Relationship between metabolically unhealthy obesity and chronic obstructive pulmonary disease among U.S. adults:...

This research aimed to examine the association of Metabolically Unhealthy Obesity (MUO) with the prevalence of Chronic Obstructive Pulmonary Disease (COPD).

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.

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.

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.