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Qvarfordt M, Lampa E, Cai GH, Lind L, Elmståhl S, Svartengren M. Bioelectrical impedance and lung function-associations with gender and central obesity: results of the EpiHealth study. BMC Pulm Med 2024; 24:319. [PMID: 38965493 PMCID: PMC11225376 DOI: 10.1186/s12890-024-03128-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 06/24/2024] [Indexed: 07/06/2024] Open
Abstract
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.
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Affiliation(s)
- Mikaela Qvarfordt
- Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala University, Uppsala, Sweden.
- Department of Laboratory Medicine, Clinical Physiology, Karolinska Institute, Stockholm, Sweden.
| | - Erik Lampa
- Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala University, Uppsala, Sweden
| | - Gui-Hong Cai
- Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala University, Uppsala, Sweden
| | - Lars Lind
- Department of Medical Sciences, Cardiovascular Epidemiology, Uppsala University, Uppsala, Sweden
| | - Sölve Elmståhl
- Division of Geriatric Medicine, Department of Clinical Sciences in Malmö, Lund University, Malmö, Sweden
| | - Magnus Svartengren
- Department of Medical Sciences, Occupational and Environmental Medicine, Uppsala University, Uppsala, Sweden.
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Sitarik AR, Wegienka G, Johnson CC, Joseph CLM. Impact of Spirometry Race-Correction on Preadolescent Black and White Children. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2023; 11:3097-3106. [PMID: 37301437 PMCID: PMC10592501 DOI: 10.1016/j.jaip.2023.05.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 05/24/2023] [Accepted: 05/30/2023] [Indexed: 06/12/2023]
Abstract
BACKGROUND Race-correction for Black patients is standard practice in spirometry testing. History suggests that these corrections are at least partially a result of racist assumptions regarding lung anatomy among Black individuals, which can potentially lead to less frequent diagnoses of pulmonary diseases in this population. OBJECTIVE To evaluate the impact of race-correction in spirometry testing among Black and White preadolescents, and examine the frequency of current asthma symptoms in Black children who were differentially classified depending on whether race-corrected or race-uncorrected reference equations were deployed. METHODS Data from Black and White children who completed a clinical examination at age 10 years from a Detroit-based unselected birth cohort were analyzed. Global Lung Initiative 2012 reference equations were applied to spirometry data using both race-corrected and race-uncorrected (ie, population-average) equations. Abnormal results were defined as values less than the fifth percentile. Asthma symptoms were assessed concurrently using the International Study of Asthma and Allergies in Childhood questionnaire, while asthma control was assessed using the Asthma Control Test. RESULTS The impact of race-correction on forced expiratory volume in 1 second (FEV1)/forced vital capacity ratio was minimal, but abnormal classification of FEV1 results more than doubled among Black children when race-uncorrected equations were used (7% vs 18.1%) and were almost 8 times greater based on forced vital capacity classification (1.5% vs 11.4%). More than half of Black children differentially classified on FEV1 (whose FEV1 was classified as normal with race-corrected equations but abnormal with race-uncorrected equations) experienced asthma symptoms in the past 12 months (52.6%), which was significantly higher than the percentage of Black children consistently classified as normal (35.5%, P = .049), but similar to that of Black children consistently classified as abnormal using both race-corrected and race-uncorrected equations (62.5%, P = .60). Asthma Control Test scores were not different based on classification. CONCLUSIONS Race-correction had an extensive impact on spirometry classification in Black children, and differentially classified children had a higher rate of asthma symptoms than children consistently classified as normal. Spirometry reference equations should be reevaluated to be aligned with current scientific perspectives on the use of race in medicine.
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Affiliation(s)
| | - Ganesa Wegienka
- Department of Public Health Sciences, Henry Ford Health, Detroit, Mich
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Teng J, Li J, Yang T, Cui J, Xia X, Chen G, Zheng S, Bao J, Wang T, Shen M, Zhang X, Meng C, Wang Z, Wu T, Xu Y, Wang Y, Ding G, Duan H, Li W. Long-term exposure to air pollution and lung function among children in China: Association and effect modification. Front Public Health 2022; 10:988242. [PMID: 36589956 PMCID: PMC9795025 DOI: 10.3389/fpubh.2022.988242] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 11/18/2022] [Indexed: 12/15/2022] Open
Abstract
Background Children are vulnerable to the respiratory effects of air pollution, and their lung function has been associated with long-term exposure to low air pollution level in developed countries. However, the impact of contemporary air pollution level in developing countries as a result of recent efforts to improve air quality on children's lung function is less understood. Methods We obtained a cross-sectional sample of 617 schoolchildren living in three differently polluted areas in Anhui province, China. 2-year average concentrations of air pollutants at the year of spirometry and the previous year (2017-2018) obtained from district-level air monitoring stations were used to characterize long-term exposure. Forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), and forced expiratory flow between 25 and 75% of FVC (FEF25-75) were determined under strict quality control. Multivariable regression was employed to evaluate the associations between air pollution level and lung function parameters, overall and by demographic characteristics, lifestyle, and vitamin D that was determined by liquid chromatography tandem mass spectrometry. Results Mean concentration of fine particulate matter was 44.7 μg/m3, which is slightly above the interim target 1 standard of the World Health Organization. After adjusting for confounders, FVC, FEV1, and FEF25-75 showed inverse trends with increasing air pollution levels, with children in high exposure group exhibiting 87.9 [95% confidence interval (CI): 9.5, 166.4] mL decrement in FEV1 and 195.3 (95% CI: 30.5, 360.1) mL/s decrement in FEF25-75 compared with those in low exposure group. Additionally, the above negative associations were more pronounced among those who were younger, girls, not exposed to secondhand smoke, non-overweight, physically inactive, or vitamin D deficient. Conclusions Our study suggests that long-term exposure to relatively high air pollution was associated with impaired lung function in children. More stringent pollution control measures and intervention strategies accounting for effect modification are needed for vulnerable populations in China and other developing countries.
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Affiliation(s)
- Jingjing Teng
- Anhui Center for Disease Control and Prevention, Public Health Research Institute of Anhui Province, Hefei, China
| | - Jie Li
- Department of Occupational and Environmental Health, School of Public Health, Capital Medical University, Beijing, China,Beijing Key Laboratory of Environmental Toxicology, School of Public Health, Capital Medical University, Beijing, China
| | - Tongjin Yang
- Anhui Center for Disease Control and Prevention, Public Health Research Institute of Anhui Province, Hefei, China
| | - Jie Cui
- Anhui Center for Disease Control and Prevention, Public Health Research Institute of Anhui Province, Hefei, China
| | - Xin Xia
- Anhui Center for Disease Control and Prevention, Public Health Research Institute of Anhui Province, Hefei, China
| | - Guoping Chen
- Anhui Center for Disease Control and Prevention, Public Health Research Institute of Anhui Province, Hefei, China
| | - Siyu Zheng
- Anhui Center for Disease Control and Prevention, Public Health Research Institute of Anhui Province, Hefei, China
| | - Junhui Bao
- Anhui Center for Disease Control and Prevention, Public Health Research Institute of Anhui Province, Hefei, China
| | - Ting Wang
- Chinese Center for Disease Control and Prevention, National Institute for Occupational Health and Poison Control, Beijing, China
| | - Meili Shen
- Chinese Center for Disease Control and Prevention, National Institute for Occupational Health and Poison Control, Beijing, China
| | - Xiao Zhang
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Can Meng
- Anhui Center for Disease Control and Prevention, Public Health Research Institute of Anhui Province, Hefei, China
| | - Zhiqiang Wang
- Anhui Center for Disease Control and Prevention, Public Health Research Institute of Anhui Province, Hefei, China
| | - Tongjun Wu
- Anhui Center for Disease Control and Prevention, Public Health Research Institute of Anhui Province, Hefei, China
| | - Yanlong Xu
- Anhui Center for Disease Control and Prevention, Public Health Research Institute of Anhui Province, Hefei, China
| | - Yan Wang
- Anhui Center for Disease Control and Prevention, Public Health Research Institute of Anhui Province, Hefei, China
| | - Gang Ding
- Anhui Center for Disease Control and Prevention, Public Health Research Institute of Anhui Province, Hefei, China
| | - Huawei Duan
- Chinese Center for Disease Control and Prevention, National Institute for Occupational Health and Poison Control, Beijing, China
| | - Weidong Li
- Anhui Center for Disease Control and Prevention, Public Health Research Institute of Anhui Province, Hefei, China,*Correspondence: Weidong Li
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Komici K, D’Amico F, Verderosa S, Piomboni I, D’Addona C, Picerno V, Bianco A, Caiazzo A, Bencivenga L, Rengo G, Guerra G. Impact of Body Composition Parameters on Lung Function in Athletes. Nutrients 2022; 14:nu14183844. [PMID: 36145219 PMCID: PMC9500777 DOI: 10.3390/nu14183844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 09/09/2022] [Accepted: 09/13/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Given the potential risk of unhealthy weight management, the monitoring of body composition in athletes is advised. However, limited data reveal how body composition measurements can benefit athlete health and, in particular, respiratory function. The aim of this study is to evaluate the impact of body composition on pulmonary function in a population of adult athletes. Methods: Data from 435 competitive adult athletes regarding body compositions parameters and spirometry are retrospectively analyzed. Results: Our study population consists of 335 males and 100 female athletes. Muscle mass and fat-free mass are significantly and positively associated with forced expiratory volume in the first second (FEV1) and forced vital capacity (FVC) in the male and female population, while waist-to-height ratio is negatively associated with FEV1, FVC, and FEV1/FVC in the male population. In multivariable analysis, muscle mass and fat-free mass show significant association with FEV1 and FVC in both males and females (p < 0.05), and waist-to-height ratio is significantly and inversely associated with FEV1 and FVC in males (p < 0.05). Conclusions: Fat-free mass and muscle mass are positively and independently associated with FEV1 and FVC in athletes of both genders, and waist-to-height ratio is inversely associated with FEV1 and FVC only among male athletes. These findings suggest that body composition in athletes may be helpful in monitoring respiratory function.
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Affiliation(s)
- Klara Komici
- Department of Medicine and Health Sciences, University of Molise, 86100 Campobasso, Italy
- Exercise and Sports Medicine Unit, Antonio Cardarelli Hospital, 86100 Campobasso, Italy
- Correspondence: ; Tel.: +39-0874404739
| | - Fabio D’Amico
- Department of Medicine and Health Sciences, University of Molise, 86100 Campobasso, Italy
- Exercise and Sports Medicine Unit, Antonio Cardarelli Hospital, 86100 Campobasso, Italy
| | - Sofia Verderosa
- Department of Medicine and Health Sciences, University of Molise, 86100 Campobasso, Italy
- Exercise and Sports Medicine Unit, Antonio Cardarelli Hospital, 86100 Campobasso, Italy
| | - Iacopo Piomboni
- Department of Medicine and Health Sciences, University of Molise, 86100 Campobasso, Italy
| | - Carmine D’Addona
- Department of Medicine and Health Sciences, University of Molise, 86100 Campobasso, Italy
| | - Vito Picerno
- Department of Medicine and Health Sciences, University of Molise, 86100 Campobasso, Italy
| | - Antonio Bianco
- Department of Medicine and Health Sciences, University of Molise, 86100 Campobasso, Italy
- Exercise and Sports Medicine Unit, Antonio Cardarelli Hospital, 86100 Campobasso, Italy
| | - Andrea Caiazzo
- Department of Medicine and Health Sciences, University of Molise, 86100 Campobasso, Italy
- Exercise and Sports Medicine Unit, Antonio Cardarelli Hospital, 86100 Campobasso, Italy
| | - Leonardo Bencivenga
- Department of Advanced Biomedical Sciences, University of Naples Federico II, 80131 Naples, Italy
- Gérontopôle de Toulouse, Institut du Vieillissement, CHU de Toulouse, 31000 Toulouse, France
| | - Giuseppe Rengo
- Department of Translational Medical Sciences, University of Naples Federico II, 80131 Naples, Italy
- Istituti Clinici Scientifici Maugeri SpA Società Benefit (ICS Maugeri SpA SB), 82037 Telese Terme, Italy
| | - Germano Guerra
- Department of Medicine and Health Sciences, University of Molise, 86100 Campobasso, Italy
- Exercise and Sports Medicine Unit, Antonio Cardarelli Hospital, 86100 Campobasso, Italy
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5
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Stevens DR, Rohn MCH, Hinkle SN, Williams AD, Kumar R, Lipsky LM, Grobman W, Sherman S, Kanner J, Chen Z, Mendola P. Maternal body composition and gestational weight gain in relation to asthma control during pregnancy. PLoS One 2022; 17:e0267122. [PMID: 35442986 PMCID: PMC9020691 DOI: 10.1371/journal.pone.0267122] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 04/02/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Poor asthma control is common during pregnancy and contributes to adverse pregnancy outcomes. Identification of risk factors for poor gestational asthma control is crucial. OBJECTIVE Examine associations of body composition and gestational weight gain with asthma control in a prospective pregnancy cohort (n = 299). METHODS Exposures included pre-pregnancy body mass index (BMI), first trimester skinfolds, and trimester-specific gestational weight gain. Outcomes included percent predicted forced expiratory volumes (FEV1, FEV6), forced vital capacity (FVC), peak expiratory flow (PEF), FEV1/FVC, symptoms (activity limitation, nighttime symptoms, inhaler use, and respiratory symptoms), and exacerbations (asthma attacks, medical encounters). Linear and Poisson models examined associations with lung function (β (95% confidence interval (CI)), asthma symptom burden (relative rate ratio (RR (95%CI)), and exacerbations (RR (95%CI)). RESULTS Women with a BMI ≥ 30 had lower percent predicted FVC across pregnancy (βThirdTrimester: -5.20 (-8.61, -1.78)) and more frequent night symptoms in the first trimester (RR: 1.66 (1.08, 2.56)). Higher first trimester skinfolds were associated with lower FEV1, FEV6, and FVC, and more frequent night symptoms and inhaler use across pregnancy. Excessive first trimester gestational weight gain was associated with more frequent activity limitation in the first trimester (RR: 3.36 (1.15, 9.80)) and inhaler use across pregnancy (RRThirdTrimester: 3.49 (1.21, 10.02)). CONCLUSIONS Higher adiposity and first trimester excessive gestational weight gain were associated with restrictive changes in lung function and symptomology during pregnancy.
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Affiliation(s)
- Danielle R. Stevens
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD, United States of America
| | - Matthew C. H. Rohn
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD, United States of America
| | - Stefanie N. Hinkle
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD, United States of America
| | - Andrew D. Williams
- UND School of Medicine and Health Sciences, University of North Dakota, Grand Forks, ND, United States of America
| | - Rajesh Kumar
- Northwestern University Feinberg School of Medicine, Chicago, IL, United States of America
| | - Leah M. Lipsky
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD, United States of America
| | - William Grobman
- Northwestern University Feinberg School of Medicine, Chicago, IL, United States of America
| | - Seth Sherman
- The Emmes Company, Rockville, MD, United States of America
| | - Jenna Kanner
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD, United States of America
| | - Zhen Chen
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD, United States of America
| | - Pauline Mendola
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD, United States of America
- School of Public Health and Health Professions, University at Buffalo, Buffalo NY, United States of America
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Lad N, Murphy A, Parenti C, Nelson C, Williams N, Sharpe G, McTernan P. Asthma and obesity: endotoxin another insult to add to injury? Clin Sci (Lond) 2021; 135:2729-2748. [PMID: 34918742 PMCID: PMC8689194 DOI: 10.1042/cs20210790] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 11/29/2021] [Accepted: 12/06/2021] [Indexed: 12/20/2022]
Abstract
Low-grade inflammation is often an underlying cause of several chronic diseases such as asthma, obesity, cardiovascular disease, and type 2 diabetes mellitus (T2DM). Defining the mediators of such chronic low-grade inflammation often appears dependent on which disease is being investigated. However, downstream systemic inflammatory cytokine responses in these diseases often overlap, noting there is no doubt more than one factor at play to heighten the inflammatory response. Furthermore, it is increasingly believed that diet and an altered gut microbiota may play an important role in the pathology of such diverse diseases. More specifically, the inflammatory mediator endotoxin, which is a complex lipopolysaccharide (LPS) derived from the outer membrane cell wall of Gram-negative bacteria and is abundant within the gut microbiota, and may play a direct role alongside inhaled allergens in eliciting an inflammatory response in asthma. Endotoxin has immunogenic effects and is sufficiently microscopic to traverse the gut mucosa and enter the systemic circulation to act as a mediator of chronic low-grade inflammation in disease. Whilst the role of endotoxin has been considered in conditions of obesity, cardiovascular disease and T2DM, endotoxin as an inflammatory trigger in asthma is less well understood. This review has sought to examine the current evidence for the role of endotoxin in asthma, and whether the gut microbiota could be a dietary target to improve disease management. This may expand our understanding of endotoxin as a mediator of further low-grade inflammatory diseases, and how endotoxin may represent yet another insult to add to injury.
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Affiliation(s)
- Nikita Lad
- Department of Biosciences, School of Science and Technology, Nottingham Trent University, Nottingham, NG11 8NS, U.K
| | - Alice M. Murphy
- Department of Biosciences, School of Science and Technology, Nottingham Trent University, Nottingham, NG11 8NS, U.K
| | - Cristina Parenti
- SHAPE Research Centre, School of Science and Technology, Nottingham Trent University, Nottingham, NG11 8NS, U.K
| | - Carl P. Nelson
- Department of Biosciences, School of Science and Technology, Nottingham Trent University, Nottingham, NG11 8NS, U.K
| | - Neil C. Williams
- SHAPE Research Centre, School of Science and Technology, Nottingham Trent University, Nottingham, NG11 8NS, U.K
| | - Graham R. Sharpe
- SHAPE Research Centre, School of Science and Technology, Nottingham Trent University, Nottingham, NG11 8NS, U.K
| | - Philip G. McTernan
- Department of Biosciences, School of Science and Technology, Nottingham Trent University, Nottingham, NG11 8NS, U.K
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Mikalsen IB, Halvorsen T, Juliusson PB, Magnus M, Nystad W, Stensrud T, Størdal K, Vollsæter M, Øymar K. Early life growth and associations with lung function and bronchial hyperresponsiveness at 11-years of age. Respir Med 2021; 177:106305. [PMID: 33482491 DOI: 10.1016/j.rmed.2021.106305] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Revised: 12/31/2020] [Accepted: 01/03/2021] [Indexed: 01/17/2023]
Abstract
Low birthweight and being born small-for-gestational age (SGA) are linked to asthma and impaired lung function. Particularly, poor intrauterine growth followed by rapid catch-up growth during childhood may predispose for respiratory disease. Bronchial hyperresponsiveness (BHR) is an essential feature of asthma, but how foetal and early childhood growth are associated with BHR is less studied. Our hypothesis was that children born SGA or with accelerated early life growth have increased BHR and altered lung function at 11-years of age. We studied the associations between SGA and early childhood growth with lung function and BHR at 11-years of age in a subgroup of 468 children from the Norwegian Mother, Father and Child Cohort Study (MoBa), and included data from the Medical Birth Registry of Norway (MBRN). Weight at 6 months of age was positively associated with forced vital capacity (adjusted Beta: 0.121; 95% Confidence interval: 0.023, 0.219) and negatively associated with the ratio of forced expiratory flow in first second/forced vital capacity (-0.204; -0.317, -0.091) at 11-years of age. Similar patterns were found for weight at 36 months and for change in weight from birth to 6 months of age. SGA or other various variables of early childhood growth were not associated with BHR at 11-years of age. Early life growth was associated with an obstructive lung function pattern, but not with BHR in 11-year old children. Foetal growth restriction or weight gain during early childhood do not seem to be important risk factors for subsequent BHR in children.
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Affiliation(s)
- Ingvild Bruun Mikalsen
- Department of Paediatrics, Stavanger University Hospital, Stavanger, Norway; Department of Clinical Science, University of Bergen, Bergen, Norway.
| | - Thomas Halvorsen
- Department of Clinical Science, University of Bergen, Bergen, Norway; Department of Paediatrics, Haukeland University Hospital, Bergen, Norway
| | - Petur Benedikt Juliusson
- Department of Clinical Science, University of Bergen, Bergen, Norway; Department of Paediatrics, Haukeland University Hospital, Bergen, Norway; Department of Health Registry Research and Development, Norwegian Institute of Public Health, Bergen, Norway
| | - Maria Magnus
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway; MRC Integrative Epidemiology Unit at the University of Bristol, Bristol, United Kingdom; Population Health Sciences, Bristol Medical School, Bristol, United Kingdom
| | - Wenche Nystad
- Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Oslo, Norway
| | - Trine Stensrud
- Department of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway
| | - Ketil Størdal
- Department of Chronic Diseases and Ageing, Norwegian Institute of Public Health, Oslo, Norway; Department of Paediatrics, Østfold Hospital Trust, Grålum, Norway
| | - Maria Vollsæter
- Department of Clinical Science, University of Bergen, Bergen, Norway; Department of Paediatrics, Haukeland University Hospital, Bergen, Norway
| | - Knut Øymar
- Department of Paediatrics, Stavanger University Hospital, Stavanger, Norway; Department of Clinical Science, University of Bergen, Bergen, Norway
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Mishra N, Salvi S, Lyngdoh T, Agrawal A. Low lung function in the developing world is analogous to stunting: a review of the evidence. Wellcome Open Res 2020; 5:147. [PMID: 33381655 PMCID: PMC7745193 DOI: 10.12688/wellcomeopenres.15929.2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/10/2020] [Indexed: 01/06/2023] Open
Abstract
Background: Low vital capacity, one of the consequences of restricted lung growth, is a strong predictor of cardiovascular mortality. Vital capacity is lower in the developing world than the developed world, even after adjusting for height, weight and gender. This difference is typically dismissed as ethnic variation, adjusted for by redefining normal. Whether this is a consequence of stunted lung growth, rather than just genetically smaller lungs, has not been investigated in detail. Therefore, we sought to compare factors implicated in both stunting and lung development, particularly in the developing world. Methods: We conducted a manual screen of articles identified through Google Scholar and assessed risk of bias. No language restrictions were applied, so long as there was an associated English abstract. We queried VizHub (Global Burden of Disease Visualization Tool) and Google Dataset search engines for disease burden and genome wide association studies. The scope of the article and the heterogeneity of the outcome measures reported required a narrative review of available evidence. To the extent possible, the review follows PRISMA reporting guidelines. Results: Early life influences operate in synergism with genetic, environmental and nutritional factors to influence lung growth and development in children. Low lung function and stunting have common anthropometric, environmental and nutritional correlates originating during early development. Similar anthropometric correlates shared chronic inflammatory pathways, indicated that the two conditions were analogous. Conclusion: The analogy between poor lung function and stunting is conspicuous in the developing world, with malnutrition at the center of non -achievement of growth potential, susceptibility to infectious diseases and intrauterine programming for metabolic syndrome. This counter the idea of redefining the normal for lung function measurements, since observed inter-ethnic variations are likely a mix of natural genetic differences as well as differences in nurture such that reduced lung function reflects early life adversities.
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Affiliation(s)
- Navya Mishra
- Public Health Foundation of India, Delhi, India.,Academy of Scientific and Innovative Research, Ghaziabad, India
| | | | | | - Anurag Agrawal
- Academy of Scientific and Innovative Research, Ghaziabad, India.,CSIR Institute of Genomics and Integrative Biology, Delhi, Delhi, India
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9
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Svartengren M, Cai GH, Malinovschi A, Theorell-Haglöw J, Janson C, Elmståhl S, Lind L, Lampa E, Lindberg E. The impact of body mass index, central obesity and physical activity on lung function: results of the EpiHealth study. ERJ Open Res 2020; 6:00214-2020. [PMID: 33263030 PMCID: PMC7682662 DOI: 10.1183/23120541.00214-2020] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 06/03/2020] [Indexed: 12/21/2022] Open
Abstract
Study objectives Obesity is often associated with lower lung function; however, the interaction of lung function with central obesity and physical inactivity is less clear. As such, we investigated the effect on lung function of body size (body mass index (BMI)), central obesity (waist circumference (WC)) and self-reported physical activity. Methods Lung function, height, weight and WC were measured in 22 743 participants (12 791 women), aged 45–75 years, from the EpiHealth cohort study. Physical activity, gender and educational level were assessed using a questionnaire. Results Obesity, central obesity and physical inactivity were all associated with lower forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC). However, in participants without central obesity there was an increase in both FEV1 and FVC by BMI (% predicted FVC increasing from median 98%, interquartile range (IQR) 89–110% in underweight participants (BMI <20) to 103%, IQR 94–113% in obese participants (BMI ≥30)). In contrast, there was a decrease in % predicted FVC in participants with central obesity (from 98%, IQR 89–109% in the normal weight group to 95%, IQR 85–105% in the obese weight group). We further found a negative association between physical activity and lung function among those with low and high levels of physical activity (% predicted FEV1 97%, IQR 86–107% versus 103%, IQR 94–113%, respectively and % predicted FVC 96%, IQR 85–106% versus 103%, IQR 94–113%, respectively). All results remained when calculated by z-scores. Conclusions The association between BMI and lung function is dependent on the presence of central obesity. Independent of obesity, there is an association between physical activity and lung function. BMI and central obesity are related to lung function in the middle-aged and elderly. BMI association with lung function is dependent on the presence of central obesity, while the association of physical activity and lung function is independent of obesity.https://bit.ly/3eQl86C
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Affiliation(s)
- Magnus Svartengren
- Dept of Medical Sciences, Occupational and Environmental Medicine, Uppsala University, Uppsala, Sweden
| | - Gui-Hong Cai
- Dept of Medical Sciences, Occupational and Environmental Medicine, Uppsala University, Uppsala, Sweden.,Dept of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
| | - Andrei Malinovschi
- Dept of Medical Sciences, Clinical Physiology, Uppsala University, Uppsala, Sweden
| | - Jenny Theorell-Haglöw
- Dept of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
| | - Christer Janson
- Dept of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
| | - Sölve Elmståhl
- Dept of Health Sciences, Division of Geriatric Medicine, Lund University, Lund, Sweden.,Clinical Research Centre (CRC), Skåne University Hospital, Malmö, Sweden
| | - Lars Lind
- Dept of Medical Sciences, Cardiovascular Epidemiology, Uppsala University, Uppsala, Sweden
| | - Erik Lampa
- Uppsala Clinical Research Center (UCR), Uppsala University, Uppsala, Sweden
| | - Eva Lindberg
- Dept of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
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10
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Mishra N, Salvi S, Lyngdoh T, Agrawal A. Low lung function in the developing world is analogous to stunting: a review of the evidence. Wellcome Open Res 2020; 5:147. [DOI: 10.12688/wellcomeopenres.15929.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/11/2020] [Indexed: 11/20/2022] Open
Abstract
Background: Low vital capacity, one of the consequences of restricted lung growth, is a strong predictor of cardiovascular mortality. Vital capacity is lower in the developing world than the developed world, even after adjusting for height, weight and gender. This difference is typically dismissed as ethnic variation, adjusted for by redefining normal. Whether this is a consequence of stunted lung growth, rather than genetically smaller lungs, has not been investigated in detail. Therefore, we sought to compare factors implicated in both stunting and lung development, particularly in the developing world. Methods: We conducted a manual screen of articles identified through Google Scholar and assessed risk of bias. No language restrictions were applied, so long as there was an associated English abstract. We queried VizHub (Global Burden of Disease Visualization Tool) and Google Dataset search engines for disease burden and genome wide association studies. The scope of the article and the heterogeneity of the outcome measures reported required a narrative review of available evidence. To the extent possible, the review follows PRISMA reporting guidelines. Results: Early life influences operate in synergism with environmental and nutritional factors to influence lung growth and development in children. Low lung function and stunting have common anthropometric, environmental and nutritional correlates originating during early development. Similar anthropometric correlates and shared chronic inflammatory pathways indicated that the two conditions were analogous. Conclusion: The analogy between poor lung function and stunting is conspicuous in the developing world, where malnutrition lies at the center of non -achievement of growth potential, susceptibility to infectious diseases and intrauterine programming for metabolic syndrome. The common pathological mechanisms governing stunting and lung function deficits counter the idea of redefining the normal for lung function measurements.
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11
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Mikalsen IB, Byberg K, Forman MR, Øymar K. Adipokines in adolescence; the associations with lung function and atopy - A cross-sectional study. Respir Med 2020; 170:106063. [PMID: 32705985 DOI: 10.1016/j.rmed.2020.106063] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 06/07/2020] [Accepted: 06/08/2020] [Indexed: 12/31/2022]
Abstract
Both inflammatory and mechanical effects have been proposed to explain the increased risk of asthma and reduced lung function observed in obese children and adults. The evidence regarding the potential role of obesity in the aetiology of atopy and allergy is more conflicting. The adipokines leptin and adiponectin are inflammatory markers of fat metabolism which may be involved in explaining the increased risk of asthma and reduced lung function in obese children and adults. In this cross-sectional study, we aimed to study how adiponectin and leptin were associated with lung function and atopic sensitisation in adolescents. The study included 384 children at mean age 12.9 years with measurements of adiponectin, leptin, lung function and atopic sensitisation. Adiponectin and leptin levels were measured in serum, lung function was measured by spirometry and atopic sensitisation was measured by serum specific Immunoglobulin E. In linear regression models, leptin was negatively associated with forced vital capacity (FVC) (Beta: -4.13; 95% Confidence Interval: -5.83, -2.44, P < 0.001) and forced expiratory volume in the first second (FEV1) (-3.74; -5.39, -2.09, P < 0.001) after adjusting for body mass index (BMI) and other covariates. No associations were observed between adiponectin and lung function or between leptin or adiponectin and atopic sensitisation. In this cross-sectional analysis of adolescents in all weight classes, leptin was negatively associated with FEV1 and FVC independent of BMI, but no associations were found between adiponectin and lung function. The results suggest that leptin may have a functional role in the airways of healthy children.
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Affiliation(s)
- Ingvild Bruun Mikalsen
- Department of Pediatrics, Stavanger University Hospital, Stavanger, Norway; Department of Clinical Science, University of Bergen, Norway.
| | - Kristine Byberg
- Department of Pediatrics, Stavanger University Hospital, Stavanger, Norway
| | - Michele R Forman
- Department of Nutritional Sciences, Purdue University, West Lafayette, IN, USA
| | - Knut Øymar
- Department of Pediatrics, Stavanger University Hospital, Stavanger, Norway; Department of Clinical Science, University of Bergen, Norway
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12
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Molina-Luque R, Romero-Saldaña M, Álvarez-Fernández C, Rodríguez-Guerrero E, Hernández-Reyes A, Molina-Recio G. Waist to Height Ratio and Metabolic Syndrome as lung dysfunction predictors. Sci Rep 2020; 10:7212. [PMID: 32350324 PMCID: PMC7190714 DOI: 10.1038/s41598-020-64130-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Accepted: 04/03/2020] [Indexed: 01/28/2023] Open
Abstract
Metabolic Syndrome (MetS) has been related to pulmonary diseases but its relationship with lung age has not been sufficiently studied. In addition, anthropometric variables have been associated with pulmonary dysfunction, highlighting the waist-to-height ratio (WHtR). The aim was to evaluate the relationship between MetS and: lung age, anthropometric variables and the alteration of lung function. A cross-sectional study was carried out in 1901 workers, evaluating lung function through lung age (Morris & Temple equation) and spirometric values. The diagnosis of MetS was based on the harmonized criteria. We measured anthropometric variables (WHtR, waist circumference, body mass index, waist to hip ratio), blood pressure and biochemical variables (glucose, cholesterol total, HDL, triglycerides). Workers suffering from MetS showed an accelerated lung aging (59.4 ± 18.7 years vs 49 ± 18.4 years). The WHtR ≥ 0.55 was significantly related to an increase in lung age (β = 6.393, p < 0.001). In addition, a significant linear trend was found between clinical categories of WHtR and lung dysfunction, restrictive and mixed pattern. MetS caused an accelerated lung aging and favored the presence of restrictive lung impairment. In addition, WHtR ≥ 0.55 has been shown as the best predictor for pulmonary health.
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Affiliation(s)
- Rafael Molina-Luque
- Department of Nursing, Faculty of Medicine and Nursing, University of Córdoba, Av. Menéndez Pidal No/No, 14004, Córdoba, Spain
| | - Manuel Romero-Saldaña
- Department of Occupational Safety and Health, Córdoba City Hall, Huerto San Pedro el Real Street, 1, 14003, Córdoba, Spain.
| | - Carlos Álvarez-Fernández
- Department of Occupational Safety and Health, Córdoba City Hall, Huerto San Pedro el Real Street, 1, 14003, Córdoba, Spain
| | | | - Alberto Hernández-Reyes
- Department of Nursing, Faculty of Medicine and Nursing, University of Córdoba, Av. Menéndez Pidal No/No, 14004, Córdoba, Spain
| | - Guillermo Molina-Recio
- Department of Nursing, Faculty of Medicine and Nursing, University of Córdoba, Av. Menéndez Pidal No/No, 14004, Córdoba, Spain
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13
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Oliveira PD, Wehrmeister FC, Gonçalves H, Assunção MC, Peréz-Padilla R, Barros FC, Menezes AMB. Body composition from 18 to 22 years and pulmonary function at 22 years-1993 Pelotas Birth Cohort. PLoS One 2019; 14:e0219077. [PMID: 31247010 PMCID: PMC6597105 DOI: 10.1371/journal.pone.0219077] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 06/15/2019] [Indexed: 12/12/2022] Open
Abstract
The objective was to verify the association between body composition from 18 to 22 years and pulmonary function at 22 years of age. This longitudinal analysis was conducted with a Brazilian birth cohort data. The outcomes were the forced expiratory volume in the first second and forced vital capacity (FVC), measured at 22 years follow-up. Main exposures: obesity (body mass index ≥ 30kg/m2), and highest tertiles of fat mass (FM) and fat mass index (air displacement plethysmography) measured at 18 and 22 years-old follow-ups. The reference category (not exposed) was defined by those individuals who were not classified in the highest adiposity categories mentioned, in both ages. Multivariable linear regressions stratified by sex were used. The sample comprised 3,511 participants. Those who belonged to the highest adiposity categories in 18 and 22 years follow-ups showed lower pulmonary function at 22 years when compared to those who were not classified in the higher adiposity categories in both ages (reference category); those in the highest tertile of FM showed a mean FVC -313mL (95%CI -421; -206) and -259mL (95%CI -336; -182) in men and women, compared to the reference category, respectively. Those who changed from the higher to the lower adiposity categories (from 18 to 22 years) showed pulmonary function similar to the reference, and those who presented the opposite body composition trajectory, showed decreased pulmonary function results at 22 years, mainly among women. We concluded that high body adiposity in two follow-ups and especially contemporary adiposity was associated with lower pulmonary function at 22 years.
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Affiliation(s)
- Paula Duarte Oliveira
- Federal University of Pelotas, Postgraduate Program in Epidemiology, Pelotas, Brazil
- * E-mail:
| | | | - Helen Gonçalves
- Federal University of Pelotas, Postgraduate Program in Epidemiology, Pelotas, Brazil
| | | | - Rogelio Peréz-Padilla
- Instituto Nacional de Enfermedades Respiratorias, Institute of Respiratory Diseases, Mexico City, Mexico
| | - Fernando C. Barros
- Catholic University of Pelotas, Postgraduate Program in Health and Behavior, Pelotas, Brazil
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