Rapid decline in lung function is temporally associated with greater metabolically active adiposity in a longitudinal study of healthy adults

Abstract

Rationale Adiposity is associated with low lung function, but the longitudinal relationship between lung function and adiposity is inadeguately studied. Objective To examine the bidirectional longitudinal associations between rapid decline in lung function and adiposity phenotypes in healthy adults. Methods This secondary analysis used a 25-year longitudinal dataset from the Coronary Artery Risk Development in Young Adults (CARDIA) study that enrolled 5115 participants. Measurements In the first analysis, metabolic syndrome at or before CARDIA year (Y) 10 (Y10) was the predictor, and subseguent rapid decline in forced vital capacity (FVC) or forced expiratory volume in 1 s (FEV1) between Y10 and Y20 was the outcome. In the second analysis, rapid decline was the predictor, and incident metabolic syndrome at Y20 and/or Y25 was the outcome. In the third analysis, rapid decline was the predictor, and subseguent CT-assessed regional fat depots at Y25 were the outcome. Results Metabolic syndrome at or before Y10 is temporally associated with rapid decline in FVC between Y10 and Y20 (adjusted p=0.04), but this association was explained by body mass index (BMI) at Y10. Rapid decline in FVC or FEV1 is temporally associated with greater incident metabolic syndrome at Y20 and/or Y25 (adjusted OR 2.10 (1.69, 2.61); p<0.001, and 1.56 (1.26, 1.94); p<0.001, respectively) and greater CT-assessed intrathoracic visceral adiposity at Y25 (adjusted standardised β 0.09; p<0.001 for both analyses). These associations were not explained by BMI levels prior to the outcome measurement. Conclusions Healthy adults with rapid decline in lung function are at risk for developing metabolic syndrome and for disproportionate accumulation of intrathoracic visceral fat. Metabolic abnormalities may be an early extrapulmonary manifestation of lung impairment that may be preventable by improving lung health.

Body Composition and COPD: A New Perspective

“…are produced by excessive adipose tissue, 56 which actively contribute to the body’s inflammatory reaction process of the organism. 50 , 57 , 58 The aberrant build up of VAT in COPD patients may worsen airway obstruction by decreasing lung compliance, impairing chest wall or diaphragm movement. 59 …”

“…In patients with COPD, the WBC count and the serum levels of CRP, IL-6 and fibrinogen, but not those of IL-8 and TNF-α, tended to increase with the severity of airflow limitation. Damien Viglino et al 58 2020 Prospective study Canada Age, gender, smoking status, weight, height, WC, Pittsburgh Sleep Quality Index, hip circumferences, glucose, lipid profiles, lung function, VAT, Blood sample and biochemical analysis Triglycerides, total/HDL cholesterol ratio and HOMA-IR were positively associated with the three indices of adiposity (BMI, waist-to-hip ratio and VAT area) in individuals with COPD and controls. (all regression lines with a p<0.05).…”

Regular Physical Activity Levels and Incidence of Restrictive Spirometry Pattern: A Longitudinal Analysis of 2 Population-Based Cohorts

“…One hypothesis is that physical activity prevents weight-gain in the aging population, whose lung function is in the declining phase. Indeed, weight-gain (BMI increase) has been associated with accelerated FVC decline over 10-years in adults (19), which could result in a higher risk of incident restrictive spirometry pattern. This hypothesis is not fully supported by our study because the association between physical activity and the incidence of restrictive spirometry pattern remained after adjustment by BMI changes during follow-up.…”

Glomerular hyperfiltration may be a novel risk factor of restrictive spirometry pattern: Analysis of the Korea National Health and Nutrition Examination Survey (KNHANES) 2009-2015

“…Since the purpose of this study was to investigate the nature of the RSP, we defined the RSP as the outcome with MetS and GHF as the exposure variable. However, it is also true that RSP is an important exposure for metabolic disorders and kidney diseases [52, 53]. Therefore, multi-dimensional approaches are required for a better understanding of the RSP characteristics.…”