Dynamic Hyperinflation with Bronchoconstriction

Sutherland, Tim; Cowan, Jan O.; Taylor, D. Robin

doi:10.1164/rccm.200711-1738oc

Cited by 57 publications

(21 citation statements)

References 23 publications

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“…These differences may contribute to reported differences in perceived impairment and asthma symptoms between obese and nonobese adults. 38 In children, there were no significant differences in FEV 1 , FVC, or FEV 1 :FVC ratio between obese and nonobese patients. In addition, the response to bronchodilators was similar in pediatric patients who were normal weight, overweight, or obese.…”

Section: Discussionmentioning

confidence: 76%

Impact of obesity in asthma: evidence from a large prospective disease management study

Peters

McKinney

Smith

et al. 2011

Annals of Allergy, Asthma & Immunology

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Section: Discussionmentioning

confidence: 76%

Impact of obesity in asthma: evidence from a large prospective disease management study

Peters

McKinney

Smith

et al. 2011

Annals of Allergy, Asthma & Immunology

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“…The reduction in lung operating volumes leads to expiratory airflow limitation and dynamic hyperinflation 49,50. In asthma, this worsens with bronchospasm 51. Together with the increased oxygen cost for exercise due to the metabolic cost resulting from the increased weight, this dynamic hyperinflation likely contributes to the dyspnea on exertion noted by obese individuals and particularly those with asthma.…”

Section: The Impact Of Obesity On Copd Outcomesmentioning

confidence: 99%

Influence of diet and obesity on COPD development and outcomes

Hanson¹,

Rutten²,

Wouters³

et al. 2014

COPD

102

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The global increase in the prevalence and incidence of obesity has called serious attention to this issue as a major public health concern. Obesity is associated with many chronic diseases, including cardiovascular disease and diabetes, and recently the role of overweight and obesity in lung disease has received new interest. Independently of obesity, diet also plays a role as a risk factor for many chronic diseases, and evidence is accumulating to support a role for diet in the prevention and management of several lung diseases. Chronic obstructive lung disease is the third-leading cause of death globally, and both obesity and diet appear to play roles in its pathophysiology. Obesity has been associated with decreased lung-function measures in population-based studies, with increased prevalence of several lung diseases and with compromised pulmonary function. In contrast, obesity has a protective effect against mortality in severe chronic obstructive pulmonary disease (COPD). Nutrient intake and dietary patterns have also been associated with lung-function measures and the development and progression of COPD. Taken together, this suggests that a focus on obesity and diet should be part of public health campaigns to reduce the burden of lung disease, and could have important implications for clinicians in the management of their patients. Future research should also focus on elucidating these relationships in diverse populations and age-groups, and on understanding the complex interaction between behavior, environment, and genetics in the development and progression of COPD. The goal of this article is to review current evidence regarding the role that obesity and diet play in the development of COPD, and in COPD-related outcomes.

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“…Obese asthmatics have greater disease severity [2], lower pulmonary function [3, 4] and lower response to medications [5] than normal-weight asthmatics. The disease burden is higher in Hispanics [6, 7], in whom obesity [8], and asthma [7] are more prevalent than in non-Hispanic whites [9].…”

Section: Introductionmentioning

confidence: 99%

Association of systemic inflammation, adiposity, and metabolic dysregulation with asthma burden among Hispanic adults

Rastogi

Jung

Strizich

et al. 2017

Respiratory Medicine

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Rationale Obesity-related asthma is associated with higher disease burden than normal-weight asthma among Hispanics. Adiposity, metabolic dysregulation, and inflammation are all implicated in pathogenesis of obesity-related asthma, but their independent contributions are poorly understood. Objective To examine the independent contributions of body fat distribution, metabolic abnormalities and inflammation on asthma symptoms and pulmonary function among Hispanics. Methods Participants of the Hispanic Community Health Study/Study of Latinos with doctor-diagnosed asthma who completed an asthma symptom questionnaire and performed a valid spirometry were included in the analysis (n=1,126). Multivariate analysis was used to examine the independent association of general adiposity (assessed using body mass index), truncal adiposity (assessed by waist circumference), metabolic dysregulation (presence of insulin resistance and low HDL) and inflammation (high-sensitivity C-Reactive Protein≥3mg/L) with reported asthma symptoms or pulmonary function measures (FEV1, and FVC) while adjusting for demographic and clinical covariates. Results Of the 1,126 participants, 334 (29.5%) were overweight, and 648 (57.8%) were obese. FEV1 and FVC were lower in obese compared to normal-weight asthmatics. In analyses controlling for metabolic and adiposity factors, high hs-CRP (>7 mg/L) was associated with more symptoms (prevalence-ratio 1.27 (95%CI 1.05, 1.54), and lower FVC (β −138ml (95%CI −27ml, −249ml)) and FEV1 (β −155ml (95% CI −38ml, −272ml). Low HDL was also associated with lower FVC (β −111ml (−22ml, −201ml) and FEV1 (β −100ml (−12ml, −188ml)). Results were similar in men and women. Conclusions Our findings suggest that hs-CRP and low HDL, rather than general and truncal adiposity, are associated with asthma burden among overweight and obese Hispanic adults.

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Dynamic Hyperinflation with Bronchoconstriction

Abstract: Changes in respiratory function, notably dynamic hyperinflation, are greater in obese individuals with bronchoconstriction. This may potentially alter the perception and assessment of asthma severity in obese patients with asthma.

Cited by 57 publications

References 23 publications

Impact of obesity in asthma: evidence from a large prospective disease management study

Impact of obesity in asthma: evidence from a large prospective disease management study

Influence of diet and obesity on COPD development and outcomes

Association of systemic inflammation, adiposity, and metabolic dysregulation with asthma burden among Hispanic adults

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