Chest
Volume 129, Issue 4, April 2006, Pages 853-862
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Original Research
Pulmonary Function and Abdominal Adiposity in the General Population

https://doi.org/10.1378/chest.129.4.853Get rights and content

Background

The prevalence of obesity is increasing, and there is evidence that obesity, in particular abdominal obesity as a marker of insulin resistance, is negatively associated with pulmonary function. The mechanism for this association and the best marker of abdominal adiposity in relation to pulmonary function is not known.

Study objective

We assessed the association between pulmonary function and weight, body mass index (BMI), waist circumference, waist/hip ratio, and abdominal height as markers of adiposity and body fat distribution. We used multiple linear regression to analyze the association of pulmonary function (ie, FEV1 and FVC) [with maneuvers performed in the sitting position] with overall adiposity markers (ie, weight and BMI) and abdominal adiposity markers, stratified by gender, and adjusted for height, age, race, smoking, and other covariates.

Setting and participants

A random sample of individuals (n = 2,153) from the general population living in western New York state, 35 to 79 years of age.

Results

In women, abdominal height and waist circumference were negatively associated with FEV1 percent predicted, while all five adiposity markers were negatively associated with FVC percent predicted. In men, all overall and abdominal adiposity markers were inversely associated with FEV1 percent predicted and FVC percent predicted.

Conclusion

These results suggest that abdominal adiposity is a better predictor of pulmonary function than weight or BMI, and investigators should consider it when investigating the determinants of pulmonary function.

Section snippets

Study Subjects

We recruited participants from Erie and Niagara counties in western New York, as previously described.17 In brief, we recruited a sample of the general population using lists supplied by the New York State Department of Motor Vehicles (respondents aged 35 to 65 years) and the Health Care Financing Administration (respondents aged > 65 years). We used letters and telephone contact to recruit participants. All study protocols were approved by the University at Buffalo institutional review board.

Results

The mean age of participants in the sample was 56.8 years (SD, 11.3 years) for women and 58.5 years (SD, 12.5 years) for men. Approximately 6.5% of all participants were African-American. Raw FEV1 and FVC values were higher for men, but once we removed the effects of age, height, and race, FEV1 percent predicted and FVC percent predicted values were higher for women (p < 0.001). More women in our sample were current smokers, but men had a higher lifetime exposure to cigarettes (p < 0.001). The

Discussion

We investigated the relation of a number of adiposity markers with pulmonary function in a population-based study. We found inverse associations of abdominal height and waist circumference with pulmonary function in men and women with BMI values of ≥ 25 kg/m2. Abdominal height and waist circumference explained the greatest proportion of variance in FEV1 and FVC relative to other markers of adiposity. Also, the inverse association of abdominal height and pulmonary function was evident only in

Conclusion

We found negative associations of abdominal adiposity and pulmonary function in men and women from the general population that are not limited to severely obese persons. Abdominal adiposity is an important determinant of impaired pulmonary function, and it is of greater importance than overall adiposity markers such as weight and BMI. We suggest that investigators consider the inclusion of markers of abdominal adiposity as a potential confounding factor when investigating the determinants of

ACKNOWLEDGMENT

We thank Richard W. Browne in the Department of Clinical Laboratory Science at the University at Buffalo for laboratory measurements. We would also like to thank the personnel at the Center for Preventive Medicine, University at Buffalo, for their contribution to the study.

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    Drs. Ochs-Balcom, Grant, Muti, Freudenheim, Trevisan, Cassano, and Schünemann disclose that they have received no financial support or had involvement with organizations with a financial interest in the subject matter of this study.

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