Pulmonary Function in Obese Subjects With a Normal FEV1/FVC Ratio

Sahebjami, Hamid; Gartside, Peter S.

doi:10.1378/chest.110.6.1425

Cited by 116 publications

(91 citation statements)

References 21 publications

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“…Obesity as a separate factor in the absence of other respiratory diseases can affect the respiratory system 19 . Rubinstein et al 20 supported this statement in a study on 293 patients divided…”

Section: Discussionmentioning

confidence: 99%

Pulmonary function and quality of life in patients with morbid obesity six months after bariatric surgery

Xavier¹,

Ceneviva²,

Filho³

et al. 2010

Acta Cir. Bras.

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Purpose: To investigate the body weight, pulmonary function and quality of life of twenty patients with morbid obesity six months after the Fobi-Capella operation. Methods: Patients were evaluated before and six months after surgery. The patients were mainly female (75%), the average age was 40.5 ± 10.27 years; average weight 110.11 kg ± 21.77 and average body mass index (BMI) 39.93 ± 7.13 kg/m 2 in the postoperative evaluation. Pulmonary function was assessed by spirometry using a Pulmonet/Godart NV Bilt Vetr Hotland spirometer and quality of life was assessed by applying the Moorehead-Ardelt questionnaire. The pre-and postoperative spirometry values were compared by the paired Student t test and the correlation between weight loss and pulmonary function was determined by linear regression, with the level of significance set at p < 0.05. Results: The spirometry variables Respiratory Frequency (RF), Expiratory Reserve Volume (ERV) and Functional Residual Capacity (FRC) differed significantly between the pre-and postoperative periods, whereas Residual Volume (RV), Vital Capacity (VC), Total Lung Capacity (TLC), FEF (Forced Expiratory Flow between 25 and 75% FVC) and FEV1/FVC% (Forced Expiratory Volume in the 1 st second/ Forced Vital Capacity ratio) did not differ between periods. Only one patient reported worsening of quality of life. There was a positive correlation between weight loss and ERV (p=0.0117, r=0.5514), but no correlations were observed for the other variables. Conclusions: There was a significant weight loss and an improvement of pulmonary function as seen by respiratory frequency, reduction and increased expiratory reserve volume and functional residual capacity. The quality of life of the patients also improved after the Fobi-Capella operation. Key words: Obesity, Morbid. Respiratory Function Tests. Quality of Life. Bariatric Surgery. RESUMOObjetivo: Investigar a evolução do peso corpóreo, da função pulmonar e da qualidade de vida de 20 pacientes obesos mórbidos seis meses após operação de Fobi-Capella. Métodos: Os pacientes foram avaliados antes e seis meses após a cirurgia e o sexo feminino predominou em 75%, com média de idade de 40,5 anos ± 10, 27, média de peso de 110,11 kg ± 21,77 e IMC de 39,93 kg/m 2 ± 7,13. Para a avaliação da função pulmonar foi realizada espirometria por meio do espirômetro Pulmonet Godart NV Bilt Vetr Holland, e para a qualidade de vida foi aplicado o questionário de Moorehead-Ardelt. As comparações entre os valores espirométricos do pré e do pós-operatório foram realizadas pelo teste t de Student para amostras pareadas, e para a correlação entre a perda de peso e função pulmonar utilizou-se análise de regressão linear simples, adotando-se p < 0,05 para todos os resultados. Resultados: As variáveis espirométricas Freqüência Respiratória (FR), Volume de Reserva Expiratório (VRE) e Capacidade Residual Funcional (CRF) apresentaram, aos seis meses após a operação, diferença estatisticamente significativa com os valores pré-operatórios, porém, não houve diferença ...

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Section: Discussionmentioning

confidence: 99%

Pulmonary function and quality of life in patients with morbid obesity six months after bariatric surgery

Xavier¹,

Ceneviva²,

Filho³

et al. 2010

Acta Cir. Bras.

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“…28 Among obese subjects, there is evidence of peripheral airway obstruction, as manifested by air trapping and reduced maximum expiratory flow rates. 29,30 Thus, independent of smoking status, excess FM in the abdomen may contribute to airflow limitation. Crosssectional studies of elderly patients have already shown that lung function decreases with increasing fat mass and central body fat distribution.…”

Section: Discussionmentioning

confidence: 99%

Body composition and pulmonary function in the elderly: a 7-year longitudinal study

et al. 2008

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Objective: To evaluate over a 7-year follow-up period the relationships between changes in body composition, fat distribution and pulmonary function in a sample of elderly men and women. Design: Longitudinal clinical study. Subjects: A total of 47 women and 30 men aged 71.6±2.3 and 71.7±2.2 years, respectively, at baseline with body mass index (BMI) values of 24.96 ± 3.28 and 27.04 ± 3.35 kg m À2 were followed for 7 years. Measurements: Body weight, waist circumference, sagittal abdominal diameter (SAD), fat-free mass (FFM) and fat mass as measured by dual energy X-ray absorptiometry (DXA) and forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) by spirometry were evaluated at baseline and after a 7-year mean follow-up. Results: In women as in men there were no significant changes in weight, SAD and BMI. A significant decrease in height and FFM was observed in both women and men. Height-adjusted FEV1 and FVC decreased significantly in women and men over the 7-year follow-up. Changes in SAD were the most powerful predictors of 7-year follow-up of FEV1 and FVC after taking into account, respectively, baseline FEV1 and FVC. Linear regression analysis, performed by using 7-year follow-up lung function variables as dependent variables and changes in body composition variables as independent variables, showed that 1 cm SAD increase predicted a decrease in FEV1 and FVC of 31 and 46 ml, respectively, and 1 kg FFM decrease predicted a decrease in FVC of 38 ml. After subdividing our study population into four categories of change in FFM and SAD, patients with decreased FFM and increased SAD showed the highest probability of having a worsening in FEV1 and FVC. Conclusion: Increase in abdominal fat and FFM decline are significant predictors of lung function decline in the elderly. Old subjects developing both abdominal fat gain and FFM loss show the highest probability of developing worsening in lung function.

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“…19,21 The most reported pulmonary function test abnormalities in obesity are reduced expiratory reserve volume (ERV) and functional residual capacity (FRC) due to alterations in chest wall mechanics, which also lead to decreased total respiratory compliance. 26 After weight loss, increases in functional residual capacity, residual volume, total lung capacity, and expira- tory reserve volume tend to restore ventilatory normality. 21 In the current study, restrictive transformations were demonstrated in 20.9% of the candidates, although a larger impact on lung physiology would not have been inappropriate in such high-BMI population.…”

Section: Discussionmentioning

confidence: 99%

“…17,18 Although few specific references to bariatric candidates could be identified in the literature, it is reasonable to propose that more encouraging outcomes would be elicited if progressive physical conditioning were offered to this population jointly with surgical therapy. [26][27][28][29][30] …”

Section: Discussionmentioning

confidence: 99%

Pulmonary function and aerobic capacity in asymptomatic bariatric candidates with very severe morbid obesity

et al. 2004

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PURPOSE:Aerobic capacity and respiratory function may be compromised in obesity, but few studies have been done in highly obese bariatric candidates. In a prospective study, these variables were documented in the preoperative period, aiming to define possible physiologic limitations in a apparently healthy and asymptomatic population.METHOD: Forty-six consecutively enrolled adults (age 39.6 ± 8.4 years, 87.0% females, body mass index /BMI 49.6 ± 6.3 kg/m 2 ) were analyzed. Ventilatory variables were investigated by automated spirometry, aerobic capacity was estimated by a modified Bruce test in an ergometric treadmill, and body composition was determined by bioimpedance analysis.RESULTS: Total fat was greatly increased (46.4 ± 4.6% of body weight) and body water reduced (47.3 ± 4.6 % body weight), as expected for such obese group. Spirometric findings including forced vital capacity of 3.3 ± 0.8 L and forced expiratory volume-1 second of 2.6 ± 0.6 L were usually acceptable for age and gender, but mild restrictive pulmonary insufficiency was diagnosed in 20.9%. Aerobic capacity was more markedly diminished, as reflected by very modest maximal time (4.5 ± 1.1 min) and distance (322 ±142 m) along with proportionally elevated maximal oxygen consumption (23.4 ± 9.5 mL/kg/min) achieved by these subjects during test exercise.CONCLUSIONS: 1) Cardiopulmonary evaluation was feasible and well-tolerated in this severely obese population; 2) Mean spirometric variables were not diminished in this study, but part of the population displayed mild restrictive changes; 3) Exercise tolerance was very negatively influenced by obesity, resulting in reduced endurance and excessive metabolic cost for the treadmill run; 4) More attention to fitness and aerobic capacity is recommended for seriously obese bariatric candidates;

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Pulmonary Function in Obese Subjects With a Normal FEV1/FVC Ratio

Cited by 116 publications

References 21 publications

Pulmonary function and quality of life in patients with morbid obesity six months after bariatric surgery

Pulmonary function and quality of life in patients with morbid obesity six months after bariatric surgery

Body composition and pulmonary function in the elderly: a 7-year longitudinal study

Pulmonary function and aerobic capacity in asymptomatic bariatric candidates with very severe morbid obesity

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