ArticleBMC public health2025
Metabolic phenotypes and pulmonary function in aging: the mediating roles of cognitive function and depression in CHARLS.
Article in BMC public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- The combined impact of social isolation and unhealthy risk score on mortality risk: a study from two prospective cohorts.BMC public health · 2026Article
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Abstract
backgroundMetabolic phenotypes, defined by weight status and metabolic health, influence various physiological outcomes, yet their impact on pulmonary function in aging populations remains unclear. This study examines the longitudinal association between metabolic phenotypes and peak expiratory flow (PEF), considering the mediating roles of cognitive function and depression.
methodsWe analyzed longitudinal data (2011-2015) from 4,393 participants (mean age 58.9 years; 56.7% female) in the China Health and Retirement Longitudinal Study (CHARLS). Participants were categorized into four metabolic phenotypes: metabolically healthy normal weight (MHNW), metabolically healthy overweight/obese (MHO), metabolically unhealthy normal weight (MUNW), and metabolically unhealthy overweight/obese (MUO). PEF was assessed via linear mixed model, adjusting for sociodemographic and lifestyle factors. Chain mediation analyses evaluated cognitive function (composite score) and depression (CES-D scale), with sensitivity analyses verifying robustness.
resultsAmong middle-aged and older women, MHO was associated with modestly higher PEF versus MHNW (middle-aged: β = 7.410, P < 0.001; older: β = 10.358, P = 0.038), and MUO with higher PEF in older women (β = 14.990, P < 0.001). No significant associations were found in men. Chain mediation showed metabolic phenotypes indirectly influenced PEF via cognition→depression (total indirect effect: 0.008, P = 0.001; 17% of total effect). Sensitivity analyses confirmed robustness, though interpretations are cautious given PEF's limitations as a proxy for full lung function.
conclusionsMetabolic phenotypes significantly may influence pulmonary function in aging populations, partially mediated by cognitive and mental health, with distinct sex- and age-specific patterns. However, higher PEF in overweight/obese groups warrants caution, potentially reflecting mechanical effects rather than overall respiratory benefit. Integrated metabolic and neuropsychological health management may improve respiratory outcomes in older adults.
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