The influence of abdominal visceral fat on inflammatory pathways and mortality risk in obstructive lung disease.

Journal Article (Journal Article)

BACKGROUND: Low-grade systemic inflammation, particularly elevated IL-6, predicts mortality in chronic obstructive pulmonary disease (COPD). Although altered body composition, especially increased visceral fat (VF) mass, could be a significant contributor to low-grade systemic inflammation, this remains unexplored in COPD. OBJECTIVE: The objective was to investigate COPD-specific effects on VF and plasma adipocytokines and their predictive value for mortality. DESIGN: Within the Health, Aging, and Body Composition (Health ABC) Study, an observational study in community-dwelling older persons, we used propensity scores to match n = 729 persons with normal lung function to n = 243 persons with obstructive lung disease (OLD; defined as the ratio of forced expiratory volume in 1 s to forced vital capacity < lower limit of normal). Matching was based on age, sex, race, clinic site, BMI, and smoking status. Within this well-balanced match, we compared computed tomography-acquired visceral fat area (VFA) and plasma adipocytokines, analyzed independent associations of VFA and OLD status on plasma adipocytokines, and studied their predictive value for 9.4-y mortality. RESULTS: Whereas whole-body fat mass was comparable between groups, persons with OLD had increased VFA and higher plasma IL-6, adiponectin, and plasminogen activator inhibitor 1 (PAI-1). Both OLD status and VFA were independently positively associated with IL-6. Adiponectin was positively associated with OLD status but negatively associated with VFA. PAI-1 was no longer associated with OLD status after VFA was accounted for. Participants with OLD had increased risk of all-cause, respiratory, and cardiovascular mortality, of which IL-6 was identified as an independent predictor. CONCLUSION: Our data suggest that excessive abdominal visceral fat contributes to increased plasma IL-6, which, in turn, is strongly associated with all-cause and cause-specific mortality in older persons with OLD.

Full Text

Duke Authors

Cited Authors

  • van den Borst, B; Gosker, HR; Koster, A; Yu, B; Kritchevsky, SB; Liu, Y; Meibohm, B; Rice, TB; Shlipak, M; Yende, S; Harris, TB; Schols, AMWJ; Health, Aging, and Body Composition (Health ABC) Study,

Published Date

  • September 2012

Published In

Volume / Issue

  • 96 / 3

Start / End Page

  • 516 - 526

PubMed ID

  • 22811442

Pubmed Central ID

  • PMC3417214

Electronic International Standard Serial Number (EISSN)

  • 1938-3207

Digital Object Identifier (DOI)

  • 10.3945/ajcn.112.040774


  • eng

Conference Location

  • United States