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.
- lung function
- lung volume
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MPE and AB are first authors.
Contributors Members of SCAPIS National Steering committee and therefore responsible for funding and the planning and execution of the SCAPIS study: AB, GB, JB, GE, JEE, TJ, AR, MS, JS, SS, KT, CJÖ and EL. Responsible for the conception and design of the analyses included in the specific manuscript and first draft: ME, AB and EL. Data collection: JB, JEE, KG, TH, LTN, HLP, MS, ES and HT. Statistical analysis: ME; All authors were involved in the planning and data interpretation and revision of manuscript drafts for important intellectual content, and approval of the version to be published.
Funding The main funding body of The Swedish CArdioPulmonary bioImage Study (SCAPIS) is the Swedish Heart and Lung Foundation. The study is also funded by the Knut and Alice Wallenberg Foundation, the Swedish Research Council and VINNOVA (Sweden’s Innovation agency) the University of Gothenburg and Sahlgrenska University Hospital, Karolinska Institutet and Karolinska University Hospital, Linköping University and University Hospital, Lund University and Skåne University Hospital, Umeå University and University Hospital, Uppsala University and University Hospital. Individual research support: AR from AFA Insurance ; from the Swedish state under the agreement between Swedish government and the county councils, the ALF-agreement [ALG-GBG-74300 to K.T., G.B., J.B. A.C.O., A.R.], [ALF-VLL-548791 for S.S.] and [ALFLIO-700841 for J.E.E.]. ME was supported by unrestricted grants from The Swedish Society of Medicine, the Swedish Heart-Lung Foundation, and the Swedish Society for Medical Research.
Competing interests SS reports being an advisory board member and receiving speakers honoraria from Actelion, Bayer, MSD, outside the submitted work. Dr Olin reports having a patent WO2009045163 (Collection and measurement of exhaled particles) and being a chairholder and board member of PExA AB, outside the submitted work. JS reports advisory board work for Itrim, outside the submitted work.
Patient consent for publication Not required.
Ethics approval The study was approved by the Regional Ethical Review Board at Umeå University (Nr: 2010- 228–31 M).
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement Data are available upon reasonable request.
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