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Sex-specific effect of body weight gain on systemic inflammation in subjects with COPD: results from the SAPALDIA cohort study 2

Divisions of ¹ Pulmonary Medicine and ⁴ Community Medicine and Primary Care, University Hospitals of Geneva, Geneva, ² Institute of Social and Preventive Medicine, University of Basel, Basel, and ³ Molecular Epidemiology/Cancer Registry, Institutes of Social and Preventive Medicine and Surgical Pathology, University of Zürich, Zürich, Switzerland.

CORRESPONDENCE: P-O. Bridevaux, University Hospitals of Geneva, Division of Pulmonary Medicine, 24 rue Micheli-du-Crest, 1211 Geneva, Switzerland. E-mail: Pierre-Olivier.Bridevaux{at}hcuge.ch

Keywords: Chronic obstructive pulmonary disease, forced expiratory volume in 1s decline, obesity, sex differences, systemic inflammation

Received: October 28, 2008
Accepted February 9, 2009

Systemic inflammation may mediate the association between chronic obstructive pulmonary disease (COPD) and extrapulmonary comorbidities. We measured high-sensitivity C-reactive protein (hs-CRP) in COPD and quantified the effect modification by body weight change and sex.

Using data from the Swiss study on Air Pollution and Lung Diseases in Adults (SAPALDIA; n = 5,479) with measurements of forced expiratory volume in 1 s (FEV₁), body weight and hs-CRP, we examined the association of hs-CRP and categories of body weight change (lost weight and weight gained 0–5%, 5–9%, 9–14% and >14%) with fast FEV₁ decline.

hs-CRP was elevated both in association with fast FEV₁ decline and body weight gain. Subjects with fast FEV₁ decline and weight gain (>14%) had higher hs-CRP (2.0 mg·L^–1 for females versus 1.6 mg·L^–1 for males). After adjustment for age, smoking, physical activity, hormonal therapy and diabetes, elevated hs-CRP (>3 mg) was found to be more likely in subjects with fast FEV₁ decline (OR_males 1.38, OR_females 1.42) and in those with weight gain >14% (OR_males 2.04, OR_females 4.51).

The association of weight gain and fast FEV₁ decline predicts a higher level of systemic inflammation. Since the effect of weight gain on systemic inflammation is larger in females than in males, weight gain may be a risk factor for extrapulmonary comorbidities in females with COPD.