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The association of body mass index, weight gain and central obesity with activity-related breathlessness : The Swedish Cardiopulmonary Bioimage Study

Ekström, Magnus Pär LU orcid ; Blomberg, Anders ; Bergström, Göran ; Brandberg, John ; Caidahl, Kenneth ; Engström, Gunnar LU ; Engvall, Jan ; Eriksson, Maria ; Gränsbo, Klas LU and Hansen, Tomas , et al. (2019) In Thorax 74(10). p.958-964
Abstract

Introduction: Breathlessness is common in the population, especially in women and associated with adverse health outcomes. Obesity (body mass index (BMI) >30 kg/m2) is rapidly increasing globally and its impact on breathlessness is unclear. Methods: This population-based study aimed primarily to evaluate the association of current BMI and self-reported change in BMI since age 20 with breathlessness (modified Research Council score ≥1) in the middle-aged population. Secondary aims were to evaluate factors that contribute to breathlessness in obesity, including the interaction with spirometric lung volume and sex. Results: We included 13 437 individuals; mean age 57.5 years; 52.5% women; mean BMI 26.8 (SD 4.3); mean BMI... (More)

Introduction: Breathlessness is common in the population, especially in women and associated with adverse health outcomes. Obesity (body mass index (BMI) >30 kg/m2) is rapidly increasing globally and its impact on breathlessness is unclear. Methods: This population-based study aimed primarily to evaluate the association of current BMI and self-reported change in BMI since age 20 with breathlessness (modified Research Council score ≥1) in the middle-aged population. Secondary aims were to evaluate factors that contribute to breathlessness in obesity, including the interaction with spirometric lung volume and sex. Results: We included 13 437 individuals; mean age 57.5 years; 52.5% women; mean BMI 26.8 (SD 4.3); mean BMI increase since age 20 was 5.0 kg/m2; and 1283 (9.6%) reported breathlessness. Obesity was strongly associated with increased breathlessness, OR 3.54 (95% CI, 3.03 to 4.13) independent of age, sex, smoking, airflow obstruction, exercise level and the presence of comorbidities. The association between BMI and breathlessness was modified by lung volume; the increase in breathlessness prevalence with higher BMI was steeper for individuals with lower forced vital capacity (FVC). The higher breathlessness prevalence in obese women than men (27.4% vs 12.5%; p<0.001) was related to their lower FVC. Irrespective of current BMI and confounders, individuals who had increased in BMI since age 20 had more breathlessness. Conclusion: Breathlessness is independently associated with obesity and with weight gain in adult life, and the association is stronger for individuals with lower lung volumes.

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@article{b900a578-3a10-4861-a651-169963e31943,
  abstract     = {{<p>Introduction: Breathlessness is common in the population, especially in women and associated with adverse health outcomes. Obesity (body mass index (BMI) &gt;30 kg/m<sup>2</sup>) is rapidly increasing globally and its impact on breathlessness is unclear. Methods: This population-based study aimed primarily to evaluate the association of current BMI and self-reported change in BMI since age 20 with breathlessness (modified Research Council score ≥1) in the middle-aged population. Secondary aims were to evaluate factors that contribute to breathlessness in obesity, including the interaction with spirometric lung volume and sex. Results: We included 13 437 individuals; mean age 57.5 years; 52.5% women; mean BMI 26.8 (SD 4.3); mean BMI increase since age 20 was 5.0 kg/m<sup>2</sup>; and 1283 (9.6%) reported breathlessness. Obesity was strongly associated with increased breathlessness, OR 3.54 (95% CI, 3.03 to 4.13) independent of age, sex, smoking, airflow obstruction, exercise level and the presence of comorbidities. The association between BMI and breathlessness was modified by lung volume; the increase in breathlessness prevalence with higher BMI was steeper for individuals with lower forced vital capacity (FVC). The higher breathlessness prevalence in obese women than men (27.4% vs 12.5%; p&lt;0.001) was related to their lower FVC. Irrespective of current BMI and confounders, individuals who had increased in BMI since age 20 had more breathlessness. Conclusion: Breathlessness is independently associated with obesity and with weight gain in adult life, and the association is stronger for individuals with lower lung volumes.</p>}},
  author       = {{Ekström, Magnus Pär and Blomberg, Anders and Bergström, Göran and Brandberg, John and Caidahl, Kenneth and Engström, Gunnar and Engvall, Jan and Eriksson, Maria and Gränsbo, Klas and Hansen, Tomas and Jernberg, Tomas and Nilsson, Lars and Nilsson, Ulf and Olin, Anna-Carin and Persson, Lennart and Rosengren, Annika and Sandelin, Martin and Sköld, Magnus and Sundström, Johan and Swahn, Eva and Söderberg, Stefan and Tanash, Hanan A. and Torén, Kjell and Östgren, Carl Johan and Lindberg, Eva}},
  issn         = {{0040-6376}},
  keywords     = {{dyspnoea; lung function; lung volume; sex; weight}},
  language     = {{eng}},
  month        = {{08}},
  number       = {{10}},
  pages        = {{958--964}},
  publisher    = {{BMJ Publishing Group}},
  series       = {{Thorax}},
  title        = {{The association of body mass index, weight gain and central obesity with activity-related breathlessness : The Swedish Cardiopulmonary Bioimage Study}},
  url          = {{http://dx.doi.org/10.1136/thoraxjnl-2019-213349}},
  doi          = {{10.1136/thoraxjnl-2019-213349}},
  volume       = {{74}},
  year         = {{2019}},
}