A Dyadic Growth Modeling Approach for Examining Associations between Weight Gain and Lung Function Decline

Talea Cornelius, Joseph E. Schwartz, Pallavi Balte, Surya P. Bhatt, Patricia A. Cassano, David Currow, David R. Jacobs, Miriam Johnson, Ravi Kalhan, Richard Kronmal, Laura Loehr, George T. O'Connor, Benjamin Smith, Wendy B. White, Sachin Yende, Elizabeth C. Oelsner

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3 Scopus citations


The relationship between body weight and lung function is complex. Using a dyadic multilevel linear modeling approach, treating body mass index (BMI; weight (kg)/height (m)2) and lung function as paired, within-person outcomes, we tested the hypothesis that persons with more rapid increase in BMI exhibit more rapid decline in lung function, as measured by forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), and their ratio (FEV1:FVC). Models included random intercepts and slopes and adjusted for sociodemographic and smoking-related factors. A sample of 9,115 adults with paired measurements of BMI and lung function taken at ≥3 visits were selected from a pooled set of 5 US population-based cohort studies (1983-2018; mean age at baseline = 46 years; median follow-up, 19 years). At age 46 years, average annual rates of change in BMI, FEV1, FVC, and FEV1:FVC ratio were 0.22 kg/m2/year,-25.50 mL/year,-21.99 mL/year, and-0.24%/year, respectively. Persons with steeper BMI increases had faster declines in FEV1 (r =-0.16) and FVC (r =-0.26) and slower declines in FEV1:FVC ratio (r = 0.11) (all P values < 0.0001). Results were similar in subgroup analyses. Residual correlations were negative (P < 0.0001), suggesting additional interdependence between BMI and lung function. Results show that greater rates of weight gain are associated with greater rates of lung function loss.

Original languageEnglish (US)
Pages (from-to)1173-1184
Number of pages12
JournalAmerican journal of epidemiology
Issue number10
StatePublished - Oct 1 2020

Bibliographical note

Publisher Copyright:
© 2020 The Author(s) 2020. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.


  • body mass index
  • chronic obstructive lung disease
  • cohort studies
  • dyadic models
  • longitudinal studies
  • lung function
  • obesity
  • spirometry


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