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1 CNUCE Institute of the National Research Council (CNR), 2 Cardiac and Thoracic Dept, University and Hospital of Pisa and 3 Institute of Clinical Physiology of the National Research Council (CNR), Pisa, Italy
CORRESPONDENCE: M. Bottai, Istituto CNUCE, National Research Council of Italy, Via Morizzi 1, 56124, Pisa, Italy. Fax: 39 0503138091/8092. E-mail: matteo.bottai@cnuce.cnr.it
Keywords: body mass index, diffusing capacity, forced expiratory volume, spirometry, vital capacity
Received: August 9, 2001
Accepted January 25, 2002
This study was supported in part by the National Research Council, targeted project "Prevention and Control of Disease Factors, SP2, contract no. 91.00171.PF41"; a grant from the Italian Electric Power Authority (ENEL) and the CNR-ENEL project "Interactions of the Energy System with Human Health Environment", Rome, Italy; by contract no. BMH1-CT92-0849 (BIOMED1) between the European Economic Community and the University of Pisa, Italy; by educational grants from SmithKline Beecham Pharmaceuticals, Collegeville, PA, USA (1999–2000), and from GlaxoSmithKline, London, UK (2001).
The aim of this study was to evaluate the effects of body mass index (BMI) changes over an 8-yr follow-up, on longitudinal changes of vital capacity (VC), forced vital capacity (FVC), forced expiratory volume in one second (FEV1), and carbon monoxide diffusing capacity of the lung (DL,CO) indices in a general population sample of North Italy.
To avoid including weight changes possibly related to physical growth, only the 1,426 adults (>24 yrs, 46% males) with complete follow-up were selected. Median linear regression models were applied to estimate the medians of change (computed as follow-up minus baseline values) of VC, FVC, FEV1 and DL,CO indices, as functions of changes of BMI over the follow-up period, separately by sex, after considering several potential confounders and effect modifiers.
The extent of lung function loss tended to be higher among those who, at baseline, reported greater BMI values. Males experienced larger losses than females (20 and 16 mL FEV1 median reduction for a BMI unit increase in males and females, respectively). Conversely, longitudinal changes of BMI caused a slight and nonsignificant increase in DL,CO values in both sexes.
Over an 8-yr follow-up, the detrimental effect of gaining weight might be reversible for many adults as most of those who reduced their body mass index values also increased their lung function. Overweight patients with ventilatory impairment should be routinely encouraged to lose weight for improving their lung function.
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