The associations between dynapenic abdominal obesity and new-onset asthma: a prospective cohort study from the English Longitudinal Study of Ageing.

BACKGROUND

The combination of reduced muscle power and excess central fat, known as dynapenic abdominal obesity (DAO), is increasingly tied to poor health in midlife and beyond, such as heart-related deaths, metabolic disorders, and worsening frailty. Yet, its link to emerging asthma cases has not been studied longitudinally. We examined if DAO predicts asthma onset among those 50 and above.

METHODS

Using the English Longitudinal Study of Ageing (ELSA), a broad panel tracking English residents over 50 at home, we analyzed asthma-free individuals from 2004 to 2005 (Wave 2) to 2018–2019 (Wave 9). DAO involved weak grip (< 26 kg men, < 16 kg women) plus large waist (> 102 cm men, > 88 cm women). Groups included non-weak/non-central fat (ND/NAO), non-weak/central fat (ND/AO), weak/non-central fat (D/NAO), and weak/central fat (D/AO). New asthma was based on reported physician confirmation post-baseline. We applied Cox models for risk estimates, controlling for demographics such as age, gender, body mass, ethnicity, schooling, relationship status, tobacco use, and alcohol habits.

RESULTS

A total of 5,746 participants were included in the study, 496 new asthma events arose during follow-up. Relative to ND/NAO, D/AO linked to higher risk in the unadjusted model (HR 2.35, 95% CI 1.37–4.04, p = 0.002) and adjusted (HR 2.39, 95% CI 1.24–4.60, p = 0.009). ND/AO (adjusted HR 1.02, 95% CI 0.67–1.56, p = 0.924) and D/NAO (adjusted HR 0.36, 95% CI 0.09–1.47, p = 0.153) showed no significant association.

CONCLUSIONS

D/AO was associated with greater asthma emergence than ND/AO and D/NAO in older adults, suggesting that the combination of low muscle power and central obesity may drive greater risk.