Body Mass Index and Bronchodilator Responsiveness in Adults: Analysis of 2 Population-Based Studies in 4 South American Countries

Anderson N. Soriano-Moreno; Andrés G. Lescano; Robert H. Gilman; J. Jaime Miranda; Antonio Bernabé‐Ortiz; Adolfo Rubinstein; Laura Gutiérrez; Vilma Irazola; Robert A. Wise; William Checkley

doi:10.15326/jcopdf.2025.0608

Body Mass Index and Bronchodilator Responsiveness in Adults: Analysis of 2 Population-Based Studies in 4 South American Countries

Author(s)

Anderson N. Soriano-Moreno

Andrés G. Lescano

Robert H. Gilman

J. Jaime Miranda

Antonio Bernabé‐Ortiz

Adolfo Rubinstein

Laura Gutiérrez

Vilma Irazola

Robert A. Wise

William Checkley

Date Issued

1 de enero de 2025

Type

Article

Volume

12

Issue

6

Start Page

477

End Page

489

DOI

10.15326/jcopdf.2025.0608

Abstract

Introduction:In South America, the rise in chronic respiratory diseases and weight-related issues due to the ongoing epidemiological transition has prompted research into their interrelationship. Methods:We sought to assess the association between body mass index (BMI) and bronchodilator responsiveness (BDR) among adults in Peru, Chile, Uruguay, and Argentina, using population-based data from two cohort studies.We defined BDR as a 12% and 200 mL increase in either forced expiratory volume in one second (FEV1) or forced vital capacity (FVC) after administration of a short-acting bronchodilator.The analysis also distinguished between FEV-and FVC-specific BDR.We used logistic regression adjusted for confounders to evaluate associations with BMI.Results: Among 7,160 participants (55.2% men, mean age 57.3 years), 23.7% had a BMI <25 kg/m and 35.5% had a BMI 30 kg/m.Overall, 9.5% met the criteria for BDR; with 7.8% showing FEV1specific and 4.9% FVC-specific responses.Compared to a BMI of 20-24.9kg/m, a BMI 30 kg/m was associated with higher odds of FVC-specific BDR (adjusted OR = 1.47, 95% CI 1.08-2.03),whereas a BMI <20 kg/m was associated with FEV-specific BDR among participants with asthma (6.34, 1.16-35.1)and chronic bronchitis (4.71, 1.28-15.9),and with higher odds of any BDR in those with chronic bronchitis (3.90, 1.19-11.93). Conclusion:There was a differential relationship between BMI and types of BDR: higher BMI was associated with FVC-specific responsiveness, whereas lower BMI was linked to FEV-specific BDR in individuals with asthma and chronic bronchitis and to overall BDR in those with chronic bronchitis.