The role of visceral fat mass in preserved ratio impaired spirometry (PRISm): The Nagahama study.

BACKGROUND AND

OBJECTIVE

Recent studies have revealed the association between PRISm and the risk of cardiac mortality. Obesity is common among patients with PRISm, but the role of adiposity in PRISm is unclear. This study investigates PRISm in the context of adiposity, including visceral fat, in a large-scale general population study.

METHODS

In this community-based study involving 9850 participants aged 34-91 years from Nagahama city, we investigated the relationships among fat mass (including visceral fat), spirometry categories (normal: FEV1/FVC ≥ LLN and FEV1 ≥ 80 % predicted; PRISm: FEV1/FVC ≥ LLN and FEV1 < 80 % predicted; GOLD1: FEV1/FVC < LLN and FEV1 ≥ 80 % predicted; and GOLD2: FEV1/FVC < LLN and FEV1 < 80 %), and history of coronary artery diseases. The fat mass index and visceral fat content were evaluated using bioimpedance analysis.

RESULTS

A total of 9752 subjects were included in the analysis. The prevalence of PRISm increased with increasing fat mass index or visceral fat. The opposite relationship was observed for GOLD1. With respect to the history of coronary artery diseases, a positive interaction effect was noted between visceral fat and PRISm independent of body mass index. Among PRISm subjects, those with visceral adiposity had a fourfold greater risk of pre-existing coronary artery disease than did those without visceral adiposity (12 % vs. 3 %).

CONCLUSION

Fat mass, especially visceral fat, was independently associated with PRISm. Individuals with both PRISm and visceral adiposity are at high risk of coronary artery disease.