Spirometry and volumetric capnography in lung function assessment of obese and normal-weight individuals without asthma

Abstract

Even without the diagnosis of asthma by clinical criteria and without response to bronchodilator use, obese individuals showed lower FEV/FVC values and forced expiratory flow, indicating the presence of an obstructive process. Volumetric capnography showed that obese individuals had higher alveolar tidal volume, with no alterations in ventilation homogeneity, suggesting flow alterations, without affecting lung volumes.

Lung function in obese children and adolescents without respiratory disease: a systematic review

“…Therefore, including children with previous respiratory diseases could evolve into sampling (selection of individuals), confounding (proven impact on outcomes) or information bias (previous knowledge of an existing problem). In this context, 66.7% (22/33) [ 12 – 15 , 17 – 21 , 25 , 26 , 29 , 32 – 37 , 39 – 42 ] of the studies excluded individuals with respiratory diseases, 27.3% (9/33) [ 16 , 22 – 24 , 27 , 28 , 30 , 31 , 38 ] did not mention respiratory diseases as a factor of exclusion or non-inclusion, and 6% (2/33) [ 11 , 43 ] excluded only individuals with a history of smoking. Among the studies that excluded previous respiratory diseases, several exclusion criteria could be observed: some authors excluded only individuals with exacerbation of asthma or cough; others excluded any respiratory conditions that might impair the evaluation; and others used standardized instruments such as the ISAAC questionnaire (The International Study of Asthma and Allergies in Childhood).…”

“…The articles included were produced in 18 countries, with a predominance of European (8) [ 21 – 23 , 31 , 34 , 35 , 40 ], South American (8) [ 17 , 18 , 26 , 32 , 33 , 37 , 39 , 41 ] and Asian (7) [ 11 , 13 , 15 , 27 , 30 , 31 , 42 ] countries. Also, 4 studies from North America were included [ 19 , 24 , 38 , 43 ], as well as one from Central America [ 29 ], one from Oceania [ 20 ] and four from intercontinental countries ( three Euroasians [ 14 , 25 , 36 ] and one from Asia and Oceania [ 12 ]).…”

“…There was no uniform definition of obesity among studies: 27.3% (9/33) [ 11 , 14 , 15 , 20 , 35 – 37 , 40 , 42 ] used references by Cole et al [ 45 – 47 ]; 21.2% (7/33) [ 12 , 17 , 19 , 26 , 29 , 38 , 43 ] used the criteria established by the Center for Disease Control and Prevention (CDC); 15.1% (5/33) [ 13 , 18 , 33 , 39 , 41 ] used the definition of the World Health Organization (WHO); 12.1% (4/33) [ 16 , 24 , 32 , 34 ] did not mention any references for the definition of obesity; and 27.3% (9/33) [ 14 , 21 – 23 , 25 , 27 , 28 , 31 , 36 ] used references according to their countries of origin. Two [ 14 , 36 ] of the studies mentioned above, used references by Cole et al [ 45 – 47 ] in addition to references according to their countries of origin.…”

“…Spirometry was the most commonly used tool to assess lung function, i.e., in 93.9% (31/33) [ 11 – 24 , 26 , 27 , 29 – 43 ] of the studies. Next, body plethysmography and measurement of the respiratory muscle strength (RMS) were the most used tools in 12.1% (4/33) [ 15 , 19 , 40 , 43 ] and 9.1% (3/33) [ 18 , 37 , 41 ] of the studies, respectively.…”

“…In the division by age group (5 to 11 years or > 11 years) there were changes of FEV 1 /FVC in both groups and only in the older individuals for expiratory flow and pulmonary volume Even without the diagnosis of asthma by clinical criteria and without response to BD, individuals with obesity show lower FEV 1 /FVC and FEF, indicating an obstructive process. In CV, in the group with individuals with obesity, there was higher TV alv , with no alteration in ventilation homogeneity, suggesting that these individuals have altered flow, but no changes in lung volumes Del-Rio Navarro et al [ 26 ] (2013) - Mexico To compare bronchial hyperreactivity by the methacholine challenge testing in Mexican children with normal weight. In addition, to associate the group with normal weight with children with obesity or morbid obesity Yes (underweight children, chronic respiratory diseases – including asthma and rhinitis, acute respiratory infection in the last month, endocrine diseases, dysmorphic dysfunction or exposure to tobacco) Cross-sectional 229 children aged 10 to 18 years (40 – normal weight, 116 – with obesity and 73 – with morbidly obesity) Spirometry (Vmax, Sensor Medics, Anaheim, CA), methacholine challenge testing (provocholine, 100 mg, Methaparm, Inc., Coral Springs, Fl) performed with dosimeter (Mark Salter Labs, Arvin, CA) Spirometry: ATS - sitting FVC, FEV 1 , FEF 25–75% , PEF In the group with obesity or morbid obesity, there was higher FVC and lower FEF 25–75% , when compared to children with normal weight.…”