Objective  To investigate the association between central obesity and chronic obstructive pulmonary disease (COPD) among middle-aged and elderly residents in Jiangsu province, and to provide references for early detection of COPD high-risk groups and the development of COPD prevention and control strategies and measures.

  Methods  With multistage cluster random sampling, we recruited 3 600 permanent residents aged 40 years and above in 6 surveillance areas of Jiangsu province. Face-to-face questionnaire interview, physical examination and pulmonary function test were carried out among the selected residents during July – December 2015.

  Results  Of the 3 365 residents with complete information, 1 545 (45.9%) were identified with central obesity and 428 (12.7%) were diagnosed with COPD. The results of unconditional multivariate logistic regression analysis revealed that the residents with central obesity were at a significantly increased risk of COPD (odds ratio = 1.41, 95% confidence interval: 1.05 – 1.89) compared to those without central obesity after adjusting for sex, age, education, smoking status, history of passive smoking exposure, history of biomass and lampblack for cooking exposure, history of biomass for heating exposure, history of occupational harmful gas or dust exposure, body mass index, and hypertension. Stratified analysis demonstrated that the residents being female, aged ≥ 60 years, with the education of elementary school and below, being farmer/forestry worker/stock farmer/fisherman, without the history of heating fuel exposure, ever exposed to occupational dust or harmful gas, and with central obesity but without hypertension had a significantly higher risk of COPD (all P < 0.05).

  Conclusion  The risk of COPD is higher among the middle-aged and elderly residents with central obesity in Jiangsu province.