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.
Bibliographical noteFunding Information:
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.
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