Lung function in the absence of respiratory symptoms in overweight children and adolescents

Abstract

OBJECTIVE: To describe lung function findings in overweight children and adolescents without respiratory disease. METHODS: This was a cross-sectional study involving male and female overweight children and adolescents in the 8-18 year age bracket, without respiratory disease. All of the participants underwent anthropometric assessment, chest X-ray, pulse oximetry, spirometry, and lung volume measurements. Individuals with respiratory disease were excluded, as were those who were smokers, those with abnormal chest X-rays, and those with an SpO2 = 92%. Waist circumference was measured in centimeters. The body mass index-for-age Z score for boys and girls was used in order to classify the individuals as overweight, obese, or severely obese. Lung function variables were expressed in percentage of the predicted value and were correlated with the anthropometric indices.RESULTS: We included 59 individuals (30 males and 29 females). The mean age was 11.7 ± 2.7 years. Lung function was normal in 21 individuals (35.6%). Of the 38 remaining individuals, 19 (32.2%), 15 (25.4%), and 4 (6.7%) presented with obstructive, restrictive, and mixed ventilatory disorder, respectively. The bronchodilator response was positive in 15 individuals (25.4%), and TLC measurements revealed that all of the individuals with reduced VC had restrictive ventilatory disorder. There were significant negative correlations between the anthropometric indices and the Tiffeneau index in the individuals with mixed ventilatory disorder. CONCLUSIONS:Lung function was abnormal in approximately 65% of the individuals evaluated here, all of whom were overweight. Obstructive ventilatory disorder and positive bronchodilator response predominated.

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).…”

“…In addition, there was a (−) correlation between BMI with WC and FEV 1 /FVC in the MVD group Asymptomatic respiratory individuals with excess weight had a high prevalence of ventilatory disorders, predominantly OVD. Additionally, there was a (+) response to the BD, higher than that reported in the literature, most frequently in morbid obesity Van de Griendt et al [ 39 ] (2012) – The Netherlands To evaluate the effects of weight reduction on lung function in children with morbid obesity in children aged 8 to 18 years Yes (asthma or regular use of inhaled corticosteroids) Longitudinal 112 children aged 8 to 18 and with BMI ≥ 30 Kg/m 2 with comorbidities or BMI ≥ 35 Kg/m 2 Spirometry and Body Plethysmography (MasterScreen PFT + body box - Jaeger Viasys, Wuerzburg, Germany) Standardized instrument and position not mentioned FEV 1 , FEF 50% , ERV, FRC, TLC and FuncVC After 6 months of treatment to reduce weight, there was an increase of 3.08% in FuncVC, 2.91% in FEV 1 , 2.27% in TLC and 14.8% in ERV. WC had a (−) correlation with ERV.…”

The obese child in the Intensive Care Unit. Update

“…79 Overweight is also associated with a general reduction in lung volume, which may be reflected in a worse functional capacity. 80 A recent study in overweight school children and adolescents described that, in the absence of respiratory symptoms, 65% of them had an abnormal pulmonary function. Obstructive ventilatory defect and positive bronchodilator response were the most common abnormalities.…”

El niño obeso en la Unidad de Cuidados Intensivos. Puesta al día

“…La alteración ventilatoria obstructiva y la respuesta positiva a los broncodilatadores fueron las más frecuentes. 81 En niños, los efectos de la adiposidad en la función pulmonar dependen del sexo y del IMC.…”