 ml (22-32 ml) and FVC with (+/-) 36 ml (28-44 ml). There were no changes in the FEV1/FVC-ratio. The effect of adiposity changes increased with the level of adipose tissue mass at the start of the study (baseline), thus, indicating an aggregate effect of the total adipose tissue mass. Atopy did not modify these associations. There were no statistically significant associations between changes in adiposity measures and risk of incident asthma or wheeze.

Conclusions: Over a five-year period, increasing adiposity was associated with decreasing lung function, whereas decreasing adiposity was associated with increasing lung function. This effect was significantly greater in males than in females and increased with pre-existing adiposity, but was independent of atopy.

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Related in: MedlinePlus

Changes of lung function according to weight changes. Five-year changes of FEV1 (upper panel) and FVC (lower panel) in quintiles of weight change in males (circles) and females (diamonds). Quintile one-two include individuals with weight loss, quintile four-five include individuals with weight gain. The middle quintile is used as reference. Analysis adjusted for age, tobacco use (pack years), and atopy.
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Fig1: Changes of lung function according to weight changes. Five-year changes of FEV1 (upper panel) and FVC (lower panel) in quintiles of weight change in males (circles) and females (diamonds). Quintile one-two include individuals with weight loss, quintile four-five include individuals with weight gain. The middle quintile is used as reference. Analysis adjusted for age, tobacco use (pack years), and atopy.

Mentions: From baseline to five-year follow-up, lung function was inversely associated with the level of adiposity as reflected by all four adiposity measures. In participants with weight gain, lung function declined; whereas in participants with weight loss, lung function increased to a similar extend (Figure 1 and Table 2). This pattern was observed in both males and females but the strength of these associations differed significantly between the two genders (Table 2): For all four adiposity measures, the estimated effect of adiposity changes on changes in FEV1 and FVC were approximately three times higher in males than in females in absolute numbers. The percentage changes were the double in males as compared to females. For instance, for every one standard deviation of weight change (5.4 kg) from baseline to follow-up, FEV1 either increased or decreased with approximately 72 ml (66-78 ml) in males and 26 ml (21-31 ml) in females, similarly FVC either increased or decreased with 111 ml (101-121 ml) in males and 35 ml (27-43 ml) in females. The metabolic markers, s-triglyceride, s-HDL, or HOMA-IR did not attenuate the effects of adiposity measures on changes in FEV1 and FVC (data not shown). Estimated mean declines for one year of increasing age were approximately 32.8 (31.3-34.4) ml FEV1 and 21.4 (19.0-23.9) ml FVC. In never-smokers, the corresponding estimates were 31.0 (28.7-33.3) ml FEV1and 21.0 (17.4-24.6) ml FVC. All age-estimates were essentially similar in males and females but were significantly smaller in younger than in older individuals.Figure 1


The longitudinal relationship of changes of adiposity to changes in pulmonary function and risk of asthma in a general adult population.

Fenger RV, Gonzalez-Quintela A, Vidal C, Husemoen LL, Skaaby T, Thuesen BH, Aadahl M, Madsen F, Linneberg A - BMC Pulm Med (2014)

Changes of lung function according to weight changes. Five-year changes of FEV1 (upper panel) and FVC (lower panel) in quintiles of weight change in males (circles) and females (diamonds). Quintile one-two include individuals with weight loss, quintile four-five include individuals with weight gain. The middle quintile is used as reference. Analysis adjusted for age, tobacco use (pack years), and atopy.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4364582&req=5

Fig1: Changes of lung function according to weight changes. Five-year changes of FEV1 (upper panel) and FVC (lower panel) in quintiles of weight change in males (circles) and females (diamonds). Quintile one-two include individuals with weight loss, quintile four-five include individuals with weight gain. The middle quintile is used as reference. Analysis adjusted for age, tobacco use (pack years), and atopy.
Mentions: From baseline to five-year follow-up, lung function was inversely associated with the level of adiposity as reflected by all four adiposity measures. In participants with weight gain, lung function declined; whereas in participants with weight loss, lung function increased to a similar extend (Figure 1 and Table 2). This pattern was observed in both males and females but the strength of these associations differed significantly between the two genders (Table 2): For all four adiposity measures, the estimated effect of adiposity changes on changes in FEV1 and FVC were approximately three times higher in males than in females in absolute numbers. The percentage changes were the double in males as compared to females. For instance, for every one standard deviation of weight change (5.4 kg) from baseline to follow-up, FEV1 either increased or decreased with approximately 72 ml (66-78 ml) in males and 26 ml (21-31 ml) in females, similarly FVC either increased or decreased with 111 ml (101-121 ml) in males and 35 ml (27-43 ml) in females. The metabolic markers, s-triglyceride, s-HDL, or HOMA-IR did not attenuate the effects of adiposity measures on changes in FEV1 and FVC (data not shown). Estimated mean declines for one year of increasing age were approximately 32.8 (31.3-34.4) ml FEV1 and 21.4 (19.0-23.9) ml FVC. In never-smokers, the corresponding estimates were 31.0 (28.7-33.3) ml FEV1and 21.0 (17.4-24.6) ml FVC. All age-estimates were essentially similar in males and females but were significantly smaller in younger than in older individuals.Figure 1

Bottom Line: Atopy did not modify these associations.Over a five-year period, increasing adiposity was associated with decreasing lung function, whereas decreasing adiposity was associated with increasing lung function.This effect was significantly greater in males than in females and increased with pre-existing adiposity, but was independent of atopy.

View Article: PubMed Central - PubMed

Affiliation: Research Centre for Prevention and Health, The Capital Region of Denmark, Building 84-85, Nordre Ringvej 57, DK-2600 Glostrup, Denmark. Runa.vavia.fenger@regionh.dk.

ABSTRACT

Background: Adiposity has been linked to both higher risk of asthma and reduced lung function. The effects of adiposity on asthma may depend on both atopic status and gender, while the relationship is less clear with respect to lung function. This study aimed to explore longitudinal weight changes to changes in forced expiratory volume in first second (FEV1) and forced vital capacity (FVC), as well as to incident cases of asthma and wheezing, according to atopy and gender.

Methods: A general population sample aged 19-72 years was examined with the same methodology five years apart. Longitudinal changes in weight, body mass index, waist circumference, and fat percentage (bio-impedance) were analyzed with respect to changes of FEV1 and FVC (spirometry), and incidence of asthma and wheezing (questionnaire). Gender, atopy (serum specific IgE-positivity to inhalant allergens) and adipose tissue mass prior to adiposity changes were examined as potential effect modifiers.

Results: A total of 2,308 persons participated in both baseline and five-year follow-up examinations. Over the entire span of adiposity changes, adiposity gain was associated with decreasing levels of lung function, whereas adiposity loss was associated with increasing levels of lung function. All associations were dependent on gender (p-interactions < 0.0001). For one standard deviation weight gain or weight loss, FEV1 changed with (+/-)72 ml (66-78 ml) and FVC with (+/-)103 ml (94-112 ml) in males. In females FEV1 changed with (+/-) 27 ml (22-32 ml) and FVC with (+/-) 36 ml (28-44 ml). There were no changes in the FEV1/FVC-ratio. The effect of adiposity changes increased with the level of adipose tissue mass at the start of the study (baseline), thus, indicating an aggregate effect of the total adipose tissue mass. Atopy did not modify these associations. There were no statistically significant associations between changes in adiposity measures and risk of incident asthma or wheeze.

Conclusions: Over a five-year period, increasing adiposity was associated with decreasing lung function, whereas decreasing adiposity was associated with increasing lung function. This effect was significantly greater in males than in females and increased with pre-existing adiposity, but was independent of atopy.

Show MeSH
Related in: MedlinePlus