Abstract
BACKGROUND: Peak expiratory flow (PEF) serves as a direct indicator of the functional status of the respiratory system. Higher body fat content, especially abdominal obesity, may relate to a deterioration in long-term respiratory function. The "A Body Shape Index" (ABSI) better assesses abdominal obesity, but its association with PEF is poorly understood. METHODS: The analysis demonstrated data from 14,386 middle-aged and older adults from the 2015 China Health and Retirement Longitudinal Study (CHARLS). ABSI, a sex-specific metric integrating waist circumference, weight, and height via allometric modeling derived from Chinese anthropometrics, was analyzed against PEF/PEF (prediction) using multivariable linear and spline regressions to characterize nonlinear associations. Threshold effects, subgroup, and sensitivity analyses ensured robustness. RESULTS: This research showed a negative relationship between ABSI and both PEF and PEF (predictions). An inverted L-shaped curve in the spline analysis characterized the association between ABSI and PEF/PEF (prediction) across the sexes. The ABSI threshold was 0.0782 and 0.0691 in males and females, respectively. CONCLUSIONS: Abdominal obesity negatively affects respiratory function, with ABSI thresholds varying by sex. Therefore, weight management should focus on a healthy ABSI to reduce abdominal obesity and safeguard respiratory health.