Background Previous studies have reported an association between weight increase and excess lung function decline in young adults followed for short periods. We aimed to estimate lung function trajectories during adulthood from 20-year weight change profiles using data from the population-based European Community Respiratory Health Survey (ECRHS).
Methods We included 3673 participants recruited at age 20–44 years with repeated measurements of weight and lung function (forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1)) in three study waves (1991–93, 1999–2003, 2010–14) until they were 39–67 years of age. We classified subjects into weight change profiles according to baseline body mass index (BMI) categories and weight change over 20 years. We estimated trajectories of lung function over time as a function of weight change profiles using population-averaged generalised estimating equations.
Results In individuals with normal BMI, overweight and obesity at baseline, moderate (0.25–1 kg/year) and high weight gain (>1 kg/year) during follow-up were associated with accelerated FVC and FEV1 declines. Compared with participants with baseline normal BMI and stable weight (±0.25 kg/year), obese individuals with high weight gain during follow-up had −1011 mL (95% CI −1.259 to −763) lower estimated FVC at 65 years despite similar estimated FVC levels at 25 years. Obese individuals at baseline who lost weight (<−0.25 kg/year) exhibited an attenuation of FVC and FEV1 declines. We found no association between weight change profiles and FEV1/FVC decline.
Conclusion Moderate and high weight gain over 20 years was associated with accelerated lung function decline, while weight loss was related to its attenuation. Control of weight gain is important for maintaining good lung function in adult life.
- lung function
- weight change
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Contributors GPP, AM, A-EC and JG-A designed the study. GPP wrote the initial draft and conducted the statistical analyses. JG-A had full access to all the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. All authors provided substantial contributions to the conception or design of the work, or the acquisition, analysis or interpretation of data for the work, revised the manuscript for important intellectual content, approved the final version, and agreed to be accountable for all aspects of the work.
Funding The present analyses are part of the Ageing Lungs in European Cohorts (ALEC) Study (www.alecstudy.org), which has received funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement No. 633212. The local investigators and funding agencies for the European Community Respiratory Health Survey are reported in the online supplement. ISGlobal is a member of the CERCA Programme, Generalitat de Catalunya.
Disclaimer The funding sources were not involved in the study design, the collection, analysis and interpretation of data or in the writing of the report and in the decision to submit the article for publication.
Competing interests JG-A reports personal fees from Esteve, Chiesi and AstraZeneca, outside the submitted work. MJA reports grants from Pfizer, grants from Boehringer-Ingelheim and personal fees from Sanofi, outside the submitted work. PD reports personal fees from ALK, Stallergenes Greer, IQVIA, Chiesi, AstraZeneca, Thermo Fisher Scientific, Menarini, Bausch & Lomb, Mylan, ASIT Biotech, Novartis, Sanofi and Regeneron, outside the submitted work. RJ reports grants from Estonian Research Council (Personal Research Grant no 562) and personal fees from GSK, Boehringer and Novartis, outside the submitted work.
Patient consent for publication Not required.
Ethics approval Each participating centre obtained ethical approval from their local ethics committees and followed the rules for ethics and data protection from their country, which were in accordance with the Declaration of Helsinki.
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement No data are available.
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