Clinics (Sao Paulo, Brazil) · 2026
Relationship between metabolically unhealthy obesity and chronic obstructive pulmonary disease among U.S. adults: Evidence from NHANES 1999-2018.
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Li Shuang, Fang Xing, Wang Pingfei, Wei Huasheng
Аннотация
BACKGROUND: This research aimed to examine the association of Metabolically Unhealthy Obesity (MUO) with the prevalence of Chronic Obstructive Pulmonary Disease (COPD).
METHODS: The present research applied a cross-sectional design, and participants from the National Health and Nutrition Examination Survey 1999-2018 were enrolled. The association between metabolically healthy and unhealthy obesity phenotypes and COPD was examined through multivariable logistic regression analyses.
RESULTS: In total, 28,401 individuals were enrolled, among whom 2403 had COPD. After controlling for confounders, Body Mass Index (BMI) exhibited a positive association with the prevalence of COPD (OR = 1.04, 95% CI: 1.03-1.05, p < 0.001). MUO was associated with significantly elevated prevalence of COPD compared with Metabolically Healthy Normal Weight (MHNW) (OR = 2.02, 95% CI 1.51‒2.70). BMI was linearly associated with COPD in the metabolically healthy group (P-non-linear = 0.276), whereas in the metabolically unhealthy group, the association was nonlinear (P-non-linear = 0.002). According to receiver operating characteristic curve analysis, the Area Under the Curve (AUC) of BMI for diagnosing COPD was 0.735 (95% CI 0.695-0.775) in metabolically healthy individuals and 0.747 (95% CI 0.736-0.757) in metabolically unhealthy individuals.
CONCLUSION: MUO is associated with a higher prevalence of COPD in U.S. adults. Regardless of metabolic health status, obesity is associated with a higher prevalence of COPD. These findings suggest that maintaining a healthy body weight through lifestyle interventions may be beneficial across all populations, even providing additional benefits among metabolically healthy individuals.
METHODS: The present research applied a cross-sectional design, and participants from the National Health and Nutrition Examination Survey 1999-2018 were enrolled. The association between metabolically healthy and unhealthy obesity phenotypes and COPD was examined through multivariable logistic regression analyses.
RESULTS: In total, 28,401 individuals were enrolled, among whom 2403 had COPD. After controlling for confounders, Body Mass Index (BMI) exhibited a positive association with the prevalence of COPD (OR = 1.04, 95% CI: 1.03-1.05, p < 0.001). MUO was associated with significantly elevated prevalence of COPD compared with Metabolically Healthy Normal Weight (MHNW) (OR = 2.02, 95% CI 1.51‒2.70). BMI was linearly associated with COPD in the metabolically healthy group (P-non-linear = 0.276), whereas in the metabolically unhealthy group, the association was nonlinear (P-non-linear = 0.002). According to receiver operating characteristic curve analysis, the Area Under the Curve (AUC) of BMI for diagnosing COPD was 0.735 (95% CI 0.695-0.775) in metabolically healthy individuals and 0.747 (95% CI 0.736-0.757) in metabolically unhealthy individuals.
CONCLUSION: MUO is associated with a higher prevalence of COPD in U.S. adults. Regardless of metabolic health status, obesity is associated with a higher prevalence of COPD. These findings suggest that maintaining a healthy body weight through lifestyle interventions may be beneficial across all populations, even providing additional benefits among metabolically healthy individuals.