Fenger Runa V, Gonzalez-Quintela Arturo, Vidal Carmen, Husemoen Lise-Lotte, Skaaby Tea, Thuesen Betina H, Aadahl Mette, Madsen Flemming, Linneberg Allan
Research Centre for Prevention and Health, The Capital Region of Denmark, Building 84-85, Nordre Ringvej 57, DK-2600 Glostrup, Denmark.
BMC Pulm Med. 2014 Dec 22;14:208. doi: 10.1186/1471-2466-14-208.
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.
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.
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.
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.
肥胖与哮喘风险增加和肺功能下降均有关联。肥胖对哮喘的影响可能取决于特应性状态和性别，而其与肺功能的关系尚不太明确。本研究旨在探讨根据特应性和性别，体重的纵向变化与第一秒用力呼气量（FEV1）、用力肺活量（FVC）变化以及哮喘和喘息发病情况之间的关系。
对年龄在19至72岁的一般人群样本每隔五年采用相同方法进行检查。分析体重、体重指数、腰围和脂肪百分比（生物电阻抗法）的纵向变化与FEV1和FVC变化（肺量计）以及哮喘和喘息发病率（问卷调查）之间的关系。将性别、特应性（对吸入性过敏原血清特异性IgE阳性）以及肥胖变化前的脂肪组织量作为潜在效应修饰因素进行研究。
共有2308人参与了基线检查和五年后的随访检查。在整个肥胖变化期间，肥胖增加与肺功能水平下降相关，而肥胖减轻与肺功能水平上升相关。所有关联均取决于性别（p交互作用<0.0001）。对于体重增加或减少一个标准差，男性的FEV1变化为（+/-）72毫升（66 - 78毫升），FVC变化为（+/-）103毫升（94 - 112毫升）。女性的FEV1变化为（+/-）27毫升（22 - 32毫升），FVC变化为（+/-）36毫升（28 - 44毫升）。FEV1/FVC比值无变化。肥胖变化的影响随着研究开始时（基线）脂肪组织量的增加而增大，因此表明总脂肪组织量具有累积效应。特应性并未改变这些关联。肥胖测量指标的变化与哮喘或喘息发病风险之间无统计学显著关联。
在五年期间，肥胖增加与肺功能下降相关，而肥胖减轻与肺功能上升相关。这种效应在男性中比在女性中显著更大，且随着既往肥胖程度增加而增大，但与特应性无关。
