Guangzhou No.12 Hospital, Guangzhou, Guangdong, China.
School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong Province, China; School of Public Health, The University of Hong Kong, Hong Kong, China.
Respir Med. 2017 Nov;132:102-108. doi: 10.1016/j.rmed.2017.10.003. Epub 2017 Oct 7.
We examined the association between different adiposity indices and pulmonary function in Chinese adults in the Guangzhou Biobank Cohort Study (GBCS).
Participants with body mass index (BMI) < 18.5 (underweight) were excluded. Adiposity indices including BMI, waist circumference (WC), waist hip ratio, waist height ratio and body fat percentage were measured. Lung function was assessed by spirometry using a turbine flowmeter. We analyzed percent predicted for forced expiratory volume in 1 s (FEV%), forced vital capacity (FVC %) and restrictive respiratory defect (FEV/FVC ratio > low limits of normal and FVC % <0.80).
Of 16186 participants (mean age 61.4 ± 7.2 years; 74.0% women), 116 (0.7%) had only general obesity (BMI ≥28 kg/m), 4079 (25.2%) had only central obesity (WC: ≥90 cm in men, ≥80 cm in women) and 1591 (9.8%) had both central obesity and general obesity. Comparing to those with neither central nor general obesity, those with only central adiposity and with both central and general obesity had lower pulmonary function (adjusted β range from -2.85 to -6.02 for FEV% and FVC%, adjusted OR range from 1.14 to 1.70, all P < 0.05). But those with only general obesity had better but non-significant pulmonary function. (Crude β range from 1.46 to 2.92 for FEV% and FVC%, crude OR range from 0.68 to 0.93, all P > 0.05). Both FEV% and FVC% decreased per standard deviation increase in obesity indices (adjusted β from -0.46 to -3.17, all P < 0.002). A positive association of central or general obesity with restrictive respiratory defect was observed (adjusted odds ratio (AOR) from 1.50 to 2.04, all P < 0.002). Further adjustment for WC reversed the inverse association between BMI and pulmonary function (adjusted β from 1.93 to 6.22, all P < 0.001) and restrictive respiratory defect (adjusted AOR from 0.72 to 0.80, all P < 0.001).
Central adiposity and its indices, but not general adiposity and BMI, were independently associated with lower pulmonary function and higher risk of restrictive respiratory defect in older Chinese.
我们在广州生物银行队列研究（GBCS）中研究了不同肥胖指数与中国成年人肺功能之间的关系。
排除体重指数（BMI）<18.5（体重不足）的参与者。测量了肥胖指数，包括 BMI、腰围（WC）、腰臀比、腰高比和体脂百分比。使用涡轮流量计通过肺活量计评估肺功能。我们分析了用力呼气量 1 秒（FEV1%）、用力肺活量（FVC%）和限制性呼吸缺陷（FEV/FVC 比值>正常低值和 FVC%<0.80）的预测百分比。
在 16186 名参与者（平均年龄 61.4±7.2 岁；74.0%为女性）中，116 名（0.7%）仅患有普通肥胖症（BMI≥28kg/m），4079 名（25.2%）仅患有中心性肥胖症（男性 WC：≥90cm，女性≥80cm），1591 名（9.8%）同时患有中心性肥胖症和普通肥胖症。与既无中心性肥胖也无普通肥胖的参与者相比，仅存在中心性肥胖和同时存在中心性肥胖和普通肥胖的参与者的肺功能较低（调整后的β范围为 FEV%和 FVC%从-2.85 到-6.02，调整后的 OR 范围为 1.14 到 1.70，均 P<0.05）。但那些仅患有普通肥胖症的人肺功能有改善但不显著。（FEV%和 FVC%的未经调整β范围分别为 1.46 至 2.92，未经调整的 OR 范围分别为 0.68 至 0.93，均 P>0.05）。肥胖指数每增加一个标准差，FEV%和 FVC%均降低（调整后的β值范围为-0.46 至-3.17，均 P<0.002）。观察到中心性肥胖或普通肥胖与限制性呼吸缺陷之间存在正相关（调整后的优势比（AOR）范围为 1.50 至 2.04，均 P<0.002）。进一步调整 WC 后，BMI 与肺功能（调整后的β值从 1.93 到 6.22，均 P<0.001）和限制性呼吸缺陷（调整后的 AOR 从 0.72 到 0.80，均 P<0.001）之间的负相关关系逆转。
在中国老年人中，中心性肥胖及其指数与较低的肺功能和较高的限制性呼吸缺陷风险相关，而不是普通肥胖和 BMI。
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