Abstract
ObjectivePrevious studies have evaluated the link between metabolic syndrome and obesity with impaired lung function, however findings have been controversial. We aimed to compare lung function among subjects with different metabolic health and obesity status.MethodsTotal 10,071 participants were evaluated at the Health Promotion Center in Seoul St. Mary’s Hospital between January 2012 and December 2014. Being metabolically healthy was defined as having fewer than three of the following risk factors: high blood pressure, high fasting blood glucose, high triglyceride, low high-density lipoprotein cholesterol and abdominal obesity. Obesity status was defined as body mass index (BMI) higher than 25 kg/m2. Analyses of pulmonary function were performed in four groups divided according to metabolic health and obesity: metabolically healthy non-obese (MHNO), metabolically health obese (MHO), metabolically unhealthy non-obese (MUHNO), and metabolically unhealthy obese (MUHO).ResultsMetabolically unhealthy subjects were more prone to decreased lung function compared with their metabolically healthy counterparts, regardless of obesity status. When multinomial logistic regression analysis was performed according to quartiles of forced vital capacity (FVC) or forced expiratory volume in 1 second (FEV1) (% pred), after adjusting for age, sex, and smoking status, odds ratio (OR) for the lowest FVC and FEV1 (% pred) quartiles were significantly higher in MUHO subjects (1.788 [95% CI, 1.531–2.089] and 1.603 [95% CI, 1.367–1.881]) and lower in MHO subjects (0.768 [95% CI, 0.654–0.902] and 0.826 [95% CI, 0.700–0.976]) with MHNO group as the reference, when OR for highest FVC and FEV1 quartiles were considered as 1.0ConclusionMetabolic health is more closely associated with impaired lung function than obesity.
Highlights
Obesity is the main cause of various metabolic diseases leading to an increase in risk of cardiovascular disease such as coronary, cerebrovascular, peripheral arterial disease and heart failure [1,2]
Unhealthy subjects were more prone to decreased lung function compared with their metabolically healthy counterparts, regardless of obesity status
When multinomial logistic regression analysis was performed according to quartiles of forced vital capacity (FVC) or forced expiratory volume in 1 second (FEV1) (% pred), after adjusting for age, sex, and smoking status, odds ratio (OR) for the lowest FVC and FEV1 (% pred) quartiles were significantly higher in metabolically unhealthy obese (MUHO) subjects (1.788 [95% CI, 1.531–2.089] and 1.603 [95% CI, 1.367–1.881]) and lower in metabolically healthy obesity (MHO) subjects (0.768 [95% CI, 0.654–0.902] and 0.826 [95% CI, 0.700–0.976]) with metabolically healthy non-obese (MHNO) group as the reference, when Odds ratio (OR) for highest FVC and FEV1 quartiles were considered as 1.0
Summary
Obesity is the main cause of various metabolic diseases leading to an increase in risk of cardiovascular disease such as coronary, cerebrovascular, peripheral arterial disease and heart failure [1,2]. Recently subgroups of obesity that have a good metabolic profile have gained much interest. This group is referred to as the “metabolically healthy obesity (MHO)”, which indicates obese objects without satisfying the criteria for being metabolically unhealthy such as elevated blood pressure, dyslipidemia, abdominal obesity, insulin resistance, or elevated surrogate markers of systemic inflammation [5,6]. Previous studies show that metabolically unhealthy obese phenotypes tend to have higher risk of all-cause or cardiovascular mortality compared with their metabolically healthy counterpart [7,8,9,10]. The clinical significance of MHO group has not been widely examined
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