Understanding the role of body weight and composition on lung function growth and decline
- Autores: María Gabriela Prado Peralta
- Directores de la Tesis: Judith García Aymerich (dir. tes.)
- Lectura: En la Universitat Pompeu Fabra ( España ) en 2020
- Idioma: español
- Tribunal Calificador de la Tesis: María Adoración Romaguera Bosch (presid.), Joaquin Gea Guiral (secret.), Liesbeth Duijts (voc.)
- Programa de doctorado: Programa de Doctorado en Biomedicina por la Universidad Pompeu Fabra
- Materias:
- Enlaces
- Tesis en acceso abierto en: TDX
- Resumen
Background: There is evidence suggesting that body weight is associated with lung function, but results are contradictory and suffer from important limitations. We aimed to assess the association of body weight and composition with lung function growth and decline, overcoming some of the limitations of previous research.
Methods: We used data from three population-based cohorts: the Spanish INfancia y Medio Ambiente (‘Environment and Childhood’), the UK Avon Longitudinal Study of Parents and Children and the European Community Respiratory Health Survey. Lung function was measured by spirometry. Body weight was assessed using body mass index (BMI). Body composition (lean body mass and fat mass) was measured using a dual-energy X-ray absorptiometry scanner. We calculated changes over time and group-based trajectories of BMI, lean body mass and/or fat mass.
Results: (1) Independently of birth size, accelerated BMI gain from birth to four years was associated with higher lung function at seven years but also with airflow limitation. In contrast, children with lower birth size and slower BMI gain in early childhood had lower lung function at seven years. (2) Higher lean body mass from nine to fifteen years related to higher lung function at fifteen years in boys and girls. In addition, higher fat mass was associated with lower lung function in boys, and with airflow limitation in boys and girls. (3) The association of higher fat mass with airflow limitation at fifteen years was partly (20%) mediated by insulin resistance, but not by C-reactive protein. (4) Moderate and high weight gain during adulthood were associated with accelerated lung function decline, while weight loss was related to its attenuation.
Conclusions: Excess body weight and fat mass have deleterious effects on lung function over life span, while higher lean body mass benefits lung function growth. The effects of body weight on lung function seem reversible. This thesis highlights the importance of assessing body composition when studying the effects of body weight on respiratory health and of promoting body weight and fat mass control in order to reduce respiratory morbidity at all ages.
