TY - JOUR
T1 - Overweight and obesity may lead to under-diagnosis of airflow limitation
T2 - findings from the Copenhagen City Heart Study
AU - Çolak, Yunus
AU - Marott, Jacob Louis
AU - Vestbo, Jørgen
AU - Lange, Peter
PY - 2015/2/1
Y1 - 2015/2/1
N2 - Background: The prevalence of obesity has increased during the last decades and varies from 10-20 in most European countries to approximately 32 in the United States. However, data on how obesity affects the presence of airflow limitation (AFL) defined as a reduced ratio between forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC) are scarce. Methods: Data was derived from the third examination of the Copenhagen City Heart Study from 1991 until 1994 (n 10,135). We examine the impact of different adiposity markers (weight, body mass index (BMI), waist circumference, waist-hip ratio, and abdominal height) on AFL. AFL was defined in four ways: FEV1/FVC ratio < 0.70, FEV1/FVC ratio < lower limit of normal (LLN), FEV1/FVC ratio <0.70 including at least one respiratory symptom, and FEV1/FVC ratio < LLN and FEV1 of predicted < LLN. Results: All adiposity markers were positively and significantly associated with FEV1/FVC independent of age, sex, height, smoking status, and cumulative tobacco consumption. Among all adiposity markers, BMI was the strongest predictor of FEV1/FVC. FEV1/FVC increased with 0.04 in men and 0.03 in women, as BMI increased with 10 units (kg·m-2). Consequently, diagnosis of AFL was significantly less likely in subjects with BMI ≥ 25 kg·m-2 with odds ratios 0.63 or less compared to subjects with BMI between 18.524.9 kg·m-2 when AFL was defined as FEV1/FVC < 0.70. Conclusion: High BMI reduces the probability of AFL. Ultimately, this may result in under-diagnosis and under-treatment of COPD among individuals with overweight and obesity.
AB - Background: The prevalence of obesity has increased during the last decades and varies from 10-20 in most European countries to approximately 32 in the United States. However, data on how obesity affects the presence of airflow limitation (AFL) defined as a reduced ratio between forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC) are scarce. Methods: Data was derived from the third examination of the Copenhagen City Heart Study from 1991 until 1994 (n 10,135). We examine the impact of different adiposity markers (weight, body mass index (BMI), waist circumference, waist-hip ratio, and abdominal height) on AFL. AFL was defined in four ways: FEV1/FVC ratio < 0.70, FEV1/FVC ratio < lower limit of normal (LLN), FEV1/FVC ratio <0.70 including at least one respiratory symptom, and FEV1/FVC ratio < LLN and FEV1 of predicted < LLN. Results: All adiposity markers were positively and significantly associated with FEV1/FVC independent of age, sex, height, smoking status, and cumulative tobacco consumption. Among all adiposity markers, BMI was the strongest predictor of FEV1/FVC. FEV1/FVC increased with 0.04 in men and 0.03 in women, as BMI increased with 10 units (kg·m-2). Consequently, diagnosis of AFL was significantly less likely in subjects with BMI ≥ 25 kg·m-2 with odds ratios 0.63 or less compared to subjects with BMI between 18.524.9 kg·m-2 when AFL was defined as FEV1/FVC < 0.70. Conclusion: High BMI reduces the probability of AFL. Ultimately, this may result in under-diagnosis and under-treatment of COPD among individuals with overweight and obesity.
U2 - 10.3109/15412555.2014.933955
DO - 10.3109/15412555.2014.933955
M3 - Journal article
C2 - 25290888
SN - 1541-2555
VL - 12
SP - 5
EP - 13
JO - COPD: Journal of Chronic Obstructive Pulmonary Disease
JF - COPD: Journal of Chronic Obstructive Pulmonary Disease
IS - 1
ER -
