Obesity a risk factor for COPD, asthma for women regardless of menopause status

Abdominal obesity is a risk factor for COPD and asthma among premenopausal and postmenopausal women in South Korea, according to study findings published in Menopause.

“Women are more susceptible to airway obstructive diseases, and the effect of obesity on airway obstructive diseases among them is different from that among men. The action of sex hormones likely influences these properties,” Chung-Woo Lee, MD, from the department of family medicine at Korea University Ansan Hospital, College of Medicine, South Korea, and colleagues wrote. “However, studies on the effects of obesity on COPD and asthma in women before and after menopause are still insufficient.”

This nationwide population-based cohort study evaluated 1,644,635 women aged 30 years or older without a COPD or asthma diagnosis. All women underwent national cancer screening in 2009 and were classified as premenopausal (n = 807,445) or postmenopausal (n = 837,190) based on menopause status at the time. Researchers measured baseline BMI and waist circumference and then classified the women into groups based on BMI: underweight (< 18.5 kg/m²), normal weight (18.5-23 kg/m²), overweight (23-25 kg/m²), obesity (25-30 kg/m²) or severe obesity (> 30 kg/m²).

Women with high BMI and waist circumference had significantly higher incidences for COPD and asthma compared with those with normal BMI and waist circumference. As BMI and waist circumference increased, so did the HRs for COPD and asthma risk, with 1.13 in the overweight group, 1.26 in the obesity group and 1.65 in the severe obesity group among premenopausal women, and 1.04 in the overweight group, 1.18 in the obesity group and 1.51 in the severe obesity group among postmenopausal women.

Compared with women with normal weight, postmenopausal women with underweight had significantly increased risks for developing COPD (HR = 1.18; 95% CI, 1.1-1.25). Those in the obesity group had a significantly increased risk for developing asthma among both premenopausal (HR = 1.22; 95% CI, 1.19-1.24) and postmenopausal women (HR = 1.23; 95% CI, 1.22-1.25).

In addition, a waist circumference of 95 cm or more was associated with a significantly increased risk for COPD among premenopausal (HR = 1.72; 95% CI, 1.55-1.92) and postmenopausal women (HR = 1.55; 95% CI, 1.48-1.63). This association was also observed for significantly increased risks for asthma among premenopausal (HR = 1.1; 95% CI, 1.53-1.69) and postmenopausal women (HR = 1.56; 95% CI, 1.52-1.61).

“Further studies are required to determine the relationship between obesity and the occurrence of airway obstructive diseases in the general population,” the researchers wrote. “Additionally, studies comparing the impact of obesity on airway obstructive diseases in men and women, should be further investigated.”