Associations of sarcopenic obesity with chronic lung disease and peak expiratory flow in middle-aged and older adults: A cohort study based on CHARLS and ELSA.

BackgroundEvidence regarding the associations of sarcopenic obesity (SO) with chronic lung disease (CLD) and peak expiratory flow (PEF) remains limited. This study aimed to investigate the relationships between SO and CLD as well as PEF among middle-aged and older adults in China and the United Kingdom.MethodsData were derived from the China Health and Retirement Longitudinal Study (CHARLS, 2011-2020) and the English Longitudinal Study of Ageing (ELSA, waves 2-6). Cox proportional hazards models were used to evaluate the associations of SO with incident CLD and PEF-related outcomes. Inverse probability of treatment weighting (IPTW) was applied to balance baseline characteristics between participants with and without SO. Random forest-based analyses were conducted as supplementary analyses to support the main findings.ResultsA total of 3,572 participants from CHARLS and 2,436 from ELSA without CLD at baseline were included in the CLD analysis. During follow-up, SO was significantly associated with a higher risk of incident CLD. In the CHARLS cohort, SO was positively associated with CLD risk after full adjustment (Model 3: HR = 1.50, P = 0.003). Consistent results were observed in the ELSA cohort after adjustment for ethnicity (Model 1: HR = 2.19, P = 0.006). Associations between SO and PEF were not consistently observed across cohorts.ConclusionsSarcopenic obesity was associated with an increased risk of chronic lung disease among older adults, suggesting that SO may be a potential body composition-related marker of respiratory risk. Findings related to PEF were exploratory and warrant further investigation.