Lifetime Body Mass Index Trajectories and Contrasting Lung Function Abnormalities in Mid-Adulthood: Data From the Tasmanian Longitudinal Health Study

Overview

Journal Respirology

Date 2025 Jan 26

PMID 39865446

Authors

Gulshan B Ali

Adrian J Lowe

E Haydn Walters

Jennifer L Perret

Bircan Erbas

Caroline J Lodge

Gayan Bowatte

Paul S Thomas

Garun S Hamilton

Bruce R Thompson

David P Johns

John L Hopper

Michael J Abramson

Dinh S Bui

Shyamali C Dharmage

Affiliations

Soon will be listed here.

Abstract

Background And Objective: The impact of lifetime body mass index (BMI) trajectories on adult lung function abnormalities has not been investigated previously. We investigated associations of BMI trajectories from childhood to mid-adulthood with lung function deficits and COPD in mid-adulthood.

Methods: Five BMI trajectories (n = 4194) from age 5 to 43 were identified in the Tasmanian Longitudinal Health Study. Lung function outcomes were defined using spirometry at 45 and 53 years. Associations between these BMI trajectories and lung function outcomes were investigated using multivariable regression.

Results: Compared to the average BMI trajectory, the child's average-increasing BMI trajectory was associated with greater FVC decline from 45 to 53 years (β = -178 mL; 95% CI -300.6, -55.4), lower FRC, ERV and higher TLco at 45 years, lower FVC (-227 mL; -345.3, -109.1) and higher TLco at 53 years. The High BMI trajectory was also associated with lower FRC, ERV and higher TLco at 45 years, while spirometric restriction (OR = 6.9; 2.3, 21.1) and higher TLco at 53 years. The low BMI trajectory was associated with an obstructive picture: lower FEV (-124 mL; -196.4, -51.4) and FVC (-91 mL; -173.4, -7.7), and FEV/FVC (-1.2%; -2.2, -0.1) and higher ERV and lower TLco at 45 and 53 years. A similar pattern was found at 53 years. No associations were observed with spirometrically defined COPD.

Conclusion: Our findings revealed contrasting lung function abnormalities were associated with high, subsequently increasing, and low BMI trajectories. These results emphasise the importance of tracking changes in BMI over time and the need to maintain an average BMI trajectory (BMI-Z-score 0 at each time point) throughout life.

References

Do J, Park C, Lee Y, Yoon K . Association between underweight and pulmonary function in 282,135 healthy adults: A cross-sectional study in Korean population. Sci Rep. 2019; 9(1):14308. PMC: 6778122. DOI: 10.1038/s41598-019-50488-3. View

Ali G, Bui D, Lodge C, Waidyatillake N, Perret J, Sun C . Infant body mass index trajectories and asthma and lung function. J Allergy Clin Immunol. 2021; 148(3):763-770. DOI: 10.1016/j.jaci.2021.02.020. View

Vasquez M, Zhou M, Hu C, Martinez F, Guerra S . Low Lung Function in Young Adult Life Is Associated with Early Mortality. Am J Respir Crit Care Med. 2017; 195(10):1399-1401. PMC: 5443902. DOI: 10.1164/rccm.201608-1561LE. View

Bui D, Lodge C, Burgess J, Lowe A, Perret J, Bui M . Childhood predictors of lung function trajectories and future COPD risk: a prospective cohort study from the first to the sixth decade of life. Lancet Respir Med. 2018; 6(7):535-544. DOI: 10.1016/S2213-2600(18)30100-0. View

van Huisstede A, Cabezas M, Birnie E, van de Geijn G, Rudolphus A, Mannaerts G . Systemic inflammation and lung function impairment in morbidly obese subjects with the metabolic syndrome. J Obes. 2013; 2013:131349. PMC: 3595660. DOI: 10.1155/2013/131349. View

Ferreira I, Stehouwer C . Obesity paradox or inappropriate study designs? Time for life-course epidemiology. J Hypertens. 2012; 30(12):2271-5. DOI: 10.1097/HJH.0b013e32835b4fe0. View

Steier J, Lunt A, Hart N, Polkey M, Moxham J . Observational study of the effect of obesity on lung volumes. Thorax. 2014; 69(8):752-9. DOI: 10.1136/thoraxjnl-2014-205148. View

Park C, Yi Y, Do J, Lee Y, Yoon K . Relationship between skeletal muscle mass and lung function in Korean adults without clinically apparent lung disease. Medicine (Baltimore). 2018; 97(37):e12281. PMC: 6155967. DOI: 10.1097/MD.0000000000012281. View

Miller M, Hankinson J, Brusasco V, Burgos F, Casaburi R, Coates A . Standardisation of spirometry. Eur Respir J. 2005; 26(2):319-38. DOI: 10.1183/09031936.05.00034805. View

10.

Johnson J, Theurer W . A stepwise approach to the interpretation of pulmonary function tests. Am Fam Physician. 2014; 89(5):359-66. View

11.

Liu Y, Pleasants R, Croft J, Lugogo N, Ohar J, Heidari K . Body mass index, respiratory conditions, asthma, and chronic obstructive pulmonary disease. Respir Med. 2015; 109(7):851-9. PMC: 4487766. DOI: 10.1016/j.rmed.2015.05.006. View

12.

Franssen F, ODonnell D, Goossens G, Blaak E, Schols A . Obesity and the lung: 5. Obesity and COPD. Thorax. 2008; 63(12):1110-7. DOI: 10.1136/thx.2007.086827. View

13.

Bowdish D . The Aging Lung: Is Lung Health Good Health for Older Adults?. Chest. 2018; 155(2):391-400. DOI: 10.1016/j.chest.2018.09.003. View

14.

Cornelius T, Schwartz J, Balte P, Bhatt S, Cassano P, Currow D . A Dyadic Growth Modeling Approach for Examining Associations Between Weight Gain and Lung Function Decline. Am J Epidemiol. 2020; 189(10):1173-1184. PMC: 7670871. DOI: 10.1093/aje/kwaa059. View

15.

Ali G, Lowe A, Perret J, Walters E, Lodge C, Johns D . Impact of lifetime body mass index trajectories on the incidence and persistence of adult asthma. Eur Respir J. 2022; 60(3). DOI: 10.1183/13993003.02286-2021. View

16.

Eriksson B, Backman H, Bossios A, Bjerg A, Hedman L, Lindberg A . Only severe COPD is associated with being underweight results from a population survey. ERJ Open Res. 2016; 2(3). PMC: 5034593. DOI: 10.1183/23120541.00051-2015. View

17.

Santos A, Rocha G, de Andrade J . Occurrence of the potent mutagens 2- nitrobenzanthrone and 3-nitrobenzanthrone in fine airborne particles. Sci Rep. 2019; 9(1):1. PMC: 6327027. DOI: 10.1038/s41598-018-37186-2. View

17.

Saliman J, Benditt J, Flum D, Oelschlager B, Dellinger E, Goss C . Pulmonary function in the morbidly obese. Surg Obes Relat Dis. 2008; 4(5):632-9. PMC: 4175983. DOI: 10.1016/j.soard.2008.06.010. View

18.

Zewari S, Vos P, van den Elshout F, Dekhuijzen R, Heijdra Y . Obesity in COPD: Revealed and Unrevealed Issues. COPD. 2017; 14(6):663-673. DOI: 10.1080/15412555.2017.1383978. View

19.

Chang H, Hsu J, Tsai Y, Lin S, Kuo H, Yang C . Acute respiratory distress syndrome and acute myocarditis developed in a previously healthy adult with influenza B. BMC Pulm Med. 2016; 16:1. PMC: 4700760. DOI: 10.1186/s12890-015-0163-3. View