The COPD risk associated with adulthood weight change and early adulthood BMI: a prospective cohort study

Gaps concerning general adiposity and chronic obstructive pulmonary disease (COPD) are delaying policies for weight interventions in COPD prevention, especially adiposity in early adulthood and weight changes during adulthood. Based on the China Kadoorie Biobank, a prospective cohort between 2004–2008 covering 5 urban and 5 rural areas, we included 138,764 males and 194,159 females aged 35 ~ 70 years. Weight change was defined as the difference between directly measured weight at baseline and self-reported weight at age 25. Incident COPD events were followed-up until the end of 2018. Cox proportional hazard models were conducted to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) for associations of adulthood weight change and early adulthood body mass index (BMI) with COPD risk. During a mean follow-up of 11.9 years, 3,732 and 3,154 incident COPD events occurred in males and females, respectively. In males, weight change and early adulthood BMI were inversely associated with COPD risk, while early adulthood obesity (BMI ≥ 28.0 kg/m2) was associated with an increased risk of COPD (HR = 1.76; 95% CI: 1.01, 3.08), compared with the 18.5 ~ 23.9 kg/m2 early adulthood BMI group, among non-current smokers. In females, extreme weight loss and gain were associated with increased COPD risk. The effects of weight loss and gain on COPD were enhanced in the underweight and obese population, respectively, in early adulthood. Weight change and early adulthood BMI were inversely linked to COPD risk in males, while in females, both extreme weight loss or gain increased COPD risk.

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Journal
BMC Public Health
Published
2025-11-22
DOI
https://doi.org/10.1186/s12889-025-25582-z
Primary Topic
Chronic Obstructive Pulmonary Disease (COPD) Research
Type
article
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article

The COPD risk associated with adulthood weight change and early adulthood BMI: a prospective cohort study

Xin Xu, Xiangyang Zheng, Wei Jiang, Daniel Avery et al.
BMC Public Health
Chronic Obstructive Pulmonary Disease (COPD) Research
article

The COPD risk associated with adulthood weight change and early adulthood BMI: a prospective cohort study

Xin Xu, Xiangyang Zheng, Wei Jiang, Daniel Avery, Mei Lin, Huiming Luo, Kai Kang, Xiwei Yang, Yuan Cao, Haiping Duan, Yajing Zang, Yuelong Huang, Andri Iona, Chao Liu, Pek Kei Im, Jian Lan, Christopher Chen, Fang Liu, Dianjianyi Sun, Can Hou, Shaojie Wang, Canqing Yu, Enke Mao, Dan Schmidt, Kuang Lin, Yulu Qin, Xiaoyu Chang, Xukui Zhang, Sam Morris, Maryam Rahmati, Alfred Pozarickij, Donghui Jin, Ruying Hu, Pang Yao, Hannah Fry, Wei Hou, Quan Kang, Christiana Kartsonaki, Zhenzhen Lu, Iona Y. Millwood, Ningyu Chen, Kailash Kolhe, Tingting Ou, Li Yin, Mingqiang Yuan, Changping Xie, Yongmei Liu, Derrick Bennett, Jingchao Liu, Huimei Li, Aiyu Tang, Faqing Chen, Baihan Wang, Hubert Lam, Jun Lv, Zhenyuan Wu, Neil Wright, Jonathan Clarke, Huaidong Du, Tingping Zhu, Xiaoming Yang, Liuping Wei, Yuan Bo Peng, Jiaqiu Liu, Hao Wang, Ming Wu, Shixian Feng, Zhongxi Fu, Huizi Tian, Xia Wu, Mahmud Mohammad Sarder, Ahmed Edris Mohamed, Yaoming Zhai, Liangcai Ma, Hui Zhang, Xiaojun Li, Libo Zhang, Chi Wang, Xiaolin Li, Ran Tao, Lei Fan, Yiping Chen, Lin Wang, Hua Zhang, Jianwei Chen, Jun Zhang, Shuo Zhang, Feifei Li, Xianping Wu, Liming Li, Qiang Sun, Yihe Hu, Xi Zhang, Xiaofang Chen, Yanjie Li, Huilin Liu, Junzheng Wang, Jian Su, Zhendong Guo, James Hou-fu Liu, Chan Qu, Canqing Yu, Junshi Chen, Hao Zhang, Robert Clarke, Xiaohui Sun, Jie Yang, Wei Yu, Liyuan Zhou, Shanpeng Li, Yilei Li, Yun Liu, Xiao Han, Wei Sun, Lingli Chen, Pan He, Lifang Zhou, Li Pan, Sisi Wang, Xiaoyi Zhang, Lu Chen, Xiaoming Cui, Xiaocao Tian, Maxim Barnard, Zengchang Pang, Ruth Boxall, Richárd Pető, Paul Ryder, Ningmei Zhang, Qingmei Xia, Yan Lu, Shichun Yan, Rory Collins, Jinyi Zhou, Xiaoping Wang, Kaixu Xie, Ruqin Gao, Yonglin Zhou, Feng Ning, Huarong Sun, Xiaolan Ren, Dun Shen, Robin Walters, Jun Lv, Jianrong Jin, Qunhua Nie, Becky Stevens, Shukuan Wu, Liang Cheng, Ling Yang, Tao Wang, Pei Pei
article en

Abstract

Gaps concerning general adiposity and chronic obstructive pulmonary disease (COPD) are delaying policies for weight interventions in COPD prevention, especially adiposity in early adulthood and weight changes during adulthood. Based on the China Kadoorie Biobank, a prospective cohort between 2004–2008 covering 5 urban and 5 rural areas, we included 138,764 males and 194,159 females aged 35 ~ 70 years. Weight change was defined as the difference between directly measured weight at baseline and self-reported weight at age 25. Incident COPD events were followed-up until the end of 2018. Cox proportional hazard models were conducted to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) for associations of adulthood weight change and early adulthood body mass index (BMI) with COPD risk. During a mean follow-up of 11.9 years, 3,732 and 3,154 incident COPD events occurred in males and females, respectively. In males, weight change and early adulthood BMI were inversely associated with COPD risk, while early adulthood obesity (BMI ≥ 28.0 kg/m2) was associated with an increased risk of COPD (HR = 1.76; 95% CI: 1.01, 3.08), compared with the 18.5 ~ 23.9 kg/m2 early adulthood BMI group, among non-current smokers. In females, extreme weight loss and gain were associated with increased COPD risk. The effects of weight loss and gain on COPD were enhanced in the underweight and obese population, respectively, in early adulthood. Weight change and early adulthood BMI were inversely linked to COPD risk in males, while in females, both extreme weight loss or gain increased COPD risk.

BMC Public HealthVol. 26(1)
Peking University (CN), University of Oxford (GB), Ministry of Education (RO), China National Center for Food Safety Risk Assessment (CN), Taiwan Centers for Disease Control (TW)
Openalex Percentile: Top 49%
Chronic Obstructive Pulmonary Disease (COPD) Research
DOIOpen Access PDFOpenAlex
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