ORIGINAL RESEARCH article
Front. Med.
Sec. Pulmonary Medicine
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1633451
Canonical Correlation Analysis on the Association Between Pulmonary Function and Obesity in Early-onset COPD: CT-based Body Composition Analysis
Provisionally accepted
- 1Key Laboratory of Interventional Pulmonology of Zhejiang Province, Department of Pulmonary and Critical Care Medicine, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
- 2First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China
- 3Zhejiang Province Engineering Research Center for Endoscope Instruments and Technology Development, Department of Pulmonary and Critical Care Medicine, Quzhou City People's Hospital, Quzhou, China
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Background: While body composition impacts pulmonary function, the differential effects of visceral (VAT) vs. subcutaneous adipose tissue (SAT) in early-onset COPD remain unquantified. Objective: To elucidate the relationship between obesity patterns and pulmonary function in early-onset COPD versus non-COPD populations, focusing on body mass index (BMI), visceral adipose tissue (VAT), and subcutaneous adipose tissue (SAT) distribution. Methods: This retrospective cohort study analyzed 290 patients (144 early-onset COPD, 146 non-COPD) aged 20–50 years. Body composition (BMI, SAT, VAT) was quantified via CT at the L1 vertebral level. Pulmonary function was assessed by bronchodilator responsiveness testing (FEV₁/FVC, MEF₇₅, MEF₅₀, MEF₂₅). Canonical correlation analysis (CCA) was used to evaluate the multidimensional associations between body composition and pulmonary function. Results: Canonical correlation analysis revealed distinct multidimensional relationships between body composition and pulmonary function across study cohorts (p<0.05). In the early-onset COPD cohort (N=144), a statistically significant canonical variate (r=0.383, λ=0.172) demonstrated moderate association strength linking body composition (X1: BMI, SAT, VAT) with pulmonary function (Y1: FEV1/FVC/MEF75/MEF25). Conversely, the non-COPD group(N=146) exhibited stronger canonical correlation (r=0.537, λ=0.405), with body composition (X2: BMI/VAT) associating with pulmonary function (Y2: FEV1/FVC). This is a provisional file, not the final typeset article Conclusion: In summary, early-onset COPD patients with elevated BMI and VAT but reduced SAT exhibited improved pulmonary function across most parameters. This enhancement was not observed in MEF50 and MEF25. In contrast, the non-COPD cohort exhibits overall respiratory enhancement, as the cross-loading coefficient of MEF25—an indicator reflecting the weight of a variable in contributing to the canonical variate—is extremely small (0.05) and has a negligible impact on the overall association.
Keywords: chronic obstructive pulmonary disease, Early-onset COPD, Obesity, pulmonaryfunction, Body Composition
Received: 26 May 2025; Accepted: 08 Sep 2025.
Copyright: © 2025 Shi, Li, Chen, Su, Wu, Zhao and Chen. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Hongjun Zhao, Zhejiang Province Engineering Research Center for Endoscope Instruments and Technology Development, Department of Pulmonary and Critical Care Medicine, Quzhou City People's Hospital, Quzhou, 324000, China
Chengshui Chen, Key Laboratory of Interventional Pulmonology of Zhejiang Province, Department of Pulmonary and Critical Care Medicine, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
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