Zutler Moshe, Singer Jonathan P, Omachi Theodore A, Eisner Mark, Iribarren Carlos, Katz Patricia, Blanc Paul D
Department of Pulmonary, Critical Care, Allergy and Sleep Medicine, University of California, San Francisco, California 94143, USA.
Prim Care Respir J. 2012 Jun;21(2):194-201. doi: 10.4104/pcrj.2012.00028.
Obesity contributes to respiratory symptoms and exercise limitation, but the relationships between obesity, airflow obstruction (AO), respiratory symptoms and functional limitation are complex.
To determine the relationship of obesity with airflow obstruction (AO) and respiratory symptoms in adults without a previous diagnosis of chronic obstructive pulmonary disease (COPD).
We analysed data for potential referents recruited to be healthy controls for an ongoing study of COPD. The potential referents had no prior diagnosis of COPD or healthcare utilisation attributed to COPD in the 12 months prior to recruitment. Subjects completed a structured interview and a clinical assessment including body mass index, spirometry, six-minute walk test (SMWT), and the Short Performance Physical Battery (SPPB). Multiple regression analyses were used to test the associations of obesity (body mass index >30 kg/m2) and smoking with AO (forced expiratory volume in 1s/forced vital capacity ratio <0.7). We also tested the association of obesity with respiratory symptoms and impaired functional capacity (SPPB, SMWT), adjusting for AO.
Of 371 subjects (aged 40-65 years), 69 (19%) had AO. In multivariate analysis, smoking was positively associated with AO (per 10 pack-years, OR 1.24; 95% CI 1.04 to 1.49) while obesity was negatively associated with AO (OR 0.54; 95% CI 0.30 to 0.98). Obesity was associated with increased odds of reporting dyspnoea on exertion (OR 3.6; 95% CI 2.0 to 6.4), productive cough (OR 2.5; 95% CI 1.1 to 6.0), and with decrements in SMWT distance (67 ± 9 m; 95% CI 50 to 84 m) and SPPB score (OR 1.9; 95% CI 1.1 to 3.5). None of these outcomes was associated with AO.
Although AO and obesity are both common among adults without an established COPD diagnosis, obesity (but not AO) is linked to a higher risk of reporting dyspnoea on exertion, productive cough, and poorer functional capacity.
肥胖会导致呼吸症状和运动受限，但肥胖、气流阻塞（AO）、呼吸症状和功能受限之间的关系很复杂。
确定肥胖与气流阻塞（AO）以及在既往未诊断为慢性阻塞性肺疾病（COPD）的成年人中的呼吸症状之间的关系。
我们分析了为一项正在进行的COPD研究招募的潜在对照者的数据。这些潜在对照者在招募前12个月内没有COPD的既往诊断或归因于COPD的医疗保健利用情况。受试者完成了结构化访谈和临床评估，包括体重指数、肺功能测定、六分钟步行试验（SMWT）和简短体能测试（SPPB）。多元回归分析用于检验肥胖（体重指数>30 kg/m²）和吸烟与AO（一秒用力呼气量/用力肺活量比值<0.7）之间的关联。我们还检验了肥胖与呼吸症状和功能能力受损（SPPB、SMWT）之间的关联，并对AO进行了校正。
在371名受试者（年龄40 - 65岁）中，69名（19%）有AO。在多变量分析中，吸烟与AO呈正相关（每10包年，OR 1.24；95% CI 1.04至1.49），而肥胖与AO呈负相关（OR 0.54；95% CI 0.30至0.98）。肥胖与运动时报告呼吸困难的几率增加（OR 3.6；95% CI 2.0至6.4）、咳痰性咳嗽（OR 2.5；95% CI 1.1至6.0）以及SMWT距离减少（67±9 m；95% CI 50至84 m）和SPPB评分降低（OR 1.9；95% CI 1.1至3.5）相关。这些结果均与AO无关。
尽管AO和肥胖在未确诊COPD的成年人中都很常见，但肥胖（而非AO）与运动时报告呼吸困难、咳痰性咳嗽的较高风险以及较差的功能能力有关。
