Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

Visceral adiposity and respiratory outcomes in children and adults: a systematic review

Abstract

Background

This review aimed to examine the associations of visceral adipose tissue (VAT) with pulmonary function and asthma in children and adults, and chronic obstructive pulmonary disease (COPD) in adults.

Methods

Five databases were searched up to February 12, 2021, to identify articles that described associations of VAT with pulmonary function, asthma, and COPD. Information on participant characteristics, study design and assessment, and key findings were retrieved.

Results

A total of 43 studies were considered eligible, of which most studies were cross-sectional and in adults. The quality of included studies was generally moderate. In adults, strong evidence was found that a higher abdominal VAT was associated with asthma, and a higher intrathoracic VAT was associated with lower forced expiratory volume in the first second and forced vital capacity. Inconclusive results were found although a substantial number of studies suggested inverse association of abdominal VAT with pulmonary function. There is a limited number of studies addressing the relationship between VAT and COPD.

Conclusion

The literature to date provides strong evidence in adults for the associations of higher abdominal VAT with asthma, and higher intrathoracic VAT with lower lung function parameters. Future high-quality studies are warranted that adjust sufficiently for key confounding factors such as fat distribution.

This is a preview of subscription content, access via your institution

Access options

Buy article

Get time limited or full article access on ReadCube.

$32.00

All prices are NET prices.

Fig. 1: Flow diagram.

References

  1. Dixon AE, Holguin F, Sood A, Salome CM, Pratley RE, Beuther DA, et al. An official American Thoracic Society Workshop report: obesity and asthma. Proc Am Thoracic Society. 2010;7:325–35.

    Article  Google Scholar 

  2. Ladosky W, Botelho M, Albuquerque J Jr. Chest mechanics in morbidly obese non-hypoventilated patients. Respir Med. 2001;95:281–6.

    Article  CAS  PubMed  Google Scholar 

  3. Collet F, Mallart A, Bervar J, Bautin N, Matran R, Pattou F, et al. Physiologic correlates of dyspnea in patients with morbid obesity. Int J Obesity. 2007;31:700–6.

    Article  CAS  Google Scholar 

  4. Schachter L, Salome C, Peat J, Woolcock A. Obesity is a risk for asthma and wheeze but not airway hyperresponsiveness. Thorax. 2001;56:4–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  5. Zerah F, Harf A, Perlemuter L, Lorino H, Lorino A-M, Atlan G. Effects of obesity on respiratory resistance. Chest. 1993;103:1470–6.

    Article  CAS  PubMed  Google Scholar 

  6. Bhammar DM, Stickford JL, Bernhardt V, Babb TG. Effect of weight loss on operational lung volumes and oxygen cost of breathing in obese women. Int J Obesity. 2016;40:998–1004.

    Article  CAS  Google Scholar 

  7. Peroni D, Pietrobelli A, Boner A. Asthma and obesity in childhood: on the road ahead. Int J Obesity. 2010;34:599–605.

    Article  CAS  Google Scholar 

  8. Chen Y, Chih A, Chen J, Liou T, Pan W, Lee Y. Rapid adiposity growth increases risks of new-onset asthma and airway inflammation in children. Int J Obesity. 2017;41:1035–41.

    Article  Google Scholar 

  9. Ford ES. The epidemiology of obesity and asthma. J Allergy Clin Immunol. 2005;115:897–909.

    Article  PubMed  Google Scholar 

  10. Eisner MD, Blanc PD, Sidney S, Yelin EH, Lathon PV, Katz PP, et al. Body composition and functional limitation in COPD. Respir Res. 2007;8:1–10.

    Article  Google Scholar 

  11. Rossi A, Fantin F, Di Francesco V, Guariento S, Giuliano K, Fontana G, et al. Body composition and pulmonary function in the elderly: a 7-year longitudinal study. Int J Obesity. 2008;32:1423–30.

    Article  CAS  Google Scholar 

  12. Vogelezang S, Gishti O, Felix J, Van der Beek E, Abrahamse-Berkeveld M, Hofman A, et al. Tracking of abdominal subcutaneous and preperitoneal fat mass during childhood. The Generation R Study. Int J Obesity. 2016;40:595–600.

    Article  CAS  Google Scholar 

  13. Bouchard C. BMI, fat mass, abdominal adiposity and visceral fat: where is the ‘beef’? Int J Obesity. 2007;31:1552–3.

    Article  CAS  Google Scholar 

  14. Herman T, Ros KP, de Jongste JC, Reiss IK, Jaddoe VW, Duijts L. Body fat mass distribution and interrupter resistance, fractional exhaled nitric oxide, and asthma at school-age. J Allergy Clin Immunol. 2017;139:810–8. e6.

    Article  CAS  Google Scholar 

  15. Lazarus R, Sparrow D, Weiss ST. Effects of obesity and fat distribution on ventilatory function: the normative aging study. Chest. 1997;111:891–8.

    Article  CAS  PubMed  Google Scholar 

  16. Leone N, Courbon D, Thomas F, Bean K, Jégo B, Leynaert B, et al. Lung function impairment and metabolic syndrome: the critical role of abdominal obesity. Am J Respir Critc Med. 2009;179:509–16.

    Article  Google Scholar 

  17. Ochs-Balcom HM, Grant BJ, Muti P, Sempos CT, Freudenheim JL, Trevisan M, et al. Pulmonary function and abdominal adiposity in the general population. Chest. 2006;129:853–62.

    Article  PubMed  Google Scholar 

  18. Hickson DA, Liu J, Bidulescu A, Burchfiel CM, Taylor HA, Petrini MF. Pericardial fat is associated with impaired lung function and a restrictive lung pattern in adults: the Jackson Heart Study. Chest. 2011;140:1567–73.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Moher D, Shamseer L, Clarke M, Ghersi D, Liberati A, Petticrew M, et al. Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement. Systematic Rev 2015;4:1.

    Article  Google Scholar 

  20. National Heart L, Institute B. Quality assessment tool for observational cohort and cross-sectional studies. Bethesda: National Institutes of Health, Department of Health and Human Services. 2014.

  21. Slavin RE. Best evidence synthesis: an intelligent alternative to meta-analysis. J Clin Epidemiol. 1995;48:9–18.

    Article  CAS  PubMed  Google Scholar 

  22. Voortman T, van den Hooven E, Vitezova A, Leermakers E, Sedaghat S, Buitrago-Lopez A, et al. Effects of protein intake on cardiometabolic health in children: a systematic review: PO662. Ann Nutr Metabol. 2013;63.

  23. Singh A, Uijtdewilligen L, Twisk JW. Van Mechelen W, Chinapaw MJ. Physical activity and performance at school: a systematic review of the literature including a methodological quality assessment. Arch. Pediatr. Adoles Med. 2012;166:49–55.

    Article  Google Scholar 

  24. Bruijn J, Locher H, Passchier J, Dijkstra N, Arts W-F. Psychopathology in children and adolescents with migraine in clinical studies: a systematic review. Pediatrics. 2010;126:323–32.

    Article  PubMed  Google Scholar 

  25. Inomoto A, Fukuda R, Deguchi J, Kato G, Kanzaki R, Hiroshige K, et al. The association between the body composition and lifestyle affecting pulmonary function in Japanese workers. J Phys Therapy Sci. 2016;28:2883–9.

    Article  Google Scholar 

  26. Modala S, Dhar U, Thinunaraju KV, Kumar BJP, Krishna BH. Association of visceral fat with deteriorated pulmonary function in newly diagnosed hypothyroid patients. Int J Med Res Health Sci. 2015;4:630.

    Google Scholar 

  27. Capelo AV, da Fonseca VM, Peixoto MV, de Carvalho SR, Azevedo CM, Elsas MI, et al. Visceral adiposity is associated with cytokines and decrease in lung function in women with persistent asthma. Rev Port Pneumol. 2006;2016(22):255–61.

    Google Scholar 

  28. Rasslan Z, Stirbulov R, Junior RS, Curia ST, da Conceicao Lima CA, Perez EA, et al. The impact of abdominal adiposity measured by sonography on the pulmonary function of pre-menopausal females. Multidiscip Respir Med. 2015;10:23.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Inomata M, Kawagishi Y, Taka C, Kambara K, Okazawa S, Fukushima Y, et al. Visceral adipose tissue level, as estimated by the bioimpedance analysis method, is associated with impaired lung function. J Diabetes Investig. 2012;3:331–6.

    Article  PubMed  Google Scholar 

  30. Kawabata R, Soma Y, Kudo Y, Yokoyama J, Shimizu H, Akaike A, et al. Relationships between body composition and pulmonary function in a community-dwelling population in Japan. PLoS ONE. 2020;15:e0242308.

  31. Fenger RV, Gonzalez-Quintela A, Vidal C, Gude F, Husemoen LL, Aadahl M, et al. Exploring the obesity-asthma link: do all types of adiposity increase the risk of asthma? Clin Exp Allergy. 2012;42:1237–45.

    Article  CAS  PubMed  Google Scholar 

  32. He S, Yang J, Li X, Gu H, Su Q, Qin L. Visceral adiposity index is associated with lung function impairment: a population-based study. Respir Res. 2021;22.

  33. Huang L, Ye Z, Lu J, Kong C, Zhu Q, Huang B, et al. Effects of fat distribution on lung function in young adults. J Physiol Anthropol. 2019;38:7.

    Article  PubMed  PubMed Central  Google Scholar 

  34. Vijetha P, Apoorva P, Harikrishna, Jeevaratnam T. Assessment of Pulmonary Function and Functional Capacity in Overweight Young Adults: Correlation with Visceral Fat. Int J Physiol. 2016;4:155.

    Article  Google Scholar 

  35. Khathlan NA, Salem AM. The effect of adiposity markers on fractional exhaled nitric oxide (FeNO) and pulmonary function measurements. Int J Gen Med. 2020;13:955–62.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Park YS, Kwon HT, Hwang SS, Choi SH, Cho YM, Lee J, et al. Impact of visceral adiposity measured by abdominal computed tomography on pulmonary function. J Korean Med Sci. 2011;26:771–7.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Lessard A, Alméras N, Turcotte H, Tremblay A, Després J-P, Boulet L-P. Adiposity and pulmonary function: relationship with body fat distribution and systemic inflammation. Clin Invest Med . 2011;34:E64–70.

    Article  CAS  PubMed  Google Scholar 

  38. Choe EK, Kang HY, Lee Y, Choi SH, Kim HJ, Kim JS. The longitudinal association between changes in lung function and changes in abdominal visceral obesity in Korean non-smokers. PLoS One. 2018;13:e0193516.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  39. Kwack WG, Kang YS, Jeong YJ, Oh JY, Cha YK, Kim JS, et al. Association between thoracic fat measured using computed tomography and lung function in a population without respiratory diseases. J Thorac Dis. 2019;11:5300–9.

    Article  PubMed  PubMed Central  Google Scholar 

  40. Moualla M, Qualls C, Arynchyn A, Thyagarajan B, Kalhan R, Smith LJ, et al. Rapid decline in lung function is temporally associated with greater metabolically active adiposity in a longitudinal study of healthy adults. Thorax. 2017;72:1113–20.

    Article  PubMed  Google Scholar 

  41. Babb TG, Wyrick BL, DeLorey DS, Chase PJ, Feng MY. Fat distribution and end-expiratory lung volume in lean and obese men and women. Chest. 2008;134:704–11.

    Article  PubMed  Google Scholar 

  42. Schweitzer L, Geisler C, Johannsen M, Gluer CC, Muller MJ. Associations between body composition, physical capabilities and pulmonary function in healthy older adults. Eur J Clin Nutr. 2017;71:389–94.

    Article  CAS  PubMed  Google Scholar 

  43. Thijs W, Alizadeh Dehnavi R, Hiemstra PS, de Roos A, Melissant CF, Janssen K, et al. Association of lung function measurements and visceral fat in men with metabolic syndrome. Respir Med. 2014;108:351–7.

    Article  PubMed  Google Scholar 

  44. Goudarzi H, Konno S, Kimura H, Makita H, Matsumoto M, Takei N, et al. Impact of Abdominal Visceral Adiposity on Adult Asthma Symptoms. J Allergy Clin Immunol Pract. 2019;7:1222–9 e5.

    Article  PubMed  Google Scholar 

  45. Deng K, Zhang X, Liu Y, Cheng GP, Zhang HP, Wang T, et al. Visceral obesity is associated with clinical and inflammatory features of asthma: A prospective cohort study. Allergy Asthma Proc. 2020;41:348–56.

    Article  CAS  PubMed  Google Scholar 

  46. De Blasio F, Rutten EP, Wouters EF, Scalfi L, De Blasio F, Akkermans MA, et al. Preliminary study on the assessment of visceral adipose tissue using dual-energy x-ray absorptiometry in chronic obstructive pulmonary disease. Multidiscip Respir Med. 2016;11:33.

    Article  PubMed  PubMed Central  Google Scholar 

  47. Higami Y, Ogawa E, Ryujin Y, Goto K, Seto R, Wada H, et al. Increased Epicardial Adipose Tissue Is Associated with the Airway Dominant Phenotype of Chronic Obstructive Pulmonary Disease. PLoS One. 2016;11:e0148794.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  48. Martin M, Almeras N, Despres JP, Coxson HO, Washko GR, Vivodtzev I, et al. Ectopic fat accumulation in patients with COPD: an ECLIPSE substudy. Int J Chron Obstruct Pulmon Dis. 2017;12:451–60.

    Article  PubMed  PubMed Central  Google Scholar 

  49. den Dekker HT, Ros KPI, de Jongste JC, Reiss IK, Jaddoe VW, Duijts L. Body fat mass distribution and interrupter resistance, fractional exhaled nitric oxide, and asthma at school-age. J Allergy Clin Immunol. 2017;139:810–8 e6.

    Article  CAS  Google Scholar 

  50. Mensink-Bout SM, Santos S, van Meel ER, Oei EH, de Jongste JC, Jaddoe VW, et al. General and organ fat assessed by magnetic resonance imaging and respiratory outcomes in childhood. Am J Respir Crit Care Med. 2020;201:348–55.

    Article  PubMed  Google Scholar 

  51. de Oliveira PD, Wehrmeister FC, Horta BL, Perez-Padilla R, de Franca GVA, Gigante DP, et al. Visceral and subcutaneous abdominal adiposity and pulmonary function in 30-year-old adults: a cross-sectional analysis nested in a birth cohort. BMC Pulm Med. 2017;17:157.

    Article  PubMed  PubMed Central  Google Scholar 

  52. Rossi AP, Watson NL, Newman AB, Harris TB, Kritchevsky SB, Bauer DC, et al. Effects of body composition and adipose tissue distribution on respiratory function in elderly men and women: the health, aging, and body composition study. J Gerontol A Biol Sci Med Sci. 2011;66:801–8.

    Article  PubMed  Google Scholar 

  53. Lim S, Kwon SY, Yoon JW, Kim SY, Choi SH, Park YJ, et al. Association between body composition and pulmonary function in elderly people: the Korean Longitudinal Study on Health and Aging. Obesity (Silver Spring). 2011;19:631–8.

    Article  Google Scholar 

  54. Yang MS, Choi S, Choi Y, Jin KN. Association Between Airway Parameters and Abdominal Fat Measured via Computed Tomography in Asthmatic Patients. Allergy Asthma Immunol Res. 2018;10:503–15.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  55. Kim KM, Kim SS, Kwon JW, Jung JW, Kim TW, Lee SH, et al. Association between subcutaneous abdominal fat and airway hyperresponsiveness. Allergy Asthma Proc. 2011;32:68–73.

    Article  PubMed  Google Scholar 

  56. Murakami D, Anan F, Masaki T, Umeno Y, Shigenaga T, Eshima N, et al. Visceral Fat Accumulation Is Associated with Asthma in Patients with Type 2 Diabetes. J Diabetes Res. 2019;2019:3129286.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  57. Song WJ, Kim SH, Lim S, Park YJ, Kim MH, Lee SM, et al. Association between obesity and asthma in the elderly population: potential roles of abdominal subcutaneous adiposity and sarcopenia. Ann Allergy Asthma Immunol. 2012;109:243–8.

    Article  PubMed  Google Scholar 

  58. Lenártová P, Habánová M, Mrázová J, Chlebo P, Wyka J. Analysis of visceral fat in patients with chronic obstructive pulmonary disease (COPD). Roczniki Państwowego Zakładu Higieny. 2016;67.

  59. Furutate R, Ishii T, Wakabayashi R, Motegi T, Yamada K, Gemma A, et al. Excessive visceral fat accumulation in advanced chronic obstructive pulmonary disease. Int J Chron Obstruct Pulmon Dis. 2011;6:423–30.

    PubMed  PubMed Central  Google Scholar 

  60. Viglino D, Martin M, Piche ME, Brouillard C, Despres JP, Almeras N, et al. Metabolic profiles among COPD and controls in the CanCOLD population-based cohort. PLoS One. 2020;15:e0231072.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  61. Coats V, Despres JP, Almeras N, Martin M, Sin DD, Rabasa-Lhoret R, et al. Ectopic adiposity and cardiometabolic health in COPD. Int J Chron Obstruct Pulmon Dis. 2018;13:3331–40.

    Article  PubMed  PubMed Central  Google Scholar 

  62. Yilmaz M, Bozkurt Yilmaz HE, Sen N, Altin C, Tekin A, Muderrisoglu H. Investigation of the relationship between asthma and subclinical atherosclerosis by carotid/femoral intima media and epicardial fat thickness measurement. J Asthma. 2018;55:50–6.

    Article  PubMed  Google Scholar 

  63. Yilmaz HEB, Yilmaz M, Sen N, Unsal ZE, Eyuboglu FO, Akcay S. Investigation of the Relationship between Asthma and Visceral Obesity by Epicardial Fat Thickness Measurement. Turk Thorac J. 2019;20:1–5.

    Article  PubMed  PubMed Central  Google Scholar 

  64. Kaplan O, Kurtoglu E, Gozubuyuk G, Dogan C, Acar Z, EyupKoca F, et al. Epicardial adipose tissue thickness in patients with chronic obstructive pulmonary disease having right ventricular systolic dysfunction. Eur Rev Med Pharmacol Sci. 2015;19:2461–7.

    CAS  PubMed  Google Scholar 

  65. Zagaceta J, Zulueta JJ, Bastarrika G, Colina I, Alcaide AB, Campo A, et al. Epicardial adipose tissue in patients with chronic obstructive pulmonary disease. PLoS One. 2013;8:e65593.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  66. Gaisl T, Schlatzer C, Schwarz EI, Possner M, Stehli J, Sievi NA, et al. Coronary artery calcification, epicardial fat burden, and cardiovascular events in chronic obstructive pulmonary disease. PLoS One. 2015;10:e0126613.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  67. Fantuzzi G. Adipose tissue, adipokines, and inflammation. J Allergy Clin Immunol. 2005;115:911–9.

    Article  CAS  PubMed  Google Scholar 

  68. Trayhurn P, Wood IS. Adipokines: inflammation and the pleiotropic role of white adipose tissue. Br J Nutr. 2004;92:347–55.

    Article  CAS  PubMed  Google Scholar 

  69. Ibrahim MM. Subcutaneous and visceral adipose tissue: structural and functional differences. Obes Rev. 2010;11:11–8.

    Article  PubMed  Google Scholar 

  70. Gyllenhammer LE, Alderete TL, Toledo-Corral CM, Weigensberg M, Goran MI. Saturation of subcutaneous adipose tissue expansion and accumulation of ectopic fat associated with metabolic dysfunction during late and post-pubertal growth. Int J Obes. 2016;40:601–6.

    Article  CAS  Google Scholar 

  71. Salome CM, King GG, Berend N. Physiology of obesity and effects on lung function. J Appl Physiol. 2010;108:206–11.

    Article  PubMed  Google Scholar 

  72. Ray CS, Sue DY, Bray G, Hansen JE, Wasserman K. Effects of obesity on respiratory function. Am Rev Resp Disease. 1983;128:501–6.

    Article  CAS  Google Scholar 

  73. Naimark A, Cherniack R. Compliance of the respiratory system and its components in health and obesity. J Appl Physiol. 1960;15:377–82.

    Article  CAS  PubMed  Google Scholar 

  74. Peters U, Suratt BT, Bates JH, Dixon AE. Beyond BMI: obesity and lung disease. Chest. 2018;153:702–9.

    Article  PubMed  Google Scholar 

  75. Littleton SW. Impact of obesity on respiratory function. Respirology. 2012;17:43–9.

    Article  PubMed  Google Scholar 

  76. Malli F, Papaioannou AI, Gourgoulianis KI, Daniil Z. The role of leptin in the respiratory system: an overview. Resp Res. 2010;11:1–16.

    CAS  Google Scholar 

  77. Hwang Y, Hayashi T, Fujimoto W, Kahn S, Leonetti D, McNeely M, et al. Visceral abdominal fat accumulation predicts the conversion of metabolically healthy obese subjects to an unhealthy phenotype. Int J Obes. 2015;39:1365–70.

    Article  CAS  Google Scholar 

  78. Goodpaster BH, Kelley DE, Thaete FL, He J, Ross R. Skeletal muscle attenuation determined by computed tomography is associated with skeletal muscle lipid content. J Appl Physiol. 2000;89:104–10.

    Article  CAS  PubMed  Google Scholar 

  79. Lim U, Ernst T, Buchthal S, Latch M, Albright CL, Wilkens LR, et al. Asian women have greater abdominal and visceral adiposity than Caucasian women with similar body mass index. Nutr Diabetes. 2011;1:e6–e.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  80. Kujawska-Łuczak M, Suliburska J, Markuszewski L, Pupek-Musialik D, Jabłecka A, Bogdański P. The effect of L-arginine and ascorbic acid on the visceral fat and the concentrations of metalloproteinases 2 and 9 in high-fat-diet rats. Endokrynologia polska. 2015;66:526–32.

    Article  PubMed  Google Scholar 

  81. Miczke A, Suliburska J, Pupek-Musialik D, Ostrowska L, Jabłecka A, Krejpcio Z, et al. Effect of L-arginine supplementation on insulin resistance and serum adiponectin concentration in rats with fat diet. Int J Clin Exp Med. 2015;8:10358.

    CAS  PubMed  PubMed Central  Google Scholar 

  82. Chen Y-C, Fan H-Y, Huang Y-T, Huang S-Y, Liou T-H, Lee YL. Causal relationships between adiposity and childhood asthma: bi-directional Mendelian randomization analysis. Int J Obes. 2019;43:73–81.

    Article  CAS  Google Scholar 

  83. Bustos P, Amigo H, Oyarzun M, Rona R. Is there a causal relation between obesity and asthma? Evidence from Chile. Int J Obes. 2005;29:804–9.

    Article  CAS  Google Scholar 

  84. Salome C, Munoz P, Berend N, Thorpe C, Schachter L, King G. Effect of obesity on breathlessness and airway responsiveness to methacholine in non-asthmatic subjects. Int J Obes. 2008;32:502–9.

    Article  CAS  Google Scholar 

  85. Brock JM, Billeter A, Müller-Stich BP, Herth F. Obesity and the lung: what we know today. Respiration. 2020;99:856–66.

    Article  CAS  PubMed  Google Scholar 

  86. Blum A, Simsolo C, Sirchan R, Haiek S. Obesity paradox” in chronic obstructive pulmonary disease. Israel Med Association J: IMAJ. 2011;13:672–5.

    Google Scholar 

  87. Schols AMWJ, Slangen JOS, Volovics L, Wouters EFM. Weight loss is a reversible factor in the prognosis of chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 1998;157:1791–7.

    Article  CAS  PubMed  Google Scholar 

  88. Sin DD, Anthonisen N, Soriano J, Agusti A. Mortality in COPD: role of comorbidities. Eur Resp J. 2006;28:1245–57.

    Article  CAS  Google Scholar 

  89. Soeters P, Dingemans A. Prevalence and characteristics of nutritional depletion in patients with stable COPD eligible for pulmonary rehabilitation. Am Rev Respir Dis. 1993;147:1151–6.

    Article  PubMed  Google Scholar 

  90. Tai A, Tran H, Roberts M, Clarke N, Wilson J, Robertson CF. The association between childhood asthma and adult chronic obstructive pulmonary disease. Thorax. 2014;69:805–10.

    Article  PubMed  Google Scholar 

  91. De Marco R, Accordini S, Marcon A, Cerveri I, Antó JM, Gislason T, et al. Risk factors for chronic obstructive pulmonary disease in a European cohort of young adults. Am J Respir Crit Care Med. 2011;183:891–7.

    Article  PubMed  Google Scholar 

  92. Fenger R, Gonzalez‐Quintela A, Vidal C, Gude F, Husemoen L, Aadahl M, et al. Exploring the obesity‐asthma link: do all types of adiposity increase the risk of asthma? Clin Exp Allergy. 2012;42:1237–45.

    Article  CAS  PubMed  Google Scholar 

  93. Cheng X, Zhang Y, Wang C, Deng W, Wang L, Duanmu Y, et al. The optimal anatomic site for a single slice to estimate the total volume of visceral adipose tissue by using the quantitative computed tomography (QCT) in Chinese population. Eur J Clin Nutr. 2018;72:1567–75.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  94. Segal KR, Gutin B, Presta E, Wang J, Van Itallie TB. Estimation of human body composition by electrical impedance methods: a comparative study. J Appl Physiol. 1985;58:1565–71.

    Article  CAS  PubMed  Google Scholar 

  95. Roubenoff R. Applications of bioelectrical impedance analysis for body composition to epidemiologic studies. Am J Clin Nutr. 1996;64:459S–62S.

    Article  CAS  PubMed  Google Scholar 

  96. Treuth MS, Hunter GR, Kekes-Szabo T. Estimating intraabdominal adipose tissue in women by dual-energy X-ray absorptiometry. Am J Clin Nutr. 1995;62:527–32.

    Article  CAS  PubMed  Google Scholar 

  97. Clasey JL, Bouchard C, Teates CD, Riblett JE, Thorner MO, Hartman ML, et al. The use of anthropometric and dual‐energy X‐ray absorptiometry (DXA) measures to estimate total abdominal and abdominal visceral fat in men and women. Obesity Res. 1999;7:256–64.

    Article  CAS  Google Scholar 

  98. Lear SA, Humphries KH, Kohli S, Chockalingam A, Frohlich JJ, Birmingham CL. Visceral adipose tissue accumulation differs according to ethnic background: results of the Multicultural Community Health Assessment Trial (M-CHAT). Am J Clin Nutr. 2007;86:353–9.

    Article  CAS  PubMed  Google Scholar 

  99. Loftus PA, Wise SK. Epidemiology of asthma. Curr Opin Otolaryngol Head Neck Surg. 2016;24:245–9.

    Article  PubMed  Google Scholar 

  100. Masoli M, Fabian D, Holt S, Beasley R. Global Initiative for Asthma P. The global burden of asthma: executive summary of the GINA Dissemination Committee report. Allergy. 2004;59:469–78.

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

The authors wish to thank Biomedical Information Specialist Sabrina T.G. Meertens-Gunput, PhD from the Erasmus MC Medical Library for developing and updating the search strategies.

Funding

TW is supported by China Scholarship Council (CSC) PhD Fellowship for his PhD study in Erasmus Medical Center, Rotterdam, the Netherlands. The scholarship file number is 201906260304, CSC URL: http://www.csc.edu.cn/. LD is supported by funding for projects from the European Union’s Horizon 2020 research and innovation program (LIFECYCLE, grant agreement No 733206, 2016; EUCAN-Connect grant agreement No 824989; ATHLETE, grant agreement No 874583). The funders had no role in the study design, data collection, management, analysis and interpretation of data, preparation or writing the manuscript.

Author information

Authors and Affiliations

Authors

Contributions

TW, MRJ, SK, LD, and EHGO conceived the study; TW, MRJ, SMM-B, LD, and EHGO performed the literature search and selected the studies; TW, MRJ, SMM-B, LD, and EHGO collected the data from all included studies; Quality of included studies was assessed by TW, MRJ, LD and EHGO; Study results were summarized and analyzed by TW, MRJ, SK, LD, and EHGO; TW and MRJ drafted the manuscript; SK, LD, EHGO made significant revisions; EHGO had primary responsibility for final content; All authors read and approved the final manuscript.

Corresponding author

Correspondence to Edwin H. G. Oei.

Ethics declarations

Competing interests

The authors declare no competing interests.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary information

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Wu, T., Jahangir, M.R., Mensink-Bout, S.M. et al. Visceral adiposity and respiratory outcomes in children and adults: a systematic review. Int J Obes 46, 1083–1100 (2022). https://doi.org/10.1038/s41366-022-01091-6

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41366-022-01091-6

Search

Quick links