Surgically induced weight loss, including reduction in waist circumference, is associated with improved pulmonary function in obese patients

Wei, Yufeng; Tseng, Wei‐Kung; Huang, Chih‐Kun; Tai, Chi‐Ming; Hsuan, Chin-Feng; Wu, Huey-Dong

doi:10.1016/j.soard.2011.04.221

Cited by 31 publications

(25 citation statements)

References 37 publications

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“…[37], obese subjects did not exhibit changes in the respiratory pattern or lung volume/capacity in comparison to predicted values. These findings are in disagreement with those reported in our preliminary study [34] and our recent findings as well as with results described by Wei et al [32], who reported a significant change in forced vital capacity (FVC) and forced expiratory volume in the first second (FEV 1 ) among individuals with severe obesity prior to bariatric surgery.…”

Section: Discussioncontrasting

confidence: 99%

“…Significant improvements of FVC (p= 0.002), FVC% (p = 0.016), FEV 1 (p = 0.003) and FEV 1 % (p = 0.003) were found after bariatric surgery. These results are in agreement with those reported in a study carried out by Wei et al [32]. …”

Section: Discussionsupporting

confidence: 94%

“…Indeed, studies involving patients with morbid obesity submitted to bariatric surgery report that the subsequent weight loss is accompanied by a reduction in the severity of OSA [23,32]. Peppard et al .…”

Section: Discussionmentioning

confidence: 99%

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Obstructive sleep apnea and pulmonary function in patients with severe obesity before and after bariatric surgery: a randomized clinical trial

Aguiar

Freitas

Santos

et al. 2014

Multidiscip Respir Med

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BackgroundThe increasing prevalence of obesity in both developed and developing countries is one of the most serious public health problems and has led to a global epidemic. Obesity is one of the greatest risk factors of obstructive sleep apnea (OSA), which is found in 60 to 70% of obese patients mainly due to the buildup of fat tissue in the upper portion of the thorax and neck. The aim of the present randomized clinical trial is to assess daytime sleepiness, sleep architecture and pulmonary function in patients with severe obesity before and after bariatric surgery.MethodsThis randomized, controlled trial, was designed, conducted, and reported in accordance with the standards of The CONSORT (Consolidated Standards of Reporting Trials) Statement. Patients were divided into a bariatric surgery group and control group. The clinical evaluation was performed at the Sleep Laboratory of the Nove de JulhoUniversity (Sao Paulo, Brazil) and consisted of the collection of clinical data, weight, height, body mass index (BMI), measurements of neck and abdomen circumferences, spirometry, maximum ventilatory pressure measurements, standard overnight polysomnography (PSG) and the administration of the Berlin Questionnaire and Epworth Sleepiness Scale.ResultsFifty-two patients participated in the present study and performed PSG. Out of these, 16 underwent bariatric surgery. After surgery, mean BMI decreased from 48.15 ± 8.58 to 36.91 ± 6.67 Kg/m2. Significant differences were found between the preoperative and postoperative periods regarding neck (p < 0.001) and waist circumference (p < 0.001), maximum inspiratory pressure (p = 0.002 and p = 0.004) and maximum expiratory pressure (p = 0.001 and p = 0.002) for women and men, respectively, as well as sleep stage N3 (p < 0.001), REM sleep (p = 0.049) and the apnea-hypopnea index (p = 0.008).ConclusionsBariatric surgery effectively reduces neck and waist circumference, increases maximum ventilatory pressures, enhances sleep architecture and reduces respiratory sleep disorders, specifically obstructive sleep apnea, in patients with severe obesity.Trial registrationThe protocol for this study was registered with the World Health Organization (Universal Trial Number: U1111-1121-8873) and Brazilian Registry of Clinical Trials – ReBEC (RBR-9k9hhv).

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionsupporting

confidence: 94%

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Obstructive sleep apnea and pulmonary function in patients with severe obesity before and after bariatric surgery: a randomized clinical trial

Aguiar

Freitas

Santos

et al. 2014

Multidiscip Respir Med

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“…There is overwhelming evidence that significant weight loss improves lung function in both mild-to-moderate and severe obesity (Aaron et al, 2004; De Lorenzo et al, 1999; Emirgil and Sobol, 1973; Hakala et al, 1995; Santesson and Nordenstrom, 1978; Thomas et al, 1989; Wadstrom et al, 1991; Wei et al, 2011). We have previously shown that moderate weight loss improves breathing mechanics during exercise in obese men (Babb et al, 2011).…”

Section: Discussionmentioning

confidence: 99%

Weight loss reduces dyspnea on exertion in obese women

Bernhardt

Babb

2014

Respiratory Physiology & Neurobiology

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During submaximal exercise, some otherwise healthy obese women experience breathlessness, or dyspnea on exertion (+DOE), while others have mild or no DOE (−DOE). We investigated whether weight loss could reduce DOE. 29 obese women were grouped based on their Ratings of Perceived Breathlessness (RPB) during constant load 60W cycling: +DOE (n=14, RPB≥4, 34±8yr, 36±3kg/m2) and −DOE (n=15, RPB≤2, 32±8yr, 36±4kg/m2) and then completed a 12-week weight loss program. Both groups lost a moderate amount of weight (+DOE: 6.6±2.4kg, −DOE: 8.4±3.5kg, p<0.001). RPB decreased significantly in the +DOE group (from 4.7±1.1 to 3.1±1.6) and remained low in the −DOE (from 1.5±0.7 to 1.6±1.1) (interaction p<0.002). Most physiological variables measured (i.e. body composition, fat distribution, pulmonary function, oxygen cost of breathing, cardiorespiratory measures) improved with weight loss; however, the decrease in RPB was not correlated with any of these variables (p>0.05). In conclusion, moderate weight loss was effective in reducing breathlessness on exertion in obese women who experienced DOE at baseline.

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“…Gastric bypass can achieve a dramatic improvement of nonalcoholic fatty liver disease (NAFLD) both biochemically and histologically in morbid obesity [20]. Likewise, with significant weight loss and reduction of BMI after gastric bypass, pulmonary function improved in obese patients, which are correlated with decrease in waist circumference and possibly intraabdominal pressure [21].…”

Section: Improvement Of Comorbiditiesmentioning

confidence: 99%

Bariatric and Metabolic Surgery

Angrisani¹

2017

Updates in Surgery

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Obesity as a global epidemic has rapidly increased in incidence in the recent few decades and represents one of the biggest public health challenges. Obesity plays a major risk for various diseases such as cardiovascular disease (CVD), diabetes mellitus (DM), hypercholesterolemia, osteoarthritis and some form of cancers. Bariatric and metabolic surgery provides the best solution for obesity and its associated comorbidities. This chapter will discuss in detail the commonly performed bariatric and metabolic surgeries.

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Surgically induced weight loss, including reduction in waist circumference, is associated with improved pulmonary function in obese patients

Cited by 31 publications

References 37 publications

Obstructive sleep apnea and pulmonary function in patients with severe obesity before and after bariatric surgery: a randomized clinical trial

Obstructive sleep apnea and pulmonary function in patients with severe obesity before and after bariatric surgery: a randomized clinical trial

Weight loss reduces dyspnea on exertion in obese women

Bariatric and Metabolic Surgery

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