Abstract
Although body mass index (BMI) is a potential risk factor for bronchiectasis in young adults, the association between BMI and incident bronchiectasis has not been well elucidated. This study included 6,329,838 individuals aged 20–40 years from the Korean National Health Insurance Service database 2009–2012 who were followed up until the date of the diagnosis of bronchiectasis, death, or 31 December 2018. We evaluated the incidence and risk of bronchiectasis according to the BMI category. The incidence rate of bronchiectasis increased as BMI decreased in a dose-dependent manner (p for trend <0.01). In multivariable Cox regression analysis, being underweight was an independent risk factor for the development of bronchiectasis, with a hazard ratio of 1.24 (95% confidence interval, 1.19–1.30) compared to being normal weight. In subgroup analysis, the effect of being underweight on the development of bronchiectasis was more evident in males and older individuals (30–40 years) than females and younger individuals (20–29 years), respectively (p for interaction <0.01 for both). These results remained significant in subgroup analysis in which subjects with comorbidities related to being underweight were excluded. Being underweight may be a novel risk factor for the development of bronchiectasis in young adults.
Highlights
Non-cystic fibrosis bronchiectasis is a chronic lung disease characterized by chronic respiratory symptoms and recurrent infection [1]
The underweight group had the highest proportions of gastroesophageal reflux disease (GERD), respiratory diseases, solid cancer, and inflammatory bowel disease, and the lowest proportion of diabetes mellitus (DM) compared with other body mass index (BMI) categories
We focused on young adults because they have relatively fewer comorbidities that could potentially contribute to a low BMI and bronchiectasis development
Summary
Non-cystic fibrosis bronchiectasis (hereafter referred to as bronchiectasis) is a chronic lung disease characterized by chronic respiratory symptoms and recurrent infection [1]. The disease has been getting more attention because the worldwide prevalence of bronchiectasis has been increasing in recent years [2,3]. The disease burden of bronchiectasis, including medical costs and mortality, is substantial [4,5]. Recognition and interventions to prevent disease progression in young adults could potentially decrease the disease burden of bronchiectasis. Current guidelines recommend an extensive work-up to evaluate the etiology of bronchiectasis in young adults. Identifiable etiologies in young adults include immunodeficiency, autoimmune disease, and primary ciliary dyskinesia, while respiratory infections are thought to be the leading cause of the disease [6,7]. Factors that contribute to bronchiectasis, including demographic factors such as nutritional status, require further exploration [8]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
