The effect of obesity on lung function

Abstract

There is a major epidemic of obesity, and many obese patients suffer with respiratory symptoms and disease. The overall impact of obesity on lung function is multifactorial, related to mechanical and inflammatory aspects of obesity. Areas covered: Obesity causes substantial changes to the mechanics of the lungs and chest wall, and these mechanical changes cause asthma and asthma-like symptoms such as dyspnea, wheeze, and airway hyperresponsiveness. Excess adiposity is also associated with increased production of inflammatory cytokines and immune cells that may also lead to disease. This article reviews the literature addressing the relationship between obesity and lung function, and studies addressing how the mechanical and inflammatory effects of obesity might lead to changes in lung mechanics and pulmonary function in obese adults and children. Expert commentary: Obesity has significant effects on respiratory function, which contribute significantly to the burden of respiratory disease. These mechanical effects are not readily quantified with conventional pulmonary function testing and measurement of body mass index. Changes in mediators produced by adipose tissue likely also contribute to altered lung function, though as of yet this is poorly understood.

Pulmonary Function and Effects of Body Position in Patients with Obstructive Sleep Apnea

“…Obese individuals are known to show reduced lung volume and capacity compared with individuals of normal weight [25]. The impact of obesity on lung function is multifactorial, encompassing both mechanical and inflammatory aspects [26]. Obese OSA patients tended to show poorer pulmonary function compared with non-obese OSA patients in the present study, which was consistent with a previous report [25].…”

Short‐term high‐fat diet feeding protects from the development of experimental allergic asthma in mice

“…Previous studies suggest that obesity serves as a risk factor for the development, severity and weaker responsiveness to standard asthma medication . In the late‐onset non‐allergic phenotype of obesity‐associated asthma (LONA), airway hyperresponsiveness (AHR) is considered a consequence of lung compression and structural lung modifications due to increased body weight . Furthermore, animal models show that LONA is associated with T helper (Th)1‐ and Th17 aberrant immune responses .…”

“…3 In the late-onset non-allergic phenotype of obesity-associated asthma (LONA), airway hyperresponsiveness (AHR) is considered a consequence of lung compression and structural lung modifications due to increased body weight. 4,5 Furthermore, animal models show that LONA is associated with T helper (Th)1-and Th17 aberrant immune responses. 6,7 However, next to LONA, an early-onset allergic form of obesity-associated asthma has been described (EOA), 8 which is characterized by a more classical allergen-driven eosinophilia and Th2 differentiation without body weight-induced modulations.…”

A Study of the Association of Overweight and Peak Expiratory Flow Rate (Pefr) Among Children

“…Growing evidence had clearly and consistently evidenced that obesity as an essential and direct predictor of respiratory function as lung function depends on the size and specific distribution of connective tissue. 5 The main effect of overweight and obesity on decreased lung function is due to the fact that it exerts an additional load upon the respiratory system, changing the pressure balance between the lung's inward recoil and chest outward pressure. However, such action has significant consequences on exhaled nitric oxide, airway hyperresponsiveness, ventilation distribution, expiratory flow limitation, airway closure, airway mechanics and overall lung volume.…”

“…6 Lung function assessed by Spirometry including peak expiratory flow (PEF), forced expiratory flow, and forced vital capacity are not only important objective indicators of overall respiratory health but also an important long-term predictor of all-cause mortality and morbidity in both children and adults. 5 However, the critical differences in the effect of obesity on lung function varied between adults, adolescents and children 5 and this has been documented in the literature. Therefore, studies that have been conducted on adults 7 on the relationship between obesity and PEFR cannot be generalized to children and adolescents.…”