Body fat distribution, body composition, and respiratory function in elderly men

Relationship between obesity, body composition, and pulmonary function among Korean adults aged 40 years and older

Pulmonary function is influenced by factors such as age, sex, height, and weight. This study investigated the relationship between obesity, body composition, and pulmonary function measures (forced expiratory volume in one second [FEV1], forced vital capacity [FVC], and the FEV1-to-FVC ratio) of Korean adults aged 40 years and older. Using the fifth Korea national health and nutrition examination survey in 2010 and 2011, multiple regression analyses were performed to identify factors associated with pulmonary function, stratified by sex. Independent variables were waist circumference (WC) and an additional measure of obesity/muscularity (weight in model 1, body mass index [BMI] in model 2, and fat-free mass index [FFMI] in model 3). Among 3918 adults, the mean FFMI was 17.7 and 15.0 kg/m2 for men and women, respectively. Weight and BMI were positively associated with only FEV1 (B = 0.003 and B = 0.006, respectively, p < 0.01) and the FEV1-to-FVC ratio (B = 0.001, p < 0.01) in women. FFMI was positively associated with FEV1 and FVC in both sexes (B = 0.019, p < 0.05 for FEV1 and B = 0.020, p < 0.01 for FVC in men; B = 0.025, p < 0.0001 for FEV1 and B = 0.022, p < 0.0001 for FVC in women). WC was inversely associated with FEV1 and FVC in men and FEV1 in women, respectively. Weight and BMI behaved as indicators of body size based on their positive associations with pulmonary function. In conclusion, FFMI can be an important and consistent predictor of pulmonary function in both men and women.

Bioelectrical impedance and lung function-associations with gender and central obesity: results of the EpiHealth study

BACKGROUND

Obesity is a major public health concern associated with various health problems, including respiratory impairment. Bioelectrical impedance (BIA) is used in health screening to assess body fat. However, there is no consensus in healthcare on how body fat should be assessed in relation to lung function. In this study, we aimed to investigate how BIA in relation to waist circumference contribute, using data from a large Swedish population study.

METHODS

A total of 17,097 participants (aged 45-75 years) were included in the study. The relationships between fat mass, waist circumference, and lung function were analysed using weighted quantile sum regression.

RESULTS

Increased fat mass was significantly associated with decreased lung function (FEV1, FVC) in both sexes. Also, the influence of trunk fat and waist circumference on FVC and FEV1 differed by sex: in males, waist circumference and trunk fat had nearly equal importance for FVC (variable weights of 0.42 and 0.41), whereas in females, trunk fat was significantly more important (variable weights 0.84 and 0.14). For FEV1, waist circumference was more important in males, while trunk fat was more significant in females (variable weights male 0.68 and 0.28 and 0.23 and 0.77 in female).

CONCLUSIONS

Our results suggest that trunk fat should be considered when assessing the impact of adipose tissue on lung function and should potentially be included in the health controls.

Long-term changes in lung function after Roux-en-Y gastric bypass in patients with severe obesity

Obesity can decrease the lung function. The proposed mechanisms of reduced lung function in persons with obesity have been altered mechanical properties in the lung and chest wall, airway narrowing and increased respiratory resistance. The aim of this current study was to analyse the long-term results after gastric bypass surgery in patients with reduced lung function. The bariatric surgery observation study invited patients to a follow up 10 years after gastric bypass surgery. We compared the spirometry results before surgery to the spirometry 10 years after surgery. Thirty percent of 198 participants had reduced lung function before surgery. There was no significant relation between body mass index before surgery and lung function. Seventy-three percent of the participants with reduced lung function had normal lung function 10 years after surgery. There was no significant relation between the degree of weight loss and the improvement in lung function. Most participants with reduced lung function had normal lung function 10 years after gastric bypass surgery. There was no significant correlation between weight loss and improvement in lung function.

Relationship between body composition and pulmonary function in the general population-a cross-sectional study in Ningxia

Studies considering the relationship between non-obesity-related body composition and lung function are few; therefore, this study aimed to explore these correlations and effects. This cross-sectional study conducted in rural Qingtongxia City and Pingluo County, Ningxia, China, included 776 participants aged 30-75 years. Body composition and lung function were measured using direct segmental multifrequency bioelectrical impedance analysis and a digital spirometer, respectively. Their correlation was assessed using partial correlation analysis, controlling for age and smoking status, and the body composition effect on lung function was analyzed using binomial logistic regression analysis. The body components total body water content, protein content, mineral content, muscle mass, fat-free mass (FFM), skeletal muscle mass, basal metabolic volume, and chest circumference (CC) positively correlated with pulmonary function (forced vital capacity and forced expiratory volume in one second) in both sexes. Neck circumference and hip circumference positively correlated with pulmonary function in women. Additionally, lung function declines more slowly in women (odds ratio [OR] = 0.66, 95% confidence interval [CI] = 0.44-0.98, p =  0.04); CC (OR = 0.92, 95% CI = 0.86-0.98, p = 0.01) increased as a protective factor for decreased lung function. Increased waist circumference (OR = 1.04, 95% CI = 1.00-1.09, p = 0.04) was a risk factor for reduced lung function. FFM contains body composition indicators positively correlating with lung function, excluding fat-related body composition. Abdominal obesity increases the risk of decreased lung function.

Occupational respiratory morbidity and associated factors among hairdressers in Ethiopia: a cross-sectional study

OBJECTIVE

This study was designed to determine the prevalence and factors associated with occupational respiratory morbidity among hairdressers in Northwestern Ethiopia.

DESIGN

A cross-sectional study was conducted from 6 July 2022 to 17 August 2022. The data were collected using a standardised American Thoracic Society questionnaire. The collected data were entered into EpiData V.4.6 and analysed using Stata V.14. A multivariable logistic regression analysis was conducted to identify factors associated with occupational respiratory morbidity. The association was determined using an adjusted OR (AOR) with a 95% CI at a p value of <0.05.

SETTING

The study was conducted in Gondar city, Northwestern Ethiopia.

PARTICIPANTS

A total of 403 hairdressers participated in this study.

OUTCOME MEASURES

The primary outcome is the prevalence of occupational respiratory morbidity.

RESULTS

The total response rate was 95.5%. The majority, 250 (62%) of the respondents were women. The mean age (±SD) of the respondents was 27 (±6.0) years. The overall prevalence of occupational respiratory morbidity during the past 12 months was found to be 134 (33.3%) (95% CI (28.7% to 38.1%)). Female hairdressers (18.6%) showed greater respiratory morbidity than male hairdressers (14.7%). Working experience 3-5 years (AOR: 3.05; 95% CI (1.76 to 5.30)) and working experience >5 years (AOR: 6.22; 95% CI (2.73 to 14.16)), overweight (body mass index (BMI)) (AOR: 3.01; 95% CI (1.19 to 7.58)) and working near roadsides (AOR: 2.15; 95% CI (1.33 to 3.37)) were risk factors of occupational respiratory morbidity among hairdressers.

CONCLUSIONS

This study concluded that one-third of hairdressers experienced occupational respiratory morbidity. Longer work experience, higher BMI and working near roadsides were identified as significant risk factors for respiratory morbidity in hairdressers. Dietary calorie restrictions for overweight individuals and the development and implementation of air pollution mitigation measures targeted at roadside workers are advised to curb the problem.

Muscle Function in Moderate to Severe Asthma: Association With Clinical Outcomes and Inflammatory Markers

BACKGROUND

Patients with severe asthma have been shown to have low muscle mass, but the clinical consequences are unknown.

OBJECTIVE

In a clinical cohort of patients with moderate to severe asthma, we aimed to assess muscle mass and strength and their relation with functional and clinical outcomes, as well as with systemic inflammatory markers.

METHODS

Muscle mass and strength were assessed by the fat-free mass index (FFMI), creatinine excretion in a 24-hour urine sample, and handgrip strength test. Functional outcomes included pulmonary function tests and the 6-minute walking distance, whereas clinical outcomes were assessed with questionnaires on asthma control, quality of life, and health care use. Associations of muscle mass and strength with asthma outcomes were assessed with multivariable regression analyses.

RESULTS

A total of 114 patients participated (36% male; mean age, 51.9 ± 14.4 years; body mass index, 27.7 ± 5.7 kg/m²). According to predefined criteria, 16% had a low FFMI and 8% a low urinary creatinine excretion, which did not differ between categories of asthma severity. Both lower FFMI and urinary creatinine excretion were associated with lower values of FEV₁ and 6-minute walking distance, whereas a lower handgrip strength was related to worse asthma control, poorer quality of life, and a higher probability of emergency visits (all P < .05). Except for higher leukocytes in relation to lower FFMI, we did not find associations between systemic inflammatory markers and muscle function.

CONCLUSIONS

This study demonstrates that low muscle mass is prevalent in patients with moderate to severe asthma and, along with low muscle strength, is associated with poorer clinical and functional outcomes. Our results encourage longitudinal studies into muscle function as a potential target for treatment to improve asthma outcomes.

Pulmonary Function in Patients with Solitary Spinal Metastases: A Hospital-Based Cross-Sectional Study

Background

This study aimed to evaluate the pulmonary function of patients with solitary spinal metastases with the intention of providing a data-driven basis to evaluate cardiopulmonary function in patients with spinal metastases in the future.

Methods

This was a retrospective analysis of 157 patients with solitary spinal metastases in our hospital from January 2010 to December 2018. This study analyzed the influence of different stages of solitary spinal involvement on respiratory function, based on the spinal segment invaded by the metastases.

Results

The highest proportion of solitary spinal metastases occurred at the thoracic level (49.7%), with the lowest proportion at the sacral level (3.9%). The largest number of patients were in the 60-69-year age group (34.6%). There was no significant difference in pulmonary function among patients with spinal metastases at different segments (all P > 0.05). The highest vital capacity (VC), forced expiratory volume in one second (FEV₁), and forced vital capacity (FVC) were observed in patients who were overweight (all P < 0.05). There were no significant relationships between pulmonary respiratory function and body mass index (BMI) groups in male patient with spinal metastases. In female patients, the highest VC, FEV₁, FVC, and maximum voluntary ventilation were observed in patients who were overweight (all P < 0.05).

Conclusion

Thoracic vertebral metastasis was the main type of solitary spinal metastatic tumor. Spinal metastases were more common at ages 60-69 years. There was no significant difference in pulmonary function among patients with spinal metastasis at different segments. Lung function was better in patients with spinal metastases who were overweight, especially in female patients.

Pulmonary and physical function limitations in aging men with and without HIV from the Multicenter AIDS Cohort Study (MACS)

PURPOSE

We examined the associations between pulmonary impairments and physical function and whether age, HIV serostatus, or smoking modified these relationships.

METHODS

Using Multicenter AIDS Cohort Study data, we examined associations between pulmonary function (diffusing capacity for carbon monoxide [DLCO], one-second forced expiratory volume [FEV1]) and subsequent physical outcomes (gait speed, grip strength, frailty [non-frail, pre-frail, frail]) using mixed models.

RESULTS

Of 1,048 men, 55% were living with HIV, median age was 57(IQR=48,64) and median cumulative pack-years was 1.2(IQR = 0,18.1); 33% and 13% had impaired DLCO and FEV1(<80% predicted), respectively. Participants with impaired DLCO had 3.5 kg (95%CI: -4.6, -2.4) weaker grip strength, 0.04 m/sec (95%CI: -0.06, -0.02) slower gait speed and 4.44-fold (95%CI: 1.81, 10.93) greater odds of frailty compared to participants with normal DLCO. Participants with impaired FEV1 had 3.1 kg (95%CI: -4.8, -1.4) weaker grip strength, similar gait speed (-0.001 m/sec [95%CI: -0.04, 0.03]) and 5.72-fold (95%CI: 1.90, 17.19) greater odds of frailty compared to participants with normal FEV1. Age, but not smoking or HIV, significantly modified the DLCO effect on gait speed and grip strength.

CONCLUSIONS

Pulmonary impairment and decreased physical function were associated. Preserving pulmonary function may help preserve physical function in aging men with and without HIV.

The Relationship Between BMI and Lung Function in Populations with Different Characteristics: A Cross-Sectional Study Based on the Enjoying Breathing Program in China

Purpose

To analyze the relationship between body mass index (BMI) and lung function, which may help optimize the screening and management process for chronic obstructive pulmonary disease (COPD) in the early stages.

Patients and Methods

In this cross-sectional study using data from the Enjoying Breathing Program in China, participants were divided into two groups according to COPD Screening Questionnaire (COPD-SQ) scores (at risk and not at risk of COPD) and three groups based on lung function (normal lung function, preserved ratio impaired spirometry [PRISm], and obstructive lung function).

Results

A total of 32,033 subjects were enrolled in the current analysis. First, in people at risk of COPD, overweight and obese participants had better forced expiratory volume in one second (FEV1; overweight: 0.33 liters (l), 95% confidence interval [CI]: 0.27 to 0.38; obesity: 0.31 L, 95% CI: 0.22 to 0.39) values than the normal BMI group. Second, among people with PRISm, underweight participants had a lower FEV1 (−0.56 L, 95% CI: −0.86 to −0.26) and forced vital capacity (FVC; −0.33 L, 95% CI: −0.55 to −0.11) than participants with a normal weight, and obese participants had a higher FEV1 (0.22 L, 95% CI: 0.02 to 0.42) and FVC (0.16 L, 95% CI: 0.02 to 0.30) than participants with a normal weight. Taking normal BMI as the reference group, lower FEV1 (−0.80 L, 95% CI: −0.97 to −0.63) and FVC (−0.53 L, 95% CI: −0.64 to −0.42) were found in underweight participants with obstructive spirometry, and better FEV1 (obesity: 0.26 L, 95% CI: 0.12 to 0.40) was found in obese participants with obstructive spirometry.

Conclusion

Being underweight and severely obese are associated with reduced lung function. Slight obesity was shown to be a protective factor for lung function in people at risk of COPD and those with PRISm.

Influence of Nutritional Status and Physical Exercise on Immune Response in Metabolic Syndrome

Metabolic Syndrome (MetS) is a cluster of metabolic alterations mostly related to visceral adiposity, which in turn promotes glucose intolerance and a chronic systemic inflammatory state, characterized by immune cell infiltration. Such immune system activation increases the risk of severe disease subsequent to viral infections. Strong correlations between elevated body mass index (BMI), type-2-diabetes and increased risk of hospitalization after pandemic influenza H1N1 infection have been described. Similarly, a correlation between elevated blood glucose level and SARS-CoV-2 infection severity and mortality has been described, indicating MetS as an important predictor of clinical outcomes in patients with COVID-19. Adipose secretome, including two of the most abundant and well-studied adipokines, leptin and interleukin-6, is involved in the regulation of energy metabolism and obesity-related low-grade inflammation. Similarly, skeletal muscle hormones—called myokines—released in response to physical exercise affect both metabolic homeostasis and immune system function. Of note, several circulating hormones originate from both adipose tissue and skeletal muscle and display different functions, depending on the metabolic context. This review aims to summarize recent data in the field of exercise immunology, investigating the acute and chronic effects of exercise on myokines release and immune system function.

Respiratory function correlates with fat mass index and blood triglycerides in institutionalized older individuals

BACKGROUND

We investigated the relationship between respiratory function measured by spirometry analysis and anthropometric variables (skeletal and fat mass) and nutritional status in the institutionalized elderly, particularly at high risk of adverse outcomes after respiratory infections and malnutrition.

DESIGN

A multicenter cross-sectional study with quantitative approach among older people institutionalized living in nursing homes.

METHODS

Respiratory function was assessed by measuring the forced vital capacity, forced expiratory volume in the first second, the ratio between FEV1 and FVC (FEV1/FVC), and peak expiratory flow in percentage by means of spirometric analysis (values of the forced expiratory volume measured during the first second of the forced breath (FEV1) and forced vital capacity (FVC)). Nutritional assessment and anthropometry analysis were done to evaluate under or over nutrition/weight.

RESULTS

There was a significant (p<0.05) and positive correlation between FEV1 and skeletal muscle mass index, whereas fat mass index correlated significantly (p<0.01) with the FEV1/FVC index. FEV1/FVC values were both significantly (p<0.05) associated with high body mass index and triglyceride levels in blood. The prevalence of individuals with ventilator restrictive pattern (FEV1/FVC>70% with FEV1 and FVC<80%) was 27.6% and 12 individuals (21.1%) receive daily bronchodilators as part of the pharmacological treatment for respiratory disorders. A logistic regression was performed to identify predictors of restrictive respiratory pattern. The following variables were entered into the model: age group, female gender, Charlson comorbidity index, body-mass index (BMI), fat mass index, skeletal muscle mass index, total cholesterol and triglycerides concentration. The model was statistically significant (p < 0.05; R2 = 0.39), correctly classifying 70.0% of cases, with a sensitivity of 89.3% and a specificity of 50.0%. Area under curve was 0.71 (IC95% 0.54-0.88; p=0.023). The highest OR for restrictive respiratory pattern were for BMI (OR=5.09) and triglycerides concentration in blood (>150 mg/dl) (OR=5.59).

CONCLUSION

The relationship between a restrictive pattern of respiratory function and fat mass which deserves future investigation to manage these parameters as possible modifiable factor of altered respiratory function in overweight institutionalized older individuals.

Effects of 8 Weeks of High-Intensity Interval Training and Spirulina Supplementation on Immunoglobin Levels, Cardio-Respiratory Fitness, and Body Composition of Overweight and Obese Women

Simple Summary

Overweight and obese, like other forms of malnutrition, have been shown to affect immune function through changing immunoglobin or cardio-respiratory fitness levels and cell-mediated immune responses. Although calorie restriction and exercise are the most common therapies for obesity or overweight, it is unclear what kind of supplementation these people should take or how much exercise they should perform. Hence, in this study, we examined the effect of 8 weeks of high-intensity interval training (HIIT) with spirulina supplementation on the humoral immunity, cardio-respiratory fitness, and body composition of overweight and obese women. The results demonstrated that spirulina supplementation with HIIT not only decreased fat free mass but also boosted immunoglobin-A, which plays an important role in the immune system.

Abstract

Our study examined the effect of 8 weeks of high-intensity interval training (HIIT) and spirulina supplementation on the humoral immunity, cardio-respiratory fitness, and body composition of overweight and obese women. Thirty sedentary women (height: 161.7 ± 2.8 cm, body mass: 75.8 ± 8.4 kg, body mass index [BMI]: 28.8 ± 2.5 kg/m², age: 25.1 ± 6.7 years) were divided into three groups: placebo with HIIT group, spirulina group (SG), or combined group (CG). Exercise groups performed HIIT for 8 weeks, with three sessions per week and four to seven repetitions in each session of 30 s running and 30 s walking; the intensity was established at 90% of the maximum heart rate. Supplementation groups received 6 g of spirulina powder per day. Fasting blood samples were collected before and after 8 weeks to determine the concentrations of immunoglobulins (IgA and IgG). There was a significant group-by-time interaction for fat free mass (FFM; p = 0.001, f = 8.52, ηp² = 0.39) and IgA (p = 0.036, f = 3.86, ηp² = 0.22). The post hoc analysis revealed that CG reduced FFM significantly (p = 0.012, g = −0.55) after training. CG and SG showed significantly greater IgA concentrations after 8 weeks (p = 0.02, g = 0.70 and p = 0.001, g = 0.34, respectively). We conclude that spirulina supplementation with HIIT affects the body composition (lower FFM) but also boosts IgA, which plays an important role in the immune system.

Association of Body Composition with Pulmonary Function in Ningxia: The China Northwest Cohort

BACKGROUND

In recent decades, obesity has become an epidemic worldwide and is a risk factor for many chronic diseases. Lung function is also a predictor of various chronic diseases. However, research results on the association between obesity and lung function are inconsistent and few studies have evaluated the association between central obesity indicators and lung function. Therefore, this study explored the correlation between central obesity and lung function.

METHODS

This study is a cross-sectional study. The basic participant characteristics were collected by questionnaire. A tape measure was used to measure waist circumference (WC) and hip circumference (HC). Body fat percentage was measured using an InBody370. Lung function parameters were measured using a digital spirometer connected to a computer (Chestgraph HI-101). R (R4.0.5) software was used for data analysis. A generalized linear model was used to analyze the association between obesity and lung function.

RESULTS

This study found that body mass index (BMI) adjusted for WC was negatively correlated with forced vital capacity (FVC) (β=-0.05 [-0.06, -0.03] in men, β=-0.05 [-0.07, -0.04] in women) and forced expiratory volume in 1 s (FEV1)(β=-0.02 [-0.03, -0.00] in men, β=-0.03 [-0.04, -0.02] in women). Body fat percentage was negatively correlated with FVC (β=-0.01 [-0.01, -0.01] in men, β=-0.01 [-0.01, -0.00] in women).

CONCLUSION

Central obesity and combined central and general obesity were more strongly positively correlated with lung function. WC-adjusted BMI was negatively correlated with lung function. Body fat percentage was negatively correlated with lung function.

The predictors of the pulmonary function in community-dwelling older adults

Purpose: The aim of the study was to observe the relationship between age, body mass index (BMI), physical activity, and kyphosis angle parameters with respiratory function capacity in community-dwelling older adults and to determine the main predictor. Methods: A prospective cross-sectional study was carried out with 70 older adults. Physical activity level was questioned with the Physical Activity Scale for Elderly (PASE). Thoracic kyphosis degrees were measured with a digital inclinometer. Pulmonary Function Test (PFT) was used to measure pulmonary function capacity. The correlation between age, BMI, PASE, thoracic kyphosis angle with parameters of PFT measurement was analyzed. In addition, a linear multivariate regression model was built to determine the main predictor. Results: The mean age of the participants was 69.88±4.52 years. There was a low degree but a statistically significant positive correlation between BMI and FEV1 (r=0.258,p

Association between abdominal obesity and pulmonary function in apparently healthy adults: A systematic review

BACKGROUND

Obesity, especially abdominal obesity as a chronic disorder is associated with a high risk of developing non-communicable diseases such as respiratory diseases. Impaired lung function is a sign of early respiratory injury. This review summarizes the current knowledge of the effects of abdominal obesity on pulmonary function in apparently healthy adults.

METHODS

Google Scholar, PubMed, Science Direct, and Scopus databases were searched from 2014 up to August 2020 using relevant keywords. All original articles written in English evaluating the effects of abdominal obesity on pulmonary function in apparently healthy adults were eligible for this review.

RESULTS

A total of 26 studies (23 cross-sectional and three cohort) involving 68,024 participants were included in this review. More than 88% of the included studies reported that abdominal obesity significantly inversely was associated with pulmonary function.

CONCLUSION

The findings indicate that in subjects with abdominal obesity respiratory function decline possibly due to mechanical compression and obesity-induced airway inflammation. Therefore, nutrition and lifestyle interventions are required for the reduction of abdominal obesity that leads to improving pulmonary function and metabolic disease.

Association Between Body Composition and Pulmonary Function Tests Among Health Care Workers in Iran

Background:

Why is bodyweight not a predictor of lung function, while height, sex, race, and age are predictors of lung capacity and function? In this study, we want to investigate the association between body composition and pulmonary function. And, as much as possible, answer the question of why bodyweight is not predictive of lung function.

Methods:

This cross-sectional study was performed among 2967 employees of Tehran University of Medical Sciences (TUMS) who participated in the TUMS Employees Cohort (TEC) study. The body composition of the participants was measured using the Bioelectrical Impedance Analysis (BIA) method. Anthropometric variables were also measured as a confounder. The pulmonary function of participants was assessed by a forced spirometry test.

Results:

The correlation of BIA values including fat-free mass and total body water with a pulmonary function such as FEV1, FVC, and FEF25-75is higher than most anthropometric values such as weight, wrist circumference, and the waist to hip ratio. Also, in regression analysis, age and sex had an association with pulmonary function, but the weight did not show a significant relationship. On the other hand, fat-free mass and visceral fat were significantly associated with pulmonary function. One is direct and the other is inverse.

Conclusion:

We observed a negative association between visceral fat and pulmonary function tests and a direct association between Fat-free mass pulmonary function tests (FEV1 and FVC) adjusted for age, sex, and anthropometric indices.

Association of Body Mass Index with Risk of Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-Analysis

The association between body mass index (BMI) and chronic obstructive pulmonary disease (COPD) remains controversial. Therefore, a meta-analysis was conducted to further evaluate the relationship. A comprehensive literature search was performed in PubMed, Web of Science, EMBASE, China National Knowledge Infrastructure (CNKI), and Wanfang databases to identify eligible articles until July 15, 2020. Random effect model (REM) was used to compute the pooled results with 95% confidence intervals (CIs). We conducted meta-regression and subgroup analysis to explore potential sources of heterogeneity. Publication bias was evaluated by funnel plots and Egger's test. Thirty articles with 1,578,449 participants were included in the meta-analysis. The pooled OR of COPD was 1.96 (95% CI: 1.78-2.17) for the underweight group, 0.80 (95% CI: 0.73-0.87) for overweight group, and 0.86 (95% CI: 0.73-1.02) for obesity group. After further excluding 5 studies of high between-study heterogeneity in sensitivity analysis, the pooled OR of COPD was 0.77 (95% CI: 0.68-0.86) for the obesity group. This meta-analysis indicated that BMI was associated with COPD. Specifically, underweight might increase the risk of COPD; overweight and obesity might reduce the risk of COPD.

Anthropometric determinants of lung function in apparently healthy individuals

Background

Forced vital capacity (FVC) and peak expiratory flow rate (PEFR) are used to assess and monitor the management of lung pathology.

Objectives

Our study documented spirometry reference values for apparently healthy Nigerians and developed predictive equations for pulmonary function.

Method

A cross-sectional survey involving healthy adult Nigerians included anthropometric measurements of weight, height, waist, hip circumference (HC), sagittal abdominal diameter (SAD) and percentage body fat. Anthropometric indices (body mass index [BMI] and waist-to-hip ratio [WHR]) were estimated and pulmonary function tests (FVC, forced expiratory volume in 1 s [FEV1], PEFR, FEV1/FVC ratio) measured. The association amongst selected anthropometric and socio-demographic variables and pulmonary function test parameters were established using t-tests and Pearson’s product moment correlation tests. The predictors of pulmonary function were established using stepwise multiple linear regression models.

Results

Four hundred and forty-four adults (156 [35.1%] men) were included, mean age 37.3 ± 8.25 (range 22–25) years. Male participants had significantly higher lung volumes than females (p < 0.05). Age, height, weight and percentage body fat had significant low correlations with lung function test parameters (p < 0.05). Fat-free mass (FFM), fat mass (FM), SAD, height and age of participants were main predictors of FVC and FEV1 (R² = 0.43 and 0.41, respectively). Fat-free mass and SAD were main predictors of PEFR (R² = 0.53). Sagittal abdominal diameter and age were main predictors of FEV1/FVC ratio (R² = 0.34).

Conclusion

Fat-free mass, FM, height, age and SAD are important determinants of lung volumes and key variables for predictive equations of pulmonary function.

Clinical implications

An accurate documentation of pulmonary function values for apparently healthy Nigerian adults may be useful in identifying deviations from normative values thereby giving an index of suspicion for the diagnosis of pulmonary dysfunction.

Keywords

anthropometric; lung function; spirometry; fat-free mass; apparently healthy.

Relationships between body composition and pulmonary function in a community-dwelling population in Japan

Pulmonary diseases, including chronic obstructive pulmonary disease (COPD), are major chronic diseases that result in decreased pulmonary function. Relationships between body composition and pulmonary function have been reported. However, few epidemiological studies have used the visceral fat area (VFA) to measure body composition. This study aimed to examine the relationship between body composition and pulmonary function. A cross-sectional study was conducted between 2015 and 2016, using data obtained from 1,287 residents aged between 19 and 91 years living in the Iwaki area of Hirosaki City, a rural region in Aomori Prefecture, Japan. Pulmonary function was evaluated using the forced vital capacity (FVC) as a percentage of the predicted value (predicted FVC%) and the ratio of forced expiratory volume in one second (FEV1) to FVC. The measurements for evaluating body composition included the body fat percentage (BFP) of the whole body and trunk, skeletal muscle index (SMI), body mass index (BMI), VFA, waist circumference (WC) at the navel level, and waist-to-hip ratio (WHR). To adjust for potential confounders, Spearman's partial correlation analysis was used to examine the relationship between the measurements of body composition and pulmonary function. There were significant correlations between the predicted FVC% and the following parameters: BFP (whole body and trunk) in younger males; SMI in older males; WC, VFA, BMI, and SMI in younger females; and BFP (whole body and trunk) and VFA in older females. Contrastingly, WC and VFA in younger males and WC in younger females were correlated with the FEV1/FVC ratio. VFA was correlated with the FEV1/FVC ratio in younger males and predicted FVC% in older females. These findings suggest that visceral fat accumulation may increase the development of obstructive pulmonary disease in young males and accelerate the decline of pulmonary function (predicted FVC%) in older females.

A Dyadic Growth Modeling Approach for Examining Associations Between Weight Gain and Lung Function Decline

The relationship between body weight and lung function is complex. Using a dyadic multilevel linear modeling approach, treating body mass index (BMI; weight (kg)/height (m)2) and lung function as paired, within-person outcomes, we tested the hypothesis that persons with more rapid increase in BMI exhibit more rapid decline in lung function, as measured by forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), and their ratio (FEV1:FVC). Models included random intercepts and slopes and adjusted for sociodemographic and smoking-related factors. A sample of 9,115 adults with paired measurements of BMI and lung function taken at ≥3 visits were selected from a pooled set of 5 US population-based cohort studies (1983-2018; mean age at baseline = 46 years; median follow-up, 19 years). At age 46 years, average annual rates of change in BMI, FEV1, FVC, and FEV1:FVC ratio were 0.22 kg/m2/year, -25.50 mL/year, -21.99 mL/year, and -0.24%/year, respectively. Persons with steeper BMI increases had faster declines in FEV1 (r = -0.16) and FVC (r = -0.26) and slower declines in FEV1:FVC ratio (r = 0.11) (all P values < 0.0001). Results were similar in subgroup analyses. Residual correlations were negative (P < 0.0001), suggesting additional interdependence between BMI and lung function. Results show that greater rates of weight gain are associated with greater rates of lung function loss.

Correlations between Excessive Body Mass Index, Body Perception, Physical Activity, and Respiratory Functions among Youths in an Urban Setting of Vietnam

Young adults are susceptible to overweight and obesity and their adverse outcomes. However, limited studies have been conducted to understand this health problem in Vietnamese youths. This study was conducted to examine the rate of overweight and obesity, as well as the relationship between this condition on body perception, physical activity, and respiratory function among young adults in Hanoi, Vietnam. We performed a cross-sectional survey with 367 students aged 18-25 years at the Hanoi University of Pharmacy from June 2017 to June 2018. The result showed that the rate of overweight and obesity in our sample was 16.6%. There were 55.7% of overweight/obese students having the misperception of their body image. Results of multivariate regression analysis showed that overweight/obesity increased nearly three times (OR = 2.8, 95% CI: 1.5-5.0) the ability to be active. Overweight/obese students with physical activity had a better respiratory function. To conclude, this study underlined the associations between overweight and obesity with physical activity, body image, and respiratory function in our young sample. Further longitudinal studies should be warranted to examine their causal relationships.

Correlation between Lung Function and Functional Movement in Healthy Adults

It is difficult to determine whether lung function improves by simple abdominal strengthening exercises, and studies on the correlation of lung function and functional movement are insufficient. Therefore; we aimed to identify the correlation between lung function and functional movement. We recruited 204 healthy adults and measured their forced vital capacity; forced expiratory volume in 1 s, maximum voluntary ventilation, maximum expiratory pressure (MEP), and maximum inspiratory pressure (MIP). We also extracted data obtained during functional movements. Differences between lung function and functional movement by gender were determined using independent sample t-tests, while the relationship between lung function and functional movement variables were analyzed using Pearson's correlation coefficient. Significant gender-based differences between lung function and functional movement, a negative correlation between MIP and inline lunge, and a significantly positive correlation between MIP and trunk stability push-up occurred in males. In females, a positive correlation occurred between MEP and hurdle step, MIP and deep squat, and MIP and hurdle step. Aspects of lung function (MEP and MIP) showed correlations with functional movements. The results showed that lung function and functional movement were correlated, confirming that there is a relationship between lung function and functional movement in healthy adults.

Better pulmonary function is associated with greater handgrip strength in a healthy Chinese Han population

BACKGROUND

Handgrip strength (HGS) has been widely studied in clinical and epidemiological settings, but the relationship between HGS and pulmonary function is still controversial. This study analysed pulmonary function and HGS stratified by sex and age in a healthy Chinese Han population, as well as the associations between HGS and pulmonary function parameters.

METHODS

HGS was measured by a Jamar dynamometer and pulmonary function was tested using a portable spirometer. Frequencies and variables are presented as percentages and means ± standard deviations, respectively. Chi-square tests were used for comparisons of categorical variables, and Student's t-tests or Mann-Whitney U-tests were used for continuous variables. Pearson's correlation coefficients were used to analyse the normally distributed variables, and Spearman correlation coefficients were used to analyse the non-normally distributed variables. Multivariate linear regression models were employed to explore the relationships between HGS and parameters of pulmonary function. The statistical significance was set at p < 0.01.

RESULTS

Cross-sectional data were available for 1519 subjects (59.0% females, 57.9 ± 13.3 years old). Males had higher average HGS than females (40.2 vs. 25.0 kg, p < 0.01), as well as better pulmonary function. Both HGS and pulmonary function parameters were significantly inversely correlated with age (r ≤ - 0.30, p < 0.01). The maximum value of vital capacity (VC max), forced expiratory volume in 3 s (FEV 3) and forced vital capacity (FVC) were strongly correlated with HGS among the pulmonary function indices (r = 0.72, 0.70 and 0.69, respectively, p < 0.001). In the multivariate linear regression analysis, HGS and height were positively correlated, while age and pulse pressure were negatively correlated with HGS. In males, the FVC, VC max and FEV3 increased by 0.02 L, 0.023 L and 0.03 L in per 1 kg increase in HGS, respectively. The HGS coefficients for females were smaller than those for males.

CONCLUSIONS

Both pulmonary function and HGS were inversely correlated with age, and better pulmonary function was associated with greater handgrip strength.

Association between adiposity measures and COPD risk in Chinese adults

Bodyweight and fat distribution may be related to COPD risk. Limited prospective evidence linked COPD to abdominal adiposity. We investigated the association of body mass index (BMI) and measures of abdominal adiposity with COPD risk in a prospective cohort study.The China Kadoorie Biobank recruited participants aged 30-79 years from 10 areas across China. Anthropometric indexes were objectively measured at the baseline survey during 2004-2008. After exclusion of participants with prevalent COPD and major chronic diseases, 452 259 participants were included and followed-up until the end of 2016. We used Cox models to estimate adjusted hazard ratios relating adiposity to risk of COPD hospitalisation or death.Over an average of 10.1 years of follow-up, 10 739 COPD hospitalisation events and deaths were reported. Compared with subjects with normal BMI (18.5-<24.0 kg·m-2), underweight (BMI <18.5 kg·m-2) individuals had increased risk of COPD, with adjusted hazard ratio 1.78 (95% CI 1.66-1.89). Overweight (BMI 24.0-<28.0 kg·m-2) and obesity (BMI ≥28.0 kg·m-2) were not associated with an increased risk after adjustment for waist circumference. A higher waist circumference (≥85 cm for males and ≥80 cm for females) was positively associated with COPD risk after adjustment for BMI. Additionally, waist-to-hip ratio and waist-to-height ratio were positively related to COPD risk.Abdominal adiposity and underweight were risk factors for COPD in Chinese adults. Both BMI and measures of abdominal adiposity should be considered in the prevention of COPD.

[The impact of obesity on respiratory function]

The respiratory impact of obesity can be both symptomatic (resting and exertional breathlessness) and functional (pulmonary function at rest and on exercise). The prevalence of breathlessness is increased in adult obese individuals, ∼50% at rest and ∼75% on exertion (mMRC score>0). Pulmonary function abnormalities in obese adults include reduced functional residual capacity (FRC) and expiratory residual volume (ERV), and less frequently reduced total lung capacity (a restrictive defect, with TLC below the 5th percentile of predicted is present in around 15% in severe obese adults), with normal residual volume (RV). Airflows are barely affected by obesity, but bronchial hyperresponsiveness (BHR) is very prevalent, which may be due to the loss of bronchoprotective effect of deep inspiration in obesity (mechanical pathophysiology of BHR). In children, the modifications of lung volumes seen are quite different: TLC is normal while FRC and RV are reduced, explaining the increase in FVC. FEV1/FVC is therefore reduced by obesity, without true airflow obstruction (dysanaptic growth). Resting oxygen consumption (V'O₂) is increased due to obesity and normally increases with exercise. Maximum V'O₂ is normal or weakly reduced in obese patients; on the other hand, the increase in respiratory load increases the oxygen cost of ventilation, which tends to be rapid, both at rest and during exertion. Finally, it should be noted that there is only limited statistical correlation between exercise dyspnoea and respiratory function abnormalities in obesity.

Waist Circumference and Spirometric Measurements in Chronic Obstructive Pulmonary Disease

OBJECTIVES

The aim of this study was to evaluate whether the waist circumference of patients with chronic obstructive pulmonary disease (COPD), had an impact on lung function.

METHODS

There were 180 patients with COPD recruited into this prospective cross-sectional study. The age, weight, body mass index and waist circumference (WC) were measured. Spirometry parameters including forced vital capacity (FVC), and forced expiratory volume in the first second (FEV1), were measured and FEV1/FVC calculated.

RESULTS

The mean FEV1/FVC in both normal weight and overweight patients, did not statistically significantly correlate with WC. The COPD assessment test, positively correlated with WC ( p = 0.031). A positive correlation with body mass index ( p < 0.001), smoking ( p = 0.027), and global initiative for chronic obstructive lung disease score ( p = 0.009), were observed to positively associate with WC. WC, age, C-reactive protein, duration of disease, and gender (male), were observed to be statistically significant risk factors for the severity of COPD.

CONCLUSION

WC was not observed to impact upon lung function in this study but it was a predictive factor for COPD severity in patients.

Effects of fat distribution on lung function in young adults

Aims

To study the associations between fat distribution and lung functions in healthy subjects of young adults and to explore potential gender difference in these correlations.

Methods

A total of 2101 adult participants were recruited. Height, weight, and vital capacity index (VCI) were measured and recorded according to the national physical fitness test standard. Body compositions, including body mass index (BMI), body fat percentage (BFP), waist-to-hip ratio (WHR), fat-free mass (FFM), trunk muscle mass (TMM), fat mass (FM), visceral fat area (VFA), visceral adipose tissue (VAT), and subcutaneous adipose tissue (SAT), were conducted using body composition analyzer. Data were analyzed by SPSS 20.0 software.

Results

We found that male participants showed significantly higher BMI, WHR, FFM, TMM, VFA, and VCI, but lower FM, BFP, and SAT in comparison with women. However, there was no significant difference in VAT between the male and female. Lung functions represented by VCI were negatively correlated with FM, VAT, SAT, and VFA for both men and women (r < 0; P < 0.05). Among these negative correlations, VCI was more inversely correlated with VFA for men but with SAT for women, respectively. After dividing the whole populations by BMI, BFP, and WHR, further correlation analysis showed VCI was still more negatively correlated with VFA for all male subgroups (r < 0; P < 0.05). On the contrary, VCI was more negatively correlated with SAT in BMI-underweight, BMI-normal, BFP-low fat, BFP-normal fat, WHR-normal, and WHR-obese subgroups (r < 0; P < 0.05), while VFA and VAT was more inversely correlated with VCI in BMI- and BFP-overweight+obese subgroups (r < 0; P < 0.05).

Conclusions

Fat accumulation is highly associated with the vital capacity index in young adults. In general, VCI was more negatively correlated with VFA for men but with SAT for women, respectively, in comparison with other tested indices.

Left lateral intercostal region versus subxiphoid position for pleural drain during elective coronary artery bypass graft surgery: randomized clinical trial

BACKGROUND

The pleural drain insertion site after coronary artery bypass graft (CABG) surgery may alter lung function, especially respiratory muscle strength. The main objective of this study was to compare the effectiveness and safety of use of the left lateral intercostal region versus the subxiphoid position for pleural drainage during elective CABG surgery using extracorporeal circulation (ECC).

DESIGN AND SETTING

Randomized trial conducted in a tertiary-level hospital in Porto Alegre, Brazil.

METHODS

48 patients were assigned to group 1 (pleural drain in the left lateral intercostal region) or group 2 (pleural drain in the subxiphoid position). Respiratory muscle strength was measured in terms of maximal inspiratory pressure (MIP) and maximal expiratory pressure (MEP), in cmH2O, by means of manovacuometry preoperatively, 24 and 72 hours after drain removal and before discharge from hospital. Painand dyspnea scales, presence of infections, pleural effusion and atelectasis, duration of drain use, drainage volumes and surgical reinterventions were also evaluated.

RESULTS

After adjustments, there were no significant differences between the groups at the end of the study (before discharge), in predicted percentages either for MIP (delta group 1: -17.21% versus delta group 2: -22.26%; P = 0.09) or for MEP (delta group 1: -9.38% versus delta group 2: -13.13%; P = 0.17). Therewere no differences between the groups in relation to other outcomes.

CONCLUSION

There was no difference in maximal respiratory pressures in relation to the pleural drain insertion site among patients who underwent CABG surgery using ECC.

TRIAL REGISTRATION

ReBEc V1111.1159.4447.

The effects of obesity on pulmonary function in adults with asthma

Objective:

While the effects of obesity on asthma are unclear, an increased body mass index (BMI) is known to enhance the symptoms and severity of asthma and to impair asthma control. The present study evaluates the effects of nutritional habits and obesity on pulmonary function and asthma control in individuals with asthma.

Methods:

This cross-sectional study included 60 obese respondents and 60 respondents with normal body weight, who were referred to pulmonology clinics over a period of 2 months. The anthropometric measurements and macro–micro nutrient consumption records of the patients in both groups were obtained, and the two groups were compared in terms of pulmonary function and asthma control test (ACT) scores.

Results:

The mean age of the normal weight and obese respondents was 39.55 ± 11.0 and 45.1 ± 10.3 years, respectively. The ACT scores of the respondents decreased significantly with increasing BMI, waist circumference (WC), and waist–hip ratio (WHR) measurements (P < 0.05). The obese respondents had a lower mean forced vital capacity (FVC), forced expiratory volume in 1 s (FEV₁), midexpiratory flow (MEF) between 25% and 75% of the maximal expiration (MEF_25–75), MEF₇₅, MEF₅₀, MEF₂₅, and FEV₁/FVC values when compared to the respondents with normal weight (P < 0.05). The total energy and carbohydrate intake was higher in the obese respondents, while their total protein intake was lower when compared to the normal weight respondents (P < 0.05), and a significant positive correlation was found between the omega 3 intake and ACT scores of the respondents (P < 0.05).

Conclusions:

Pulmonary functions and ACT scores decrease with increasing BMI, WC, and WHR. Obese respondents with asthma should be referred to diet clinics to improve their asthma symptoms.

Association of adiposity with pulmonary function in older Chinese: Guangzhou Biobank Cohort Study

OBJECTIVE

We examined the association between different adiposity indices and pulmonary function in Chinese adults in the Guangzhou Biobank Cohort Study (GBCS).

METHODS

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 (FEV₁%), forced vital capacity (FVC %) and restrictive respiratory defect (FEV₁/FVC ratio > low limits of normal and FVC % <0.80).

RESULTS

Of 16186 participants (mean age 61.4 ± 7.2 years; 74.0% women), 116 (0.7%) had only general obesity (BMI ≥28 kg/m²), 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 FEV₁% 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 FEV₁% and FVC%, crude OR range from 0.68 to 0.93, all P > 0.05). Both FEV₁% 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).

CONCLUSION

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.

The association between anthropometric measures and lung function in a population-based study of Canadian adults

BACKGROUND

Decreased lung function has health impacts beyond diagnosable lung disease. It is therefore important to understand the factors that may influence even small changes in lung function including obesity, physical fitness and physical activity. The aim of this study was to determine the anthropometric measure most useful in examining the association with lung function and to determine how physical activity and physical fitness influence this association.

METHODS

The current study used cross-sectional data on 4662 adults aged 40-79 years from the Canadian Health Measures Survey Cycles 1 and 2. Linear regression models were used to examine the association between the anthropometric and lung function measures (forced expiratory volume in 1 s [FEV₁] and forced vital capacity [FVC]); R² values were compared among models. Physical fitness and physical activity terms were added to the models and potential confounding was assessed.

RESULTS

Models using sum of 5 skinfolds and waist circumference consistently had the highest R² values for FEV₁ and FVC, while models using body mass index consistently had among the lowest R² values for FEV₁ and FVC and for men and women. Physical activity and physical fitness were confounders of the relationships between waist circumference and the lung function measures. Waist circumference remained a significant predictor of FVC but not FEV₁ after adjustment for physical activity or physical fitness.

CONCLUSIONS

Waist circumference is an important predictor of lung function. Physical activity and physical fitness should be considered as potential confounders of the relationship between anthropometric measures and lung function.

Obesity and common respiratory diseases in children

Obesity has become an important public health problem worldwide that disproportionally affects the underserved. Obesity has been associated with many diseases and unfortunately has not spared the respiratory system. Specifically, the prevalence of common respiratory problems, such as asthma and obstructive sleep apnoea, is higher in obese children. Further, the treatment outcomes of these frequent conditions is also worse in obese children compared to lean controls.

Adiposity markers and lung function in smokers: a cross-sectional study in a Mediterranean population

Background

The aim of this study was to assess the association of key adiposity markers with lung function in smokers without respiratory disease in a Mediterranean population.

Methods

We performed a cross-sectional study with baseline data from a representative sample of the ESPITAP study in Spain. Participants were 738 smokers (52.3% men) without respiratory disease, aged 35 to 70, selected from 12 primary health care centres. We assessed weight, height, body mass index (BMI), waist circumference (WC) and waist-to-height ratio (WHtR). The pulmonary functional parameters were forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1) and FEV1/FVC ratio.

Results

In this cohort of smokers, 22.2% of individuals had central obesity. FVC% was inversely associated with all anthropometric measures (BMI, WC and WHtR) in the overall population and in men; in women, only BMI was associated with FVC%. FEV1% was inversely associated to BMI and WC in the overall population, and to all anthropometric measures in men. Furthermore, both BMI and obesity were positively associated with FEV1/FVC ratio overall and when stratified by sex; this suggests a restrictive pattern explained by the altered ventilator mechanics experienced by people with obesity.

Conclusion

In a Mediterranean population of smokers without respiratory symptoms, abdominal obesity, evaluated not only by BMI and WC but also WHtR, is inversely associated with lung function. Fat distribution appears more strongly related to pulmonary function parameters in men than in women. In smokers with high values for WC, WHtR and BMI, assessment of lung function is recommended.

Trial registration

Current Controlled Trials NCT01194596. Registered 2 September 2010.

Motor control exercises of the lumbar-pelvic region improve respiratory function in obese men. A pilot study

PURPOSE

Obese subjects have decreased pulmonary function. The hypothesis of our study was that poor coordination of the lumbar-pelvic musculature secondary to obesity may hinder the synergic activation of the respiratory muscles. The aim of the paper was to evaluate whether specific motor control exercises of the lumbar-pelvic musculature were able to improve respiratory function.

METHOD

Twenty obese male patients underwent a rehabilitation program including adapted physical activity and respiratory physiotherapy. Patients were randomly assigned to a Specific Motor Control Exercise Group (SG) and a Control Group (CG). SG followed a protocol according to the SMARTERehab concept aimed at improving posture, intra-abdominal pressure, rib cage mobility, and perception of correct muscle activation. CG performed an exercise training protocol to improve aerobic capacity and muscle strength.

RESULT

After intervention, both groups showed similar changes in body weight, fat, and fat-free mass. Respiratory function indexes improved in SG due to improved proprioception and coordination of the deep lumbar-pelvic muscles.

CONCLUSION

Our study provides preliminary evidence that breathing, postural control, and spinal stability are intertwined. Positive respiratory effects in obese men can be obtained by prescribing specific motor control exercises of the lumbar-pelvic muscles. Implications for rehabilitation Obese subjects present with decreased pulmonary function and postural changes. Poor coordination of the lumbar-pelvic muscles affects posture and the synergic activation of the respiratory muscles. Specific motor control exercises of the lumbar-pelvic musculature can improve respiratory function. Breathing and postural control are intertwined: positive respiratory effects can be obtained by enhancing motor control of the lumbar-pelvic muscles.

Smoking and Early COPD as Independent Predictors of Body Composition, Exercise Capacity, and Health Status

The effects of tobacco smoke, mild/moderate COPD disease and their combined effect on health status (HS), body composition (BC), and exercise capacity (EC) impairment are still unclear. We hypothesized that smoking and early COPD have a joint negative influence on these outcomes. We evaluated 32 smokers (smoking history >10 pack/years), 32 mild/moderate COPD (current smokers or former smokers), and 32 never smokers. All individuals underwent medical and smoking status evaluations, pre and post-bronchodilator spirometry, BC [fat-free mass (FFM) and FFM index (FFMI)], EC [six-minute walk distance (6MWD)] and HS [Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36)]. FFM (p = 0.02) and FFMI (p = 0.008) were lower in COPD than never smokers. 6MWT, as a percentage of reference values for the Brazilian population, was lower in COPD and smokers than never smokers (p = 0.01). Smokers showed worse SF-36 score for functional capacity than never smokers (p<0.001). SF-36 score for physical functioning (p<0.001) and role-emotional (p<0.001) were impaired in COPD patients than smokers. SF-36 scores for physical functioning (p<0.001), role-physical (p = 0.01), bodily pain (p = 0.01), vitality (p = 0.04) and role-emotional (p<0.001) were lower in COPD than never smokers. Multiple linear regression analysis showed that both COPD diagnosis and smoking were inversely associated with FFMI, 6MWD and HS. Smoking and early COPD have a joint negative influence on body composition, exercise capacity and health status.

The association between the body composition and lifestyle affecting pulmonary function in Japanese workers

[Purpose] The purpose of this study was to identify factors related to physical characteristics and lifestyle that affect pulmonary function. [Subjects and Methods] Ninety seven healthy male workers were recruited for this study, and basic information and details about lifestyle were collected. Body composition analyzer and visceral fat measuring device were conducted as measurements. Pulmonary function was measured using spirometer. A multiple stepwise linear regression analysis was performed with pulmonary function as the dependent variable. Variables with a significant association with pulmonary function on univariate analysis were imputed as independent variables. [Results] Height, fat free mass, upper extremity muscle mass, lower extremity muscle mass, and trunk muscle mass had significant positive correlations with FEV1 and FVC. Age, percentage of body fat, and visceral fat area were negatively correlated with FEV1 and FVC. Regarding the association between pulmonary function and lifestyle, a significant difference was found between the smoking index and the presence or absence of metabolic syndrome risk factors and both FEV1 and FVC. The multiple stepwise linear regression analysis with FEV1 as the dependent variable, adjusted for age and height, revealed that visceral fat area and fat free mass were significantly associated with FEV1. A similar analysis, FVC as the dependent variable identified visceral fat area. [Conclusion] FEV1 was independently associated with visceral fat area and fat free mass. FVC was independently associated with visceral fat area. These results may be valuable in preventing the decrease in respiratory function and, hence, in further preventing the onset of COPD.

Relationship between Body Composition and Pulmonary Function in Early Adult Life: A Cross-Sectional Analysis Nested in Two Birth Cohort Studies

BACKGROUND

Overweight/obesity has been reported to worsen pulmonary function (PF). This study aimed to examine the association between PF and several body composition (BC) measures in two population-based cohorts.

METHODS

We performed a cross-sectional analysis of individuals aged 18 and 30 years from two Pelotas Birth Cohorts in southern Brazil. PF was assessed by spirometry. Body measures that were collected included body mass index, waist circumference, skinfold thickness, percentages of total and segmented (trunk, arms and legs) fat mass (FM) and total fat-free mass (FFM). FM and FFM were measured by air-displacement plethysmography (BODPOD) and by dual-energy x-ray absorptiometry (DXA). Associations were verified through linear regressions stratified by sex, and adjusted for weight, height, skin color, and socioeconomic, behavioral, and perinatal variables.

RESULTS

A total of 7347 individuals were included in the analyses (3438 and 3909 at 30 and 18 years, respectively). Most BC measures showed a significant positive association between PF and FFM, and a negative association with FM. For each additional percentage point of FM, measured by BOD POD, the forced vital capacity regression coefficient adjusted by height, weight and skin color, at 18 years, was -33 mL (95% CI -38, -29) and -26 mL (95% CI -30, -22), and -30 mL (95% CI -35, -25) and -19 mL (95% CI -23, -14) at 30 years, in men and women, respectively. All the BOD POD regression coefficients for FFM were the same as for the FM coefficients, but in a positive trend (p<0.001 for all associations).

CONCLUSIONS

All measures that distinguish FM from FFM (skinfold thickness-FM estimation-BOD POD, total and segmental DXA measures-FM and FFM proportions) showed negative trends in the association of FM with PF for both ages and sexes. On the other hand, FFM showed a positive association with PF.

Associations between body composition, physical capabilities and pulmonary function in healthy older adults

BACKGROUND/OBJECTIVES

There are positive associations between pulmonary function (PF) and fat-free mass as well as muscle strength. Contrarily, negative associations were found with indirect measures of visceral adipose tissue (VAT). We aimed to differentiate between associations of body composition and PF by assessing mediating and moderating effects of physical capabilities.

SUBJECTS/METHODS

Cross-sectional data were assessed among 40 healthy, free-living elderly (20 males) aged 65.1-81.2 years (mean±s.d. age: 72.2±4.3 years; body mass index: 25.6±3.7 kg/m²). Total and regional skeletal muscle (SM), and adipose tissue (AT) were measured using whole-body magnetic resonance imaging. Muscle strength by handgrip dynamometry, physical activity (PA) by questionnaire, and physical performance by gait speed and sit-to-stand test (STS). Forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV₁) were assessed by spirometry.

RESULTS

Positive associations between height-standardized FVC (FVCI) as well as FEV₁ (FEVI), and SM (r=0.435-0.520, P<0.05) were found; subcutaneous AT (SAT) and FVCI correlated negatively (r=-0.374; P<0.05). HGS and PA correlated positively with FEVI (r=0.456-0.608, P<0.05), HGS also with FVCI (r=0.595, P<0.05). Stepwise multiple regression using FVCI and FEVI as dependent variables, and total/thoracic SM, VAT, SAT, HGS, PA and physical performance as independent variables showed that (i) only HGS entered the regression for predicting FVCI (R²=0.351; standard error of estimation (SEE)=0.32 l), and (ii) HGS and PA explained 50% of FEVI (SEE=0.23 l). HGS mediated the relationship between SM and PF; the STS moderated the relationship between SM and FVCI.

CONCLUSIONS

In healthy elderly, PF is positively associated with SM; physical capabilities mediate and moderate these relationships.

The relationship between body fat and respiratory function in young adults

The relationship between adiposity and respiratory function is poorly understood. Most studies investigating this have used indirect measures of body fat and few have assessed how changes in adiposity influence lung function.Body fat measured by bio-electrical impedance analysis, body mass index, waist circumference, spirometry, body plethysmography and transfer factor were measured at ages 32 and 38 years in 361 non-smoking, non-asthmatic participants from a population-based birth cohort.Higher percentage body fat was associated with lower spirometric and plethysmographic lung volumes, but not with airflow obstruction, or transfer factor at 32 years. Changes in adiposity between ages 32 and 38 years were inversely associated with changes in lung volumes. These associations were generally stronger in men than women, but an association between increasing adiposity and lower airway function (forced expiratory volume in 1 s/forced vital capacity) was only found in women. Similar associations were found for body mass index and waist circumference.Higher percentage body fat is associated with lower lung volumes. Direct and indirect measures of adiposity had similar associations with lung function. Adiposity had a greater effect on lung volumes in men than women but was associated with airway function only in women. There was little evidence that adiposity influenced transfer factor.

Body composition and lung function in cystic fibrosis and their association with adiposity and normal-weight obesity

OBJECTIVES

This study aimed to evaluate the relationship between lung function and body composition in cystic fibrosis (CF) and examine the presence of normal-weight obesity (NWO), a high body fat percentage with a normal body mass index (BMI), in this population.

METHODS

In a pilot, cross-sectional study, 32 subjects with CF and a reference group of 20 adults without CF underwent body composition analysis with air displacement plethysmography. NWO was defined as a BMI <25 kg/m(2) and body fat >30% (for women) or >23% (for men). Lung function in subjects with CF was determined by the percentage of predicted forced expiratory volume in 1 s (FEV1% predicted).

RESULTS

Despite lower BMI and fat-free mass index (P < 0.01), fat mass index and percent body fat did not differ between subjects with CF and the reference group. Among subjects with CF, FEV1% predicted was positively associated with fat-free mass index (β = 6.31 ± 2.93, P = 0.04) and inversely associated with fat mass index (β = -6.44 ± 2.93, P = 0.04), after adjusting for age, sex, and BMI. Ten subjects with CF (31%) had NWO, which corresponded with lower fat-free mass index and FEV1% predicted compared with overweight subjects (P = 0.006 and 0.004, respectively).

CONCLUSIONS

Excess adiposity, particularly in the form of NWO, was inversely associated with lung function in CF. Larger prospective studies should be undertaken to confirm these findings and determine the long-term metabolic and clinical consequences of excess adiposity in CF. As the lifespan of individuals with CF increases, nutrition screening protocols, which primarily rely on BMI, may require reassessment.

The relationship between serum fatty-acid binding protein 4 level and lung function in Korean subjects with normal ventilatory function

Background

The aim of this study was to assess the association of lung function with serum fatty-acid binding protein 4 (FABP4) in apparently healthy Korean adults.

Methods

In 495 participants in a health screening program, Force Exploratory Volume (FEV) 1 and Forced Vital Capacity (FVC) were assessed with standard spirometry. Subjects with obstructive (n = 19) and restrictive (n = 45) lung function were excluded from the analysis. Serum FABP4 level was measured by enzyme-linked immunosorbent assay and transformed into Ln(FABP4). 431 subjects with normal ventilator function (72.4 % men, mean age 41 years) were included in the final analysis.

Results

Mean Ln(FABP4) significantly decreased in subjects from 1^st quartile to 4^th quartile of FVC (p = 0.008). Ln(FABP4) did not show significant differences across the quartile groups of FEV1. The odds ratio (OR) of being in the lowest quartile of FVC was 2.704 in subject with 3^rd tertile of Ln(FABP4) after full adjustment for confounding variables {95 % confidence interval (CI) 1.397 ~ 5.357}. OR of being in the lowest quartile of FEV1 was 1.822 (95 % CI 1.021 ~ 3.298) in subjects with 3^rd tertile of Ln(FABP4) after adjustment of age and sex, which was attenuated after full adjustment for confounding variables.

Conclusion

Increased FABP4 level showed increased risk for reduced lung function in subjects with normal ventilatory function.

Electronic supplementary material

The online version of this article (doi:10.1186/s12890-016-0190-8) contains supplementary material, which is available to authorized users.

Low Serum Levels of Prealbumin, Retinol Binding Protein, and Retinol Are Frequent in Adult Type 1 Diabetic Patients

Aim. To determine the serum prealbumin (PA), retinol binding protein (RBP), and retinol levels in adult patients with type 1 diabetes (T1D) and to analyze some factors related to those levels. Methods. A total of 93 patients (47 women) were studied. Age, gender, BMI, duration of diabetes, chronic complications, HbA1c, lipid profile, creatinine, albumin, PA, RBP, and retinol were recorded. High and low parameter groups were compared by Mann-Whitney U and χ² tests. Correlation between parameters was analyzed by Spearman's test. Odds of low levels were analyzed by univariate logistic regression and included in the multivariate analysis when significant. Results. 49.5%, 48.4%, and 30.1% of patients displayed serum PA, RBP, and retinol levels below normal values, respectively. A high correlation (Rho > 0.8) between PA, RBP, and retinol serum levels was found. Patients presenting low levels of any of them were predominantly women, normal-weighted, and with lower levels of triglycerides and serum creatinine. No differences in age, macrovascular complications, duration of diabetes, or HbA1c values were observed when comparing low and normal parameter groups. Conclusion. Low serum levels of PA, RBP, and retinol are frequent in T1D adult patients. This alteration is influenced by female sex and serum creatinine and triglyceride levels.