Obesity Paradox in Lung Diseases: What Explains It?

Background: Obesity is a globally increasing health problem that impacts multiple organ systems and a potentially modifiable risk factor for many diseases. Obesity has a significant impact on lung function and is strongly linked to the pathophysiology that contributes to lung diseases. On the other...

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Bibliographic Details
Published in:Obesity facts 2023-07, Vol.16 (5), p.411-426
Main Authors: Yao, Surui, Zeng, Lei, Wang, Fengyuan, Chen, Kejie
Format: Article
Language:English
Subjects:
acute lung injury
acute respiratory distress syndrome
Body mass index
Cardiovascular disease
Chronic obstructive pulmonary disease
Cohort analysis
COVID-19
Edema
Extracorporeal membrane oxygenation
Hospitals
Hypertension
Inflammation
Lung cancer
Lung diseases
Medical prognosis
Meta-analysis
Mortality
Obesity
obesity paradox
Observational studies
Overweight
Pneumonia
Respiratory distress syndrome
Review
Review Article
Ventilation
Ventilators
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Summary:Background: Obesity is a globally increasing health problem that impacts multiple organ systems and a potentially modifiable risk factor for many diseases. Obesity has a significant impact on lung function and is strongly linked to the pathophysiology that contributes to lung diseases. On the other hand, reports have emerged that obesity is associated with a better prognosis than for normal weight individuals in some lung diseases, including pneumonia, acute lung injury/acute respiratory distress syndrome, chronic obstructive pulmonary disease, and lung cancer. The lesser mortality and better prognosis in patients with obesity is known as obesity paradox. While obesity paradox is both recognized and disputed in epidemiological studies, recent research has suggested possible mechanisms. Summary: In this review, we attempted to explain and summarize these factors and mechanisms, including immune response, pulmonary fibrosis, lung function, microbiota, fat and muscle reserves, which are significantly altered by obesity and may contribute to the obesity paradox in lung diseases. We also discuss contrary literature that attributes the “obesity paradox” to confounding. Key Messages: The review will illustrate the possible role of obesity in the prognosis or course of lung diseases, leading to a better understanding of the obesity paradox and provide hints for further basic and clinical research in lung diseases.
ISSN:1662-4025
1662-4033
DOI:10.1159/000531792