Gong Entong, Kou Ziwei, Li Yinan, Li Qinghai, Yu Xinjuan, Wang Tao, Han Wei
Graduate School, Dalian Medical University.
Department of Respiratory and Critical Care Medicine, Qingdao Hospital, University of Health and Rehabilitation Sciences (Qingdao Municipal Hospital).
Environ Health Prev Med. 2025;30:64. doi: 10.1265/ehpm.25-00059.
Despite some studies identifying a potential association between obesity and chronic obstructive pulmonary disease (COPD) risk, previous research had overlooked the dynamic nature of body weight over time, leading to inconsistent findings. The purpose of this study is to elucidate the relationship between adult weight change and COPD risk by adjusting for potential confounding factors.
We conducted a retrospective analysis using data from ten NHANES cycles (1999-2018), including adults aged 40-74 years. Weight change patterns were assessed using BMI at three time points and classified into five categories per period. Absolute weight change was also grouped into five levels. Multivariate logistic regression models, incorporating sampling weights, were used to examine associations between weight change and COPD, adjusting for demographic and lifestyle covariates.
Compared with participants who maintained normal weight, stable obesity participants had increased risk of COPD from age 25 years to 10 years before the survey (OR = 1.45, 95% CI = 1.15 to 1.83), in the 10 years period before the survey (OR = 1.75, 95% CI = 1.47 to 2.08), and from age 25 years to survey (OR = 1.84, 95% CI = 1.46 to 2.31). Three periods indicate that weight gain in adulthood was associated with risk of COPD. In addition, substantial weight gain of more than 20 kg was associated with a higher risk of COPD. In stratified analyses, we also observed a more significant association between weight change and the risk of COPD in never smokers compared to former smokers.
Our study suggested that stable obesity and weight gain in adulthood were associated with an increased risk of COPD compared to those who maintain a normal weight, and that the association between weight gain and the incidence of COPD appears closer in patients who have never smoked.
尽管一些研究发现肥胖与慢性阻塞性肺疾病（COPD）风险之间可能存在关联，但以往的研究忽略了体重随时间的动态变化性质，导致研究结果不一致。本研究的目的是通过调整潜在混杂因素来阐明成人体重变化与COPD风险之间的关系。
我们使用来自十个国家健康与营养检查调查（NHANES）周期（1999 - 2018年）的数据进行了一项回顾性分析，研究对象为40 - 74岁的成年人。通过三个时间点的体重指数（BMI）评估体重变化模式，并将每个时期分为五类。绝对体重变化也分为五个等级。采用纳入抽样权重的多变量逻辑回归模型来检验体重变化与COPD之间的关联，并对人口统计学和生活方式协变量进行调整。
与体重维持正常的参与者相比，在调查前25岁至10年期间（比值比[OR]=1.45，95%置信区间[CI]=1.15至1.83）、调查前10年期间（OR = 1.75，95% CI = 1.47至2.08）以及25岁至调查期间（OR = 1.84，95% CI = 1.46至2.31），稳定肥胖的参与者患COPD的风险增加。这三个时期表明成年期体重增加与COPD风险相关。此外，体重增加超过20 kg与更高的COPD风险相关。在分层分析中，我们还观察到与曾经吸烟者相比，从不吸烟者体重变化与COPD风险之间的关联更为显著。
我们的研究表明，与体重维持正常的人相比，成年期稳定肥胖和体重增加与COPD风险增加相关，并且体重增加与COPD发病率之间的关联在从不吸烟的患者中似乎更为密切。
