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      Relationship between Body Composition and Pulmonary Function in Early Adult Life: A Cross-Sectional Analysis Nested in Two Birth Cohort Studies

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          Abstract

          Background

          Overweight/obesity has been reported to worsen pulmonary function (PF). This study aimed to examine the association between PF and several body composition (BC) measures in two population-based cohorts.

          Methods

          We performed a cross-sectional analysis of individuals aged 18 and 30 years from two Pelotas Birth Cohorts in southern Brazil. PF was assessed by spirometry. Body measures that were collected included body mass index, waist circumference, skinfold thickness, percentages of total and segmented (trunk, arms and legs) fat mass (FM) and total fat-free mass (FFM). FM and FFM were measured by air-displacement plethysmography (BODPOD) and by dual-energy x-ray absorptiometry (DXA). Associations were verified through linear regressions stratified by sex, and adjusted for weight, height, skin color, and socioeconomic, behavioral, and perinatal variables.

          Results

          A total of 7347 individuals were included in the analyses (3438 and 3909 at 30 and 18 years, respectively). Most BC measures showed a significant positive association between PF and FFM, and a negative association with FM. For each additional percentage point of FM, measured by BOD POD, the forced vital capacity regression coefficient adjusted by height, weight and skin color, at 18 years, was −33 mL (95% CI −38, −29) and −26 mL (95% CI −30, −22), and −30 mL (95% CI −35, −25) and −19 mL (95% CI −23, −14) at 30 years, in men and women, respectively. All the BOD POD regression coefficients for FFM were the same as for the FM coefficients, but in a positive trend (p<0.001 for all associations).

          Conclusions

          All measures that distinguish FM from FFM (skinfold thickness–FM estimation–BOD POD, total and segmental DXA measures–FM and FFM proportions) showed negative trends in the association of FM with PF for both ages and sexes. On the other hand, FFM showed a positive association with PF.

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          Most cited references30

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          Impact of obesity on respiratory function.

          Obesity has long been recognized as having significant effects on respiratory function. The topic has been studied for at least the last half century, and some clear patterns have emerged. Obese patients tend to have higher respiratory rates and lower tidal volumes. Total respiratory system compliance is reduced for a variety of reasons, which will be discussed. Lung volumes tend to be decreased, especially expiratory reserve volume. Spirometry, gas exchange and airway resistance all tend to be relatively well preserved when adjusted for lung volumes. Patients may be mildly hypoxaemic, possibly due to ventilation-perfusion mismatching at the base of the lungs, where microatelectasis is likely to occur. Weight loss leads to a reversal of these changes. For all of these changes, the distribution of fat, that is, upper versus lower body, may be more important than body mass index. © 2011 The Author. Respirology © 2011 Asian Pacific Society of Respirology.
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            Obesity and respiratory diseases

            The obesity epidemic is a global problem, which is set to increase over time. However, the effects of obesity on the respiratory system are often underappreciated. In this review, we will discuss the mechanical effects of obesity on lung physiology and the function of adipose tissue as an endocrine organ producing systemic inflammation and effecting central respiratory control. Obesity plays a key role in the development of obstructive sleep apnea and obesity hypoventilation syndrome. Asthma is more common and often harder to treat in the obese population, and in this study, we review the effects of obesity on airway inflammation and respiratory mechanics. We also discuss the compounding effects of obesity on chronic obstructive pulmonary disease (COPD) and the paradoxical interaction of body mass index and COPD severity. Many practical challenges exist in caring for obese patients, and we highlight the complications faced by patients undergoing surgical procedures, especially given the increased use of bariatric surgery. Ultimately, a greater understanding of the effects of obesity on the respiratory disease and the provision of adequate health care resources is vital in order to care for this increasingly important patient population.
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              Cohort Profile update: The 1993 Pelotas (Brazil) Birth Cohort follow-up visits in adolescence

              In this paper we update the profile of the 1993 Pelotas (Brazil) Birth Cohort Study, with emphasis on a shift of priority from maternal and child health research topics to four main categories of outcome variables, collected throughout adolescence: (i) mental health; (ii) body composition; (iii) risk factors for non-communicable diseases (NCDs); (iv) human capital. We were able to trace 81.3% (n = 4106) of the original cohort at 18 years of age. For the first time, the 18-years visit took place entirely on the university premises, in a clinic equipped with state-of-the-art equipment for the assessment of body composition. We welcome requests for data analyses from outside scientists. For more information, refer to our website (http://www.epidemio-ufpel.org.projetos_de_pesquisas/estudos/coorte_1993) or e-mail the corresponding author.
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                Author and article information

                Contributors
                Role: Editor
                Journal
                PLoS One
                PLoS ONE
                plos
                plosone
                PLoS ONE
                Public Library of Science (San Francisco, CA USA )
                1932-6203
                28 September 2016
                2016
                : 11
                : 9
                : e0163428
                Affiliations
                [1 ]Federal University of Pelotas—Postgraduate Program in Epidemiology, Rua Marechal Deodoro, 1160, 3° andar, 96020–220, Pelotas, RS, Brazil
                [2 ]National Institute of Respiratory Diseases, Tlalpan, 4502, 14080, Mexico City, DF, Mexico
                [3 ]Catholic University of Pelotas—Postgraduate Program in Health and Behavior, Rua Gonçalves Chaves, 373 –sala 411, prédio C, 96015–560, Pelotas, RS, Brazil
                Hunter College, UNITED STATES
                Author notes

                Competing Interests: AMB received payment from Aztra Zeneca to carry out analysis of the PUMA study, and was paid by GSK to attend the ERS. RP received personal fees from Novartis for one lecture on epidemiology of COPD. All authors declare no conflicts of interest related to the subject of this manuscript. This does not alter our adherence to PLOS ONE policies on sharing data and materials.

                • Conceptualization: PDO AMB FCW RP.

                • Data curation: FCW BLH.

                • Formal analysis: PDO FCW RP.

                • Funding acquisition: AMB BLH DPG FCB.

                • Investigation: FCW AMB HG MCA BLH DPG.

                • Methodology: PDO AMB FCW RP HG BLH MCA DPG FCB.

                • Project administration: AMB HG MCA BLH DPG FCB.

                • Supervision: AMB HG MCA BLH DPG FCB.

                • Validation: PDO FCW BLH RP.

                • Visualization: PDO FCW AMB.

                • Writing – original draft: PDO FCW AMB.

                • Writing – review & editing: FCW AMB RP HG BLH MCA DPG FCB.

                Article
                PONE-D-16-15455
                10.1371/journal.pone.0163428
                5040394
                27682232
                602db2ad-f203-4970-a57a-51737eb42b48
                © 2016 Oliveira et al

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                : 16 April 2016
                : 8 September 2016
                Page count
                Figures: 2, Tables: 5, Pages: 15
                Funding
                Funded by: funder-id http://dx.doi.org/10.13039/100004440, Wellcome Trust;
                Award ID: 086974/Z/08/Z
                The 1982 and the 1993 birth cohort studies were supported by the Wellcome Trust through the programme entitled Major Awards for Latin America on Health Consequences of Population Change (Grant number: 086974/Z/08/Z). The International Development Research Center, World Health Organization, Overseas Development Administration, European Union, National Support Program for Centers of Excellence (PRONEX), the Brazilian National Research Council (CNPq), and the Brazilian Ministry of Health supported previous phases of the study. We are grateful to the Brazilian government for providing scholarships (a PhD scholarship to PDO). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
                Categories
                Research Article
                Biology and Life Sciences
                Biochemistry
                Lipids
                Fats
                Social Sciences
                Anthropology
                Physical Anthropology
                Anthropometry
                Biology and Life Sciences
                Physical Anthropology
                Anthropometry
                Biology and Life Sciences
                Physiology
                Physiological Parameters
                Body Weight
                Body Mass Index
                Medicine and Health Sciences
                Physiology
                Physiological Parameters
                Body Weight
                Body Mass Index
                Medicine and Health Sciences
                Women's Health
                Maternal Health
                Pregnancy
                Medicine and Health Sciences
                Women's Health
                Obstetrics and Gynecology
                Pregnancy
                Medicine and Health Sciences
                Public and Occupational Health
                Physical Activity
                Biology and Life Sciences
                Physiology
                Physiological Parameters
                Body Weight
                Birth Weight
                Medicine and Health Sciences
                Physiology
                Physiological Parameters
                Body Weight
                Birth Weight
                Medicine and Health Sciences
                Diagnostic Medicine
                Diagnostic Radiology
                Absorptiometry
                Research and Analysis Methods
                Imaging Techniques
                Diagnostic Radiology
                Absorptiometry
                Medicine and Health Sciences
                Radiology and Imaging
                Diagnostic Radiology
                Absorptiometry
                Research and Analysis Methods
                Research Design
                Cohort Studies
                Custom metadata
                All data are fully available without restriction. The data sets are available at the following links: Cohort 1993: http://epidemio-ufpel.org.br/uploads/downloads/18years-1993Cohort-PONE-D-16-15455.dta and Cohort 1982: http://epidemio-ufpel.org.br/uploads/downloads/30years-1982Cohort-PONE-D-16-15455.dta.

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