The relation between visceral fat and lung function in the general population is in part mediated by CRP and leptin

Expert Review of Respiratory Medicine, vol. 19, pp. 887–897

Abstract

Background Abdominal obesity is associated with reduced lung function. It remains unclear whether this results from mechanical pressure or whether visceral fat also plays a role via inflammation. Our aim was to examine the association between visceral fat and lung function, and the role of inflammation.Methods In this cross-sectional analysis, visceral fat was measured by magnetic resonance imaging and lung function by spirometry. We examined the association between visceral fat and lung function, and mediation by CRP, GlycA, FeNO, leptin, and adiponectin.Results We included 2,266 participants, mean age 56 (6) years and 90 (56) cm2 visceral fat. After adjusting for confounding factors including total body fat and waist circumference, per SD of visceral fat, FEV1 was 3.6% lower (95% CI: −4.9,-2.4), and FVC was 3.6% (−4.6,-2.6) lower. No mediation was observed by GlycA, FeNO and adiponectin. CRP and leptin together mediated 22% of the association with FEV1 and 19% with FVC.Conclusion In a middle-aged general population with a normal lung function, visceral fat was associated with reduced lung function. This association was for 20% mediated by CRP and leptin. Future research should explore the remaining mechanisms underlying the association between visceral fat and lung function.Trial registration CT.gov identifier NCT03410316.

Authors 9

1. Maartina J P Oosterom-Eijmael corresponding Aachen Department of Clinical Epidemiology

   Leiden University Medical Center

   Affiliation as printed

   Leiden University Medical Center

   Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands

2. Saskia le Cessie Aachen Department of Clinical Epidemiology

   Leiden University Medical Center

   Affiliation as printed

   Leiden University Medical Center

   Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands

3. Annelies Margaretha Slats Aachen Dept of Pulmonology, Leiden University Medical Center

   Leiden University Medical Center

   Affiliation as printed

   Leiden University Medical Center

   Department of Pulmonology, Leiden University Medical Center, Leiden, The Netherlands

4. Pieter Sicco Hiemstra Aachen Dept of Pulmonology, Leiden University Medical Center

   Leiden University Medical Center

   Affiliation as printed

   Leiden University Medical Center

   Department of Pulmonology, Leiden University Medical Center, Leiden, The Netherlands

5. Willemien Thijs

   Noordwest Ziekenhuisgroep

   Affiliation as printed

   Noordwest Zie kenhuisgroep

   Department of Pulmonology, Noordwest Zie kenhuisgroep, Alkmaar, The Netherlands

6. Hildo J. Lamb Aachen Department of Radiology, Leiden University Medical Center

   Leiden University Medical Center

   Affiliation as printed

   Leiden University Medical Center

   Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands

7. Ko Willems van Dijk Aachen Department of Human Genetics

   Leiden University Medical Center

   Affiliation as printed

   Leiden University Medical Center

   Department of Human Genetics, Leiden University Medical Center, Leiden, The Netherlands

8. Frits R. Rosendaal Aachen Department of Clinical Epidemiology

   Leiden University Medical Center

   Affiliation as printed

   Leiden University Medical Center

   Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands

9. Renée de Mutsert Aachen Department of Clinical Epidemiology

   Leiden University Medical Center

   Affiliation as printed

   Leiden University Medical Center

   Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands