Obesidade e testes de função pulmonar em crianças e adolescentes: uma revisão sistemática

Tenório, Luís Henrique Sarmento; Santos, Amilton da Cruz; Oliveira, Adriana Sarmento de; Lima, Anna Myrna Jaguaribe de; Brasileiro-Santos, Maria do Socorro

doi:10.1590/s0103-05822012000300018

Cited by 11 publications

(9 citation statements)

References 35 publications

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“…Only 21.7% (5/23) [ 16 , 18 , 27 , 34 , 38 ] found a negative association or lower values of FVC in children and adolescents with obesity. In a systematic review conducted in 2012, the authors concluded that the literature references demonstrated an association between reduced FVC and FEV 1 with obesity in children and adolescents, in disagreement with our findings [ 65 ].…”

Section: Discussioncontrasting

confidence: 85%

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

Ferreira¹,

Marson²,

Wolf³

et al. 2020

BMC Pulm Med

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Background Obesity in children and adolescents is associated with increased morbidity and mortality due to multisystemic impairment, including deleterious changes in lung function, which are poorly understood. Objectives To perform a systematic review to assess lung function in children and adolescents affected by obesity and to verify the presence of pulmonary changes due to obesity in individuals without previous or current respiratory diseases. Methods A systematic search was performed in the MEDLINE-PubMed (Medical Literature Analysis and Retrieval System Online), Embase (Excerpta Medica Database) and VHL (Virtual Health Library/Brazil) databases using the terms “Lung Function” and “Pediatric Obesity” and their corresponding synonyms in each database. A period of 10 years was considered, starting in February/2008. After the application of the filters, 33 articles were selected. Using the PICOS strategy, the following information was achieved: (Patient) children and adolescents; (Intervention/exposure) obesity; (Control) healthy children and adolescents; (Outcome) pulmonary function alterations; (Studies) randomized controlled trial, longitudinal studies (prospective and retrospective studies), cross-over studies and cross-sectional studies. Results Articles from 18 countries were included. Spirometry was the most widely used tool to assess lung function. There was high variability in lung function values, with a trend towards reduced lung function markers (FEV1/FVC, FRC, ERV and RV) in obese children and adolescents. Conclusion Lung function, measured by several tools, shows numerous markers with contradictory alterations. Differences concerning the reported results of lung function do not allow us to reach a consensus on lung function changes in children and adolescents with obesity, highlighting the need for more publications on this topic with a standardized methodology.

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Section: Discussioncontrasting

confidence: 85%

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

Ferreira¹,

Marson²,

Wolf³

et al. 2020

BMC Pulm Med

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“…However, this study did not investigate the effects of the obesity factor on lung volume and capacity 14. Taking into account that obesity may be considered a disease with a restrictive pattern,1 , 5 the data shown here add important information about the impact of the disease on children's respiratory system, compared to the study published in 2012 14. It is expected that future research, particularly at the national level, be designed to assess the effects of this chronic condition on the pulmonary system.…”

Section: Discussionmentioning

confidence: 98%

“…, 18 , 20 For this evaluation, we used a modified scale to quantify observational studies 16. This scale has shown to be adequate for this type of design14 and evaluates the research question, the study population, the comparison of participants, exposure measures, statistical analysis, results, discussion and funding 16. The studies included in this review seem to have some limitations, although it is believed that such restrictions did not influence the assessed research question, considering the good methodological quality that was attained.…”

Section: Discussionmentioning

confidence: 99%

“…A systematic review published in 201214 showed, through a critical analysis of five studies, that obesity leads to losses mainly in FEV 1 and FVC. However, this study only evaluated the effects of body weight on spirometric variables 14.…”

Section: Introductionmentioning

confidence: 99%

“…However, this study only evaluated the effects of body weight on spirometric variables 14. Taking into account that the spirometry test directly investigates obstructive pulmonary parameters and that the obesity factor seems to affect more the restrictive pattern,1 , 5 the importance of investigating, through plethysmography, the effects of body mass on lung volume and capacity in children is emphasized.…”

Section: Introductionmentioning

confidence: 99%

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Effects of obesity on lung volume and capacity in children and adolescents: a systematic review

Winck

Heinzmann‐Filho

Soares

et al. 2016

Revista Paulista de Pediatria (English Edition)

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Objective:To assess the effects of obesity on lung volume and capacity in children and adolescents.Data source:This is a systematic review, carried out in Pubmed, Lilacs, Scielo and PEDro databases, using the following Keywords: Plethysmography; Whole Body OR Lung Volume Measurements OR Total Lung Capacity OR Functional Residual Capacity OR Residual Volume AND Obesity. Observational studies or clinical trials that assessed the effects of obesity on lung volume and capacity in children and adolescents (0-18 years) without any other associated disease; in English; Portuguese and Spanish languages were selected. Methodological quality was assessed by the Agency for Healthcare Research and Quality.Data synthesis:Of the 1,030 articles, only four were included in the review. The studies amounted to 548 participants, predominantly males, with sample size ranging from 45 to 327 individuals. 100% of the studies evaluated nutritional status through BMI (z-score) and 50.0% reported the data on abdominal circumference. All demonstrated that obesity causes negative effects on lung volume and capacity, causing a reduction mainly in functional residual capacity in 75.0% of the studies; in the expiratory reserve volume in 50.0% and in the residual volume in 25.0%. The methodological quality ranged from moderate to high, with 75.0% of the studies classified as having high methodological quality.Conclusions:Obesity causes deleterious effects on lung volume and capacity in children and adolescents, mainly by reducing functional residual capacity, expiratory reserve volume and residual volume.

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Is it time to end race and ethnicity adjustment for pediatric pulmonary function tests?

Non

Akong

Conrad

2023

Pediatric Pulmonology

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The continued inclusion of race in spirometry reference equations is a topic of intense debate for adult lung function, but less discussion has focused on implications for children. Obtaining accurate estimates of children's lung function is an important component of the diagnosis of childhood respiratory illnesses, including asthma, cystic fibrosis, and interstitial lung disease. Given the higher burden among racial/ethnic minorities for many respiratory illnesses, it is critical to avoid racial bias in interpreting lung function. We recommend against the continued use of race‐specific reference equations for a number of reasons. The original reference populations used to develop the equations were comprised of children with restricted racial diversity, relatively small sample sizes, and likely included some unhealthy children. Moreover, there is no scientific justification for innate racial differences in lung function, as there is no clear physiological or genetic explanation for the disparities. Alternatively, many environmental factors harm lung development, including allergens from pests, asbestos, lead, prenatal smoking, and air pollution, as well as preterm birth and childhood respiratory illnesses, which are all more common among minority racial groups. Race‐neutral equations may provide a temporary solution, but still rely on the racial diversity of the reference populations used to build them. Ultimately researchers must uncover the underlying factors truly driving racial differences in lung function.

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Obesidade e testes de função pulmonar em crianças e adolescentes: uma revisão sistemática

Cited by 11 publications

References 35 publications

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

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

Effects of obesity on lung volume and capacity in children and adolescents: a systematic review

Is it time to end race and ethnicity adjustment for pediatric pulmonary function tests?

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