Association between adiposity measures and COPD risk in Chinese adults
- Jiachen Li1,
- Lu Zhu1,
- Yuxia Wei1,
- Jun Lv1,2,3,
- Yu Guo4,
- Zheng Bian4,
- Huaidong Du5,6,
- Ling Yang5,6,
- Yiping Chen5,6,
- Yonglin Zhou7,
- Ruqin Gao8,
- Junshi Chen9,
- Zhengming Chen6,
- Weihua Cao1,
- Canqing Yu1 and
- Liming Li1
- on behalf of the China Kadoorie Biobank Collaborative Group10
- 1Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
- 2Key Laboratory of Molecular Cardiovascular Sciences (Peking University), Ministry of Education, Beijing, China
- 3Peking University Institute of Environmental Medicine, Beijing, China
- 4Chinese Academy of Medical Sciences, Beijing, China
- 5Medical Research Council Population Health Research Unit at the University of Oxford, Oxford, United Kingdom
- 6Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, United Kingdom
- 7Jiangsu CDC, Nanjing, Jiangsu, China
- 8Qingdao CDC, Qingdao, Shandong, China
- 9China National Center for Food Safety Risk Assessment, Beijing, China
- 10The members of steering committee and collaborative group are listed in the supplemental material
- Canqing Yu, Department of Epidemiology and Biostatistics, Peking University Health Science Center, 38 Xueyuan Road, Beijing 100191, China. E-mail: yucanqing{at}pku.edu.cn
Abstract
Bodyweight and fat distribution may be related to Chronic obstructive pulmonary disease (COPD) risk. Limited prospective evidence linked COPD to abdominal adiposity. We investigated the association of body mass index (BMI) and measures of abdominal adiposity with COPD risk in a prospective cohort study.
The China Kadoorie Biobank (CKB) recruited participants aged 30–79 years from ten areas across China. Anthropometric indexes were objectively measured at the baseline survey during 2004–2008. After exclusion of participants with prevalent COPD and major chronic diseases, 452 259 participants were included and followed up through the end of 2016. We used Cox models to estimate adjusted hazard ratios relating adiposity to risk of COPD hospitalisation or death.
Over an average of 10.1-year follow-up, 10 739 COPD hospitalisation events and deaths were reported. Compared with normal BMI (BMI 18.5 to <24.0 kg·m−2), underweight (BMI<18.5 kg·m−2) individuals had increased risk of COPD, with adjusted HR (95% CI) to be 1.78 (1.66–1.89). Overweight (BMI 24.0 to <28.0 kg·m−2) and obesity (BMI≥28.0 kg·m−2) were not associated with an increased risk after adjustment for waist circumference. A higher waist circumference (≥85 cm for men and ≥80 cm for women) was positively associated with COPD risk after adjustment for BMI. Waist-to-hip ratio and waist-to-height ratio were also positively related to COPD risk.
Abdominal adiposity and underweight were risk factors for COPD in Chinese adults. Both BMI and measures of Abdominal adiposity should be considered in the prevention of COPD.
Footnotes
This manuscript has recently been accepted for publication in the European Respiratory Journal. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article.
Conflict of interest: Dr. J. Li has nothing to disclose.
Conflict of interest: Dr. Zhu has nothing to disclose.
Conflict of interest: Dr. Wei has nothing to disclose.
Conflict of interest: Dr. Lv has nothing to disclose.
Conflict of interest: Dr. Guo has nothing to disclose.
Conflict of interest: Dr. Bian has nothing to disclose.
Conflict of interest: Dr. Du has nothing to disclose.
Conflict of interest: Dr. Yang has nothing to disclose.
Conflict of interest: Dr. Chen has nothing to disclose.
Conflict of interest: Dr. Zhou has nothing to disclose.
Conflict of interest: Dr. Gao has nothing to disclose.
Conflict of interest: Dr. J. Chen has nothing to disclose.
Conflict of interest: Dr. Z. Chen has nothing to disclose.
Conflict of interest: Dr. Cao has nothing to disclose.
Conflict of interest: Dr. Yu has nothing to disclose.
Conflict of interest: Dr. L. Li has nothing to disclose.
This is a PDF-only article. Please click on the PDF link above to read it.
- Received September 25, 2019.
- Accepted December 20, 2019.
- Copyright ©ERS 2020