Hu Jingdi, Tang Songwen, Zhu Qijiang, Liao Huai
Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China.
Department of Endocrinology and Diabetes Center, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China.
Sci Rep. 2025 May 9;15(1):16190. doi: 10.1038/s41598-025-99490-y.
Obesity is linked to a greater risk of respiratory diseases. Due to limitations in body mass index (BMI), alternative anthropometric indicators have been developed to reflect body fat distribution. This study compares six anthropometric measures-BMI, waist circumference (WC), the waist-to-height ratio (WHtR), the body roundness index (BRI), the body shape index (ABSI), and the weight-adjusted waist index (WWI)-and their relationships with the prevalence and mortality of obstructive sleep apnoea (OSA), asthma, and chronic obstructive pulmonary disease (COPD) in the US population. Data from four NHANES cycles were analyzed. Multivariable logistic regression assessed the cross-sectional associations between the six anthropometric measures and disease prevalence. Mortality associations were analysed via Cox proportional hazards models, and time‒dependent ROC curve was utilised to evaluate the predictive performance of the significant marker for mortality. BMI, WC, WWI, BRI, ABSI, and WHtR were positively correlated with the prevalence of OSA, and COPD. For asthma, BMI, WC, BRI, and WHtR were positively associated with prevalence, while ABSI and WWI were negatively associated. Concerning mortality, higher WC and BMI were associated with better survival in the OSA and COPD groups, whereas elevated WWI and ABSI were linked to greater mortality risk in the participants with OSA symptoms. An increase of one standard deviation (SD) in the ABSI resulted in an 18% increase in mortality (95% CI 1.09-1.27) for the OSA population. The area under the curve (AUC) for ABSI was 0.752 for 3-year, 0.755 for 5-year, and 0.744 for 10-year mortality. Novel anthropometric indicators, including WWI, BRI, ABSI, and WHtR, show positive associations with the prevalence of OSA, and COPD, alongside traditional measures like BMI and WC. However, WWI and ABSI were more limited in their association with asthma prevalence. Longitudinal analyses revealed that traditional anthropometric indicators such as BMI and WC were negatively associated with mortality risks in the OSA and COPD, supporting the "obesity paradox." ABSI, however, emerged as a significant mortality predictor for OSA, providing a more nuanced view of central obesity's impact on mortality. However, in COPD patients, routine anthropometric measurements may not fully capture the effects of obesity.
肥胖与患呼吸道疾病的风险增加有关。由于体重指数（BMI）存在局限性，人们开发了其他人体测量指标来反映身体脂肪分布。本研究比较了六种人体测量指标——BMI、腰围（WC）、腰高比（WHtR）、身体圆润指数（BRI）、身体形状指数（ABSI）和体重调整腰围指数（WWI）——以及它们与美国人群中阻塞性睡眠呼吸暂停（OSA）、哮喘和慢性阻塞性肺疾病（COPD）的患病率和死亡率之间的关系。分析了四个国家健康与营养检查调查（NHANES）周期的数据。多变量逻辑回归评估了这六种人体测量指标与疾病患病率之间的横断面关联。通过Cox比例风险模型分析死亡率关联，并利用时间依赖性ROC曲线评估显著标志物对死亡率的预测性能。BMI、WC、WWI、BRI、ABSI和WHtR与OSA和COPD的患病率呈正相关。对于哮喘，BMI、WC、BRI和WHtR与患病率呈正相关，而ABSI和WWI与患病率呈负相关。关于死亡率，较高的WC和BMI与OSA和COPD组的较好生存率相关，而WWI和ABSI升高与有OSA症状参与者的更高死亡风险相关。ABSI每增加一个标准差（SD），OSA人群的死亡率就会增加18%（95%CI 1.09 - 1.27）。ABSI的曲线下面积（AUC）在3年死亡率时为0.752，5年死亡率时为0.755，10年死亡率时为0.744。包括WWI、BRI、ABSI和WHtR在内的新型人体测量指标与OSA和COPD的患病率呈正相关，与BMI和WC等传统指标一样。然而，WWI和ABSI与哮喘患病率的关联更为有限。纵向分析表明，BMI和WC等传统人体测量指标与OSA和COPD的死亡风险呈负相关，支持“肥胖悖论”。然而，ABSI成为OSA的一个重要死亡率预测指标，为中心性肥胖对死亡率的影响提供了更细致入微的观点。然而，在COPD患者中，常规人体测量可能无法完全捕捉肥胖的影响。
