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

Mar Sorlí-Aguilar,Francisco Martín-Luján,Estefania Aparicio-Llopis,Gemma Flores-Mateo,Josep Basora-Gallisà,Cristina Jardí-Piñana,Rosa Solà-Alberich

doi:10.1186/s12890-016-0341-y

Abstract

BackgroundThe 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.MethodsWe 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.ResultsIn 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.ConclusionIn 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 registrationCurrent Controlled Trials NCT01194596. Registered 2 September 2010.

Highlights

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
We evaluated the association of categories of body weight and fat distribution measures with lung function according to the spirometry results
The pattern of fat distribution appears to have a more significant influence on forced expiratory volume in 1 s (FEV1)% and forced vital capacity (FVC)% than more commonly used measures of general obesity such as continuous body mass index (BMI), our results show that BMI >25 kg/m2 has a greater direct effect on the FEV1/FVC ratio

Summary

Introduction

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. Tobacco smokers have reduced lung function, characterized by decreased forced expiratory volume after. Respiratory complications have been consistently reported in patients with obesity, a chronic disease characterized by the excessive accumulation of body fat and associated with a reduction in lung volume. The most consistent effect is an exponential decrease in FEV1% and in functional residual capacity with increasing BMI [8,9,10,11]. A low BMI is associated with increased risk of mortality and is considered a negative prognostic factor for survival based on the degree of lung dysfunction [6, 12]

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