Original article
The effect of gender on the relationship between body fat distribution and lung function

https://doi.org/10.1016/S0895-4356(00)00318-8Get rights and content

Abstract

Although abdominal obesity, as measured by waist-to-hip ratio (WHR), has long been recognized as a risk factor for metabolic and cardiovascular diseases, little is known about the effect of WHR on pulmonary function, especially in women. In this study of 1094 men and 540 women (18–102 years) from the Baltimore Longitudinal Study of Aging (BLSA), we examined the effect of WHR on forced expiratory volume in 1 s (FEV1). Cross-sectional analyses, after accounting for body mass index (BMI) and other variables, showed a strong inverse association of WHR with FEV1 in men (β = −1.338, P=.0001) but not in women. Furthermore, larger values of WHR were associated with greater reductions of forced vital capacity (FVC) in men (β = −1.383, P = .0005) compared to women (β = −0.679, P = .02). Thus, body fat distribution has independent effects on lung function that are more prominent in men than women.

Introduction

Obesity is associated with reductions in lung volumes, particularly vital capacity (VC) and forced expiratory volume in 1 s (FEV1) 1, 2, 3, 4. The mechanism for this reduction in vital capacity has usually been ascribed to the mechanical effects of obesity on the rib cage and abdomen 1, 5. In recent years, however, it has been recognized that the pattern of obesity is an important predictor of adverse health effects such as diabetes 6, 7, 8, hypertension [8], hyperlipidemia [7], and coronary events 9, 10. Specifically, a pattern of central i.e., abdominal, obesity, as measured by waist-to-hip ratio (WHR), is associated with greater health risk than lower body obesity.

Most previous studies of the relationship of obesity to lung function have used BMI as an indicator of overall obesity 2, 11, 12. Little is known about the effect of WHR on lung function per se, particularly in women. Recently, two studies have drawn attention to the effect of fat distribution on pulmonary function in men 5, 13. Additionally, findings from the Lung Health Study showed that even moderate weight gain after smoking cessation had an adverse effect on FEV1 and FVC, but that the effect was most prominent in men [14]. While that study did not measure the pattern of fat distribution, the investigators hypothesized that the gender difference was the result of differential abdominal deposition of fat in men compared with women. In men, the predominant pattern of abdominal obesity would be expected to have a greater impact on FEV1 and FVC than peripheral obesity, which is more prominent in women.

The Baltimore Longitudinal Study on Aging (BLSA) provides an ideal population to examine the relationship between patterns of obesity and pulmonary function. This is a well-characterized group of generally health community-dwelling individuals who have undergone high-quality anthropometric and spirometric measurements. Therefore, the present study was undertaken to answer the following questions:

  • 1.

    Does fat distribution, assessed by WHR, predict lung function in men and women even after accounting for overall obesity.

  • 2.

    Can the gender difference in the relationship between obesity and lung function be accounted for by different patterns of fat distribution.

Section snippets

Population

The BLSA is described in detail in other publications 15, 16, 17. Briefly, the BLSA is a long-term study of normal human aging conducted by the National Institute on Aging. The participants are community-dwelling men and women 18–90+-year-old volunteers who are predominantly recruited from the Baltimore–Washington area. Participants return approximately every 2 years for 2 days of clinical, physiological, and psychological tests for the general purpose of characterizing the normal aging process.

Participant characteristics

The characteristics of the sample are given in Table 1. The men ranged in age from 18 to 102 years (mean: 53.7 years), whereas the women ranged from 19 to 93 years (mean: 52.5 years). On average, the men had larger BMI and WHR. Approximately 43% of the men and 21% of the women had BMI between 25 and 30; 8% of men and 10% of the women had BMI > 30; only three men and one woman had BMI > 40. Only a small proportion of subjects were current smokers or had evidence of pulmonary or coronary heart

Discussion

A few previous studies have examined the relationship of fat distribution and pulmonary function in men 5, 13, 30, but no previous studies have been conducted in women. To our knowledge, this is the first time that the effect of body fat distribution, assessed by WHR, on lung function has been examined in a relatively large group of well-characterized, community-dwelling men and women with a wide age range.

The main finding of this cross-sectional study is that WHR is a more important

Acknowledgements

The authors thank Denis Muller, Naresh Punjabi, Christopher Morrell and James Fozard for their comments.

References (30)

  • B Larsson et al.

    Abdominal adipose tissue distribution, obesity, and risk of cardiovascular disease and death13 year follow up of participants in the study of men born in 1913

    Br Med J

    (1984)
  • L Lapidus et al.

    Distribution of adipose tissue and risk of cardiovascular disease and deatha 12 year follow up of participants in population study of women in Gothenburg, Sweden

    Br Med J

    (1984)
  • Y Chen et al.

    Body weight and weight gain related to pulmonary function decline in adultsa six year follow up study

    Thorax

    (1993)
  • D.J Chinn et al.

    Longitudinal effects of changes in body mass on measurement of ventilatory capacity

    Thorax

    (1996)
  • R.A Wise et al.

    Effect of weight gain on pulmonary function after smoking cessation in the Lung Health Study

    Am J Respir Crit Care Med

    (1998)
  • Cited by (118)

    • Relationship between metabolic syndrome and pulmonary function in workers with respiratory dust exposure in Iran: Metabolic syndrome and pulmonary function

      2021, Diabetes and Metabolic Syndrome: Clinical Research and Reviews
      Citation Excerpt :

      Our study had several limitations. Gender differences in the association between lung function and MetS were recognized [1,22]. However, the subjects we studied were male workers in the industry, and it was not possible to study women.

    View all citing articles on Scopus
    View full text