Objective

We aimed to examine the associations of obesity-related traits (body mass index [BMI], central obesity) and their genetic predisposition with the risk of developing severe COVID-19 in a population-based data.

Research design and methods

We analyzed data from 489,769 adults enrolled in the UK Biobank—a population-based cohort study. The exposures of interest are BMI categories and central obesity (e.g., larger waist circumference). Using genome-wide genotyping data, we also computed polygenic risk scores (PRSs) that represent an individual's overall genetic risk for each obesity trait. The outcome was severe COVID-19, defined by hospitalization for laboratory-confirmed COVID-19.

Results

Of 489,769 individuals, 33% were normal weight (BMI, 18.5–24.9 kg/m²), 43% overweight (25.0–29.9 kg/m²), and 24% obese (≥30.0 kg/m²). The UK Biobank identified 641 patients with severe COVID-19. Compared to adults with normal weight, those with a higher BMI had a dose-response increases in the risk of severe COVID-19, with the following adjusted ORs: for 25.0–29.9 kg/m², 1.40 (95%CI 1.14–1.73; P = 0.002); for 30.0–34.9 kg/m², 1.73 (95%CI 1.36–2.20; P < 0.001); for 35.0–39.9 kg/m², 2.82 (95%CI 2.08–3.83; P < 0.001); and for ≥40.0 kg/m², 3.30 (95%CI 2.17–5.03; P < 0.001). Likewise, central obesity was associated with significantly higher risk of severe COVID-19 (P < 0.001). Furthermore, larger PRS for BMI was associated with higher risk of outcome (adjusted OR per BMI PRS Z-score 1.14, 95%CI 1.05–1.24; P = 0.004).

Conclusions

In this large population-based cohort, individuals with more-severe obesity, central obesity, or genetic predisposition for obesity are at higher risk of developing severe-COVID-19.

中文翻译：

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肥胖及其遗传倾向与严重 COVID-19 风险的关联：基于人群的队列数据分析。

客观的

我们的目的是在基于人群的数据中检查与肥胖相关的特征（体重指数 [BMI]、中心性肥胖）及其遗传倾向与患严重 COVID-19 的风险之间的关联。

研究设计和方法

我们分析了来自英国生物银行（一项基于人群的队列研究）的 489,769 名成年人的数据。感兴趣的暴露是 BMI 类别和向心性肥胖（例如，较大的腰围）。使用全基因组基因分型数据，我们还计算了多基因风险评分 (PRS)，代表每个肥胖特征的个体整体遗传风险。结果是严重的 COVID-19，定义为因实验室确诊的 COVID-19 而住院。

结果

在 489,769 名个体中，33% 为正常体重（BMI，18.5–24.9 kg/m ²），43% 为超重（25.0–29.9 kg/m ²），24% 为肥胖（≥30.0 kg/m ²）。英国生物银行确定了 641 名重症 COVID-19 患者。与体重正常的成年人相比，BMI 较高的人患严重 COVID-19 的风险呈剂量反应性增加，调整后的 OR 如下：25.0–29.9 kg/m ²，1.40 (95%CI 1.14–1.73 ; P  = 0.002); 对于 30.0–34.9 kg/m ²，1.73（95%CI 1.36–2.20；P  < 0.001）；35.0–39.9 kg/m ² , 2.82 (95%CI 2.08–3.83; P  < 0.001); 并且对于≥40.0 kg/m ², 3.30 (95% CI 2.17–5.03; P < 0.001)。同样，向心性肥胖与严重 COVID-19 的风险显着升高相关（P < 0.001）。此外，BMI 较大的 PRS 与较高的结果风险相关（根据 BMI PRS Z 分数调整后的 OR 为 1.14，95%CI 为 1.05–1.24；P  = 0.004）。

结论

在这个以人群为基础的大型队列中，肥胖、向心性肥胖或肥胖遗传易感性更严重的个体患重症 COVID-19 的风险更高。