High fitness levels offset the increased risk of chronic obstructive pulmonary disease due to low socioeconomic status: A cohort study

Setor K Kunutsor; Sae Young Jae; Timo H Mäkikallio; Sudhir Kurl; Jari A Laukkanen

doi:10.1016/j.rmed.2021.106647

High fitness levels offset the increased risk of chronic obstructive pulmonary disease due to low socioeconomic status: A cohort study

Respir Med. 2021 Nov-Dec:189:106647. doi: 10.1016/j.rmed.2021.106647. Epub 2021 Oct 11.

Authors

Setor K Kunutsor¹, Sae Young Jae², Timo H Mäkikallio³, Sudhir Kurl⁴, Jari A Laukkanen⁵

Affiliations

¹ National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust and the University of Bristol, Bristol, UK; Musculoskeletal Research Unit, Translational Health Sciences, Bristol Medical School, University of Bristol, Learning & Research Building (Level 1), Southmead Hospital, Bristol, UK; Central Finland Health Care District Hospital District, Department of Medicine, Jyväskylä, Finland District, Jyväskylä, Finland. Electronic address: skk31@cantab.net.
² Department of Sport Science, University of Seoul, Seoul, Republic of Korea.
³ Department of Medicine, University of Helsinki, Helsinki, Finland; Department of Medicine, South-Karelia Central Hospital, Lappeenranta, Finland.
⁴ Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.
⁵ Central Finland Health Care District Hospital District, Department of Medicine, Jyväskylä, Finland District, Jyväskylä, Finland; Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland; Institute of Clinical Medicine, Department of Medicine, University of Eastern Finland, Kuopio, Finland.

PMID: 34655960
DOI: 10.1016/j.rmed.2021.106647

Abstract

Objective: Evidence suggests that higher cardiorespiratory fitness (CRF) levels can offset the increased risk of adverse outcomes due to other risk factors. The impact of high CRF levels on the increased risk of chronic obstructive pulmonary disease (COPD) due to low socioeconomic status (SES) is unknown. We aimed to assess the combined effects of SES and CRF on the future risk of COPD.

Methods: We employed a prospective cohort of 2312 Finnish men aged 42-61 years at study entry. Socioeconomic status was self-reported and CRF was objectively assessed using respiratory gas exchange analyzers. Both exposures were categorized as low and high based on median cutoffs. Multivariable-adjusted hazard ratios (HRs) with confidence intervals (CIs) were estimated.

Results: During 26.0 years median follow-up, 120 COPD cases occurred. Low SES was associated with increased COPD risk and high CRF was associated with reduced COPD risk. Compared with high SES-low CRF, low SES-low CRF was associated with an increased COPD risk 2.36 (95% CI: 1.44-3.87), with no evidence of an association for low SES-high CRF and COPD risk 1.46 (95% CI:0.82-2.60).

Conclusion: In middle-aged Finnish men, SES and CRF are each independently associated with COPD risk. However, high CRF levels offset the increased COPD risk related to low SES.

Keywords: Cardiorespiratory fitness; Chronic obstructive pulmonary disease; Cohort study; Socioeconomic status.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adult
Cardiorespiratory Fitness*
Cohort Studies
Finland / epidemiology
Humans
Male
Middle Aged
Pulmonary Disease, Chronic Obstructive / epidemiology*
Pulmonary Disease, Chronic Obstructive / physiopathology*
Risk Factors
Social Class*