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

Journal article
Authors Magnus Pär Ekström
Anders Blomberg
Göran Bergström
John Brandberg
Kenneth Caidahl
Gunnar Engström
Jan Engvall
Maria Eriksson
Klas Gränsbo
Tomas Hansen
Tomas Jernberg
Lars Nilsson
Ulf Nilsson
Anna-Carin Olin
Lennart Persson
Annika Rosengren
Martin Sandelin
Magnus Sköld
Johan Sundström
Eva Swahn
Stefan Söderberg
Hanan A Tanash
Kjell Torén
Carl Johan Östgren
Eva Lindberg
Published in Thorax
Volume 74
Issue 10
Pages 958-964
ISSN 1468-3296
Publication year 2019
Published at Wallenberg Laboratory
Institute of Medicine, Department of Public Health and Community Medicine, Section of Occupational and environmental medicine
Institute of Clinical Sciences, Department of Radiology
Institute of Medicine, Department of Molecular and Clinical Medicine
Pages 958-964
Language en
Links dx.doi.org/10.1136/thoraxjnl-2019-2...
www.ncbi.nlm.nih.gov/entrez/query.f...
Subject categories Clinical Medicine

Abstract

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.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.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.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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