Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunan-ro, Jongno-gu, Seoul, 03181, Republic of Korea.
Department of Internal Medicine, Jeju National University Hospital, Jeju National University School of Medicine, Jeju, Republic of Korea.
Sci Rep. 2023 Mar 27;13(1):4938. doi: 10.1038/s41598-023-31960-7.
We investigated the association of metabolically healthy (MH) and unhealthy (MU) obesity with incident lung dysfunction. This cohort study included 253,698 Korean lung disease-free adults (mean age, 37.4 years) at baseline. Spirometry-defined lung dysfunction was classified as a restrictive pattern (RP) or obstructive pattern (OP). We defined obesity as BMI ≥ 25 kg/m and MH as the absence of any metabolic syndrome components with a homeostasis model assessment of insulin resistance < 2.5: otherwise, participants were considered MU. During a median follow-up of 4.9 years, 10,775 RP cases and 7140 OP cases develped. Both MH and MU obesity showed a positive association with incident RP, with a stronger association in the MU than in the MH group (P = 0.001). Multivariable-adjusted hazard ratios (95% CI) for incident RP comparing obesity to the normal-weight category was 1.15 (1.05-1.25) among the MH group and 1.38 (1.30-1.47) among MU group. Conversely, obesity was inversely associated with OP because of a greater decline in forced vital capacity than forced expiratory volume in 1 s. Both MH and MU obesity were positively associated with RP. However, the associations between obesity, metabolic health, and lung functions might vary depending on the type of lung disease.
我们研究了代谢健康（MH）和不健康（MU）肥胖与新发肺功能障碍的相关性。这项队列研究纳入了 253698 名韩国无肺部疾病的成年人（平均年龄 37.4 岁）作为基线人群。根据肺量计定义的肺功能障碍分为限制型模式（RP）或阻塞型模式（OP）。我们将肥胖定义为 BMI≥25kg/m2，将 MH 定义为不存在任何代谢综合征成分且稳态模型评估的胰岛素抵抗<2.5：否则，参与者被认为是 MU。在中位随访 4.9 年期间，有 10775 例 RP 病例和 7140 例 OP 病例发生。MH 和 MU 肥胖均与新发 RP 呈正相关，MU 肥胖的相关性强于 MH 肥胖（P=0.001）。在多变量调整的危险比（95%CI）中，与正常体重组相比，MH 组肥胖发生 RP 的比值比为 1.15（1.05-1.25），MU 组为 1.38（1.30-1.47）。相反，由于用力肺活量的下降大于 1 秒用力呼气量，肥胖与 OP 呈负相关。MH 和 MU 肥胖均与 RP 呈正相关。然而，肥胖、代谢健康和肺功能之间的关联可能因肺部疾病的类型而异。
