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Murray AG, Murison PJ. Complete tracheal obstruction during anaesthesia for ventral slot decompression surgery in a dog. VETERINARY RECORD CASE REPORTS 2022. [DOI: 10.1002/vrc2.461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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D'Auria E, Calcaterra V, Gasparini C, De Silvestri A, Lamberti R, Ghezzi M, Zuccotti G. The impact of adiposity indices on lung function in children with respiratory allergic diseases. Obes Res Clin Pract 2022; 16:314-318. [PMID: 35850917 DOI: 10.1016/j.orcp.2022.06.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 06/07/2022] [Accepted: 06/30/2022] [Indexed: 10/17/2022]
Abstract
INTRODUCTION The effect of obesity on lung function in children stratified by asthma status is not fully elucidated. We evaluated the impact of adiposity indices, including Body Mass Index (BMI) and estimated fat mass (eFT), on lung changes in asthmatic and non-asthmatic children with rhinitis. PATIENTS AND METHODS We performed a retrospective review of 400 pediatric patients, classified into an asthma group (n = 200) and a no-asthma group (n = 200). According to the BMI z-score all subjects were classified into normal-weight patients (NW; -2 ≤ BMI z-score <1) and overweight patients/patients with obesity (OW/OB; BMI z-score ≥1). Lung function parameters were measured by spirometry. BMI and eFM were considered as adiposity indices. RESULTS Excess weight/obesity was present in 37 % of patients. The OW/OB group showed higher basal forced expiratory vital capacity (FVC) and lower forced expiratory volume in 1 s (FEV1), FEV1/FVC ratio compared to the NW group (p ≤ 0.01). FVC and FEV1 were correlated with the BMI z-score, and FEV1/FVC with eFT (p ≤ 0.01). No differences were noted between the NW and the OW/OB groups in terms of respiratory parameters except for FVC (p < 0.01). In the OW/OB group, asthma patients were significantly different based on FEV1, FEV1/FVC, and forced expiratory flow at 25-75 % of FVC (FEF25/75) (p < 0.01). The BMI z-score was correlated with FVC and FEV1 in both the no-asthma and asthma groups (p ≤ 0.01 and p ≤ 0.05, respectively), while eFM was correlated with FEV1/FVC (p = 0.007) in the asthma group only. CONCLUSION Obesity seems to have a significant impact on lung function in children with respiratory allergic diseases. BMI and eFM may be used to evaluate the impact of adiposity on lung function.
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Affiliation(s)
- Enza D'Auria
- Pediatric Department, "Vittore Buzzi" Children's Hospital, 20154 Milan, Italy; Department of Biomedical and Clinical Science "L. Sacco", University of Milan, 20157 Milan, Italy.
| | - Valeria Calcaterra
- Pediatric Department, "Vittore Buzzi" Children's Hospital, 20154 Milan, Italy; Pediatric and Adolescent Unit, Department of Internal Medicine, University of Pavia, 27100 Pavia, Italy
| | - Chiara Gasparini
- Pediatric Department, "Vittore Buzzi" Children's Hospital, 20154 Milan, Italy
| | - Annalisa De Silvestri
- Biometry and Clinical Epidemiology, Scientific Direction, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy
| | - Rossella Lamberti
- Pediatric Department, "Vittore Buzzi" Children's Hospital, 20154 Milan, Italy
| | - Michele Ghezzi
- Pediatric Department, "Vittore Buzzi" Children's Hospital, 20154 Milan, Italy
| | - GianVincenzo Zuccotti
- Pediatric Department, "Vittore Buzzi" Children's Hospital, 20154 Milan, Italy; Department of Biomedical and Clinical Science "L. Sacco", University of Milan, 20157 Milan, Italy
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Lubrano R, Bloise S, Sanseviero M, Marcellino A, Proietti Ciolli C, De Luca E, Testa A, Dilillo A, Mallardo S, Isoldi S, Martucci V, Del Giudice E, Leone R, Iorfida D, Ventriglia F. Assessment of Cardio-Respiratory Function in Overweight and Obese Children Wearing Face Masks during the COVID-19 Pandemic. CHILDREN (BASEL, SWITZERLAND) 2022; 9:1053. [PMID: 35884037 PMCID: PMC9319347 DOI: 10.3390/children9071053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 07/11/2022] [Accepted: 07/11/2022] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To evaluate whether the use of a surgical and N95 mask for overweight and obese children was associated with respiratory distress. METHODS We enrolled 15 healthy and 14 overweight or obese children. We performed two sessions: one wearing a surgical, the other an N95 mask. We tracked changes in partial pressure of end-tidal carbon dioxide (PETCO2), oxygen saturation (SaO2), pulse rate (PR), and respiratory rate (RR) during a 72 min test: 30 min without a mask, 30 min wearing a mask, and then during a 12 min walking test. RESULTS In healthy children, there was no significant change in SaO2 and PETCO2 during the study; there was a significant increase in PR and RR after the walking test with both the masks. In overweight or obese children, there was no significant change in SaO2 during the study period; there was a significant increase in PETCO2 as fast as wearing the mask and an increase in PETCO2, PR, and RR after walking test. After the walking test, we showed a significant correlation between PETCO2 and body mass index. CONCLUSION Overweight or Obese children who wear a mask are more prone to developing respiratory distress, which causes them to remove it frequently. In a crowded environment, they are at greater risk of infection. For this reason, it is desirable that they attend environments where everyone uses a mask.
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Affiliation(s)
| | - Silvia Bloise
- Dipartimento Materno Infantile e di Scienze Urologiche, Sapienza Università di Roma, UOC di Pediatria e Neonatologia-Polo Pontino, 04100 Latina, Italy; (R.L.); (M.S.); (A.M.); (C.P.C.); (E.D.L.); (A.T.); (A.D.); (S.M.); (S.I.); (V.M.); (E.D.G.); (R.L.); (D.I.); (F.V.)
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Bhammar DM, Balmain BN, Babb TG, Bernhardt V. Sex differences in the ventilatory responses to exercise in mild-moderate obesity. Exp Physiol 2022; 107:965-977. [PMID: 35771362 PMCID: PMC9357174 DOI: 10.1113/ep090309] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 06/20/2022] [Indexed: 11/08/2022]
Abstract
NEW FINDINGS What is the central question of the study? What are the sex differences in ventilatory responses during exercise in adults with obesity. What is the main finding and its importance? Tidal volume and expiratory flows are lower in females when compared with males at higher levels of ventilation despite small increases in end-expiratory lung volumes. Since dyspnea on exertion is a frequent complaint, particularly in females with obesity, careful attention should be paid to unpleasant respiratory symptoms and mechanical ventilatory constraints before prescribing exercise. ABSTRACT Obesity is associated with altered ventilatory responses, which may be exacerbated in females due to the functional consequences of sex-related morphological differences in the respiratory system. This study examined sex differences in ventilatory responses during exercise in adults with obesity. Healthy adults with obesity (n = 73; 48 females) underwent pulmonary function testing, underwater weighing, magnetic resonance imaging, a graded exercise test to exhaustion, and two constant work rate exercise tests; one at a fixed work rate (60W for females and 105W for males) and one at a relative intensity (50% of peak oxygen uptake, V̇O2peak ). Metabolic, respiratory, and perceptual responses were assessed during exercise. Compared with males, females used a smaller proportion of their ventilatory capacity at peak exercise (69.13 ± 14.49 vs. 77.41 ± 17.06 % maximum voluntary ventilation, P = 0.0374). Females also utilized a smaller proportion of their forced vital capacity (FVC) at peak exercise (tidal volume: 48.51±9.29 vs. 54.12±10.43 %FVC, P = 0.0218). End-expiratory lung volumes were 2-4% higher in females compared with males during exercise (P<0.05), while end-inspiratory lung volumes were similar. Since the males were initiating inspiration from a lower lung volume, they experienced greater expiratory flow limitation during exercise. Ratings of perceived breathlessness during exercise were similar between females and males at comparable levels of ventilation. In summary, sex differences in the manifestations of obestity-related mechanical ventilatory constraints were observed. Since dyspnea on exertion is a common complaint in patients with obesity, particularly in females, exercise prescriptions should be tailored with the goal of minimizing unpleasant respiratory sensations. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Dharini M Bhammar
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas and UT Southwestern Medical Center, Dallas, TX, USA.,Center for Tobacco Research, Division of Medical Oncology, Department of Internal Medicine, The Ohio State University, Columbus, OH, USA
| | - Bryce N Balmain
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas and UT Southwestern Medical Center, Dallas, TX, USA
| | - Tony G Babb
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas and UT Southwestern Medical Center, Dallas, TX, USA
| | - Vipa Bernhardt
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas and UT Southwestern Medical Center, Dallas, TX, USA.,Department of Health & Human Performance, Texas A&M University - Commerce, Commerce, TX, USA
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55
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Patel N, Chong K, Baydur A. Methods and Applications in Respiratory Physiology: Respiratory Mechanics, Drive and Muscle Function in Neuromuscular and Chest Wall Disorders. Front Physiol 2022; 13:838414. [PMID: 35774289 PMCID: PMC9237333 DOI: 10.3389/fphys.2022.838414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 05/10/2022] [Indexed: 11/13/2022] Open
Abstract
Individuals with neuromuscular and chest wall disorders experience respiratory muscle weakness, reduced lung volume and increases in respiratory elastance and resistance which lead to increase in work of breathing, impaired gas exchange and respiratory pump failure. Recently developed methods to assess respiratory muscle weakness, mechanics and movement supplement traditionally employed spirometry and methods to evaluate gas exchange. These include recording postural change in vital capacity, respiratory pressures (mouth and sniff), electromyography and ultrasound evaluation of diaphragmatic thickness and excursions. In this review, we highlight key aspects of the pathophysiology of these conditions as they impact the patient and describe measures to evaluate respiratory dysfunction. We discuss potential areas of physiologic investigation in the evaluation of respiratory aspects of these disorders.
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56
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Stier C, Koschker AC, Kim M, Stier R, Chiappetta S, Stein J. Fast-track rescue weight reduction therapy to achieve rapid technical operability for emergency bariatric surgery in patients with life-threatening inoperable severe obesity – A proof of concept study. Clin Nutr ESPEN 2022; 50:238-246. [PMID: 35871930 DOI: 10.1016/j.clnesp.2022.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 05/14/2022] [Accepted: 05/17/2022] [Indexed: 10/18/2022]
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57
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Zhang X, Chen H, Gu K, Jiang X. Association of Body Mass Index and Abdominal Obesity with the Risk of Airflow Obstruction: National Health and Nutrition Examination Survey (NHANES) 2007-2012. COPD 2022; 19:99-108. [PMID: 35385365 DOI: 10.1080/15412555.2022.2032627] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
This study aimed to explore the relationship between body mass index (BMI) and abdominal obesity and the risk of airflow obstruction, based on the data from the 2007-2012 National Health and Nutrition Survey (NHANES). Logistic regression was applied to assess the relationships between BMI or abdominal obesity and the risk of airflow obstruction by the fixed ratio method and the lower limit of normal (LLN) method. We further used the restricted cubic splines with 3 knots located at the 5th, 50th, and 95th percentiles of the distribution to evaluate the dose-response relationship. A total of 12,865 individuals aged 20-80 years old were included. In the fixed ratio method, underweight was positively correlated with the risk of airflow obstruction, and overweight and obesity were negatively correlated with the risk of airflow obstruction. In the LLN method, the results were consistent with the fixed ratio method. Abdominal obesity was positively associated with the risk of airflow obstruction only in the fixed ratio method (OR: 1.41, 95% CI: 1.04-1.90). There was an additive interaction between underweight and smoking on airflow obstruction in both methods. Abdominal obesity and smoking had additive interactions in the LLN method. Dose-response analysis indicated that there was a non-linear trend between BMI and the risk of airflow obstruction (Pfor nonlinearity < 0.01). Our study suggested that underweight and abdominal obesity were associated with the increased risk of airflow obstruction, and overweight and general obesity were associated with the decreased risk of airflow obstruction.
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Affiliation(s)
- Xiaofei Zhang
- Department of Epidemiology and Health Statistics, The School of Public Health, Qingdao University, Qingdao, Shandong, China
| | - Hongru Chen
- Department of Epidemiology and Health Statistics, The School of Public Health, Qingdao University, Qingdao, Shandong, China
| | - Kunfang Gu
- Weifang Center for Disease Control and Prevention, Weifang, Shandong, China
| | - Xiubo Jiang
- Department of Epidemiology and Health Statistics, The School of Public Health, Qingdao University, Qingdao, Shandong, China
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58
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Seyni-Boureima R, Zhang Z, Antoine MMLK, Antoine-Frank CD. A review on the anesthetic management of obese patients undergoing surgery. BMC Anesthesiol 2022; 22:98. [PMID: 35382771 PMCID: PMC8985303 DOI: 10.1186/s12871-022-01579-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Accepted: 01/27/2022] [Indexed: 12/01/2022] Open
Abstract
There has been an observed increase in theprevalence of obesity over the past few decades. The prevalence of anesthesiology related complications is also observed more frequently in obese patients as compared to patients that are not obese. Due to the increased complications that accompany obesity, obese patients are now more often requiring surgical interventions. Therefore, it is important that anesthesiologists be aware of this development and is equipped to manage these patients effectively and appropriately. As a result, this review highlights the effective management of obese patients undergoing surgery focusing on the preoperative, perioperative and postoperative care of these patients.
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Affiliation(s)
- Rimanatou Seyni-Boureima
- Department of Anaesthesiology, Zhongnan Hospital, Wuhan University, East Lake Road, 430071, Wuhan, Hubei, China
| | - Zongze Zhang
- Department of Anaesthesiology, Zhongnan Hospital, Wuhan University, East Lake Road, 430071, Wuhan, Hubei, China.
| | - Malyn M L K Antoine
- Department of Endocrinology, Zhongnan Hospital, Wuhan University, East Lake Road, 430071, Wuhan, Hubei, China
| | - Chrystal D Antoine-Frank
- Department of Anatomical Sciences, St. George's University, True Blue,Grand Anse, West Indies, St. George, Grenada
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59
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Ji Y, Liang Y, Mak JC, Ip MS. Obstructive sleep apnea, intermittent hypoxia and non-alcoholic fatty liver disease. Sleep Med 2022; 95:16-28. [DOI: 10.1016/j.sleep.2022.04.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 04/10/2022] [Accepted: 04/11/2022] [Indexed: 12/15/2022]
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60
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Kaminsky DA, Simpson SJ, Berger KI, Calverley P, de Melo PL, Dandurand R, Dellacà RL, Farah CS, Farré R, Hall GL, Ioan I, Irvin CG, Kaczka DW, King GG, Kurosawa H, Lombardi E, Maksym GN, Marchal F, Oostveen E, Oppenheimer BW, Robinson PD, van den Berge M, Thamrin C. Clinical significance and applications of oscillometry. Eur Respir Rev 2022; 31:31/163/210208. [PMID: 35140105 PMCID: PMC9488764 DOI: 10.1183/16000617.0208-2021] [Citation(s) in RCA: 70] [Impact Index Per Article: 35.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Accepted: 10/29/2021] [Indexed: 12/28/2022] Open
Abstract
Recently, “Technical standards for respiratory oscillometry” was published, which reviewed the physiological basis of oscillometric measures and detailed the technical factors related to equipment and test performance, quality assurance and reporting of results. Here we present a review of the clinical significance and applications of oscillometry. We briefly review the physiological principles of oscillometry and the basics of oscillometry interpretation, and then describe what is currently known about oscillometry in its role as a sensitive measure of airway resistance, bronchodilator responsiveness and bronchial challenge testing, and response to medical therapy, particularly in asthma and COPD. The technique may have unique advantages in situations where spirometry and other lung function tests are not suitable, such as in infants, neuromuscular disease, sleep apnoea and critical care. Other potential applications include detection of bronchiolitis obliterans, vocal cord dysfunction and the effects of environmental exposures. However, despite great promise as a useful clinical tool, we identify a number of areas in which more evidence of clinical utility is needed before oscillometry becomes routinely used for diagnosing or monitoring respiratory disease. This paper provides a current review of the interpretation, clinical significance and application of oscillometry in respiratory medicine, with special emphasis on limitations of evidence and suggestions for future research.https://bit.ly/3GQPViA
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Affiliation(s)
- David A Kaminsky
- Dept of Medicine, Pulmonary and Critical Care Medicine, University of Vermont, Larner College of Medicine, Burlington, VT, USA.,These authors have contributed equally to this manuscript
| | - Shannon J Simpson
- Children's Lung Health, Telethon Kids Institute, School of Allied Health, Curtin University, Perth, Australia.,These authors have contributed equally to this manuscript
| | - Kenneth I Berger
- Division of Pulmonary, Critical Care, and Sleep Medicine, NYU School of Medicine and André Cournand Pulmonary Physiology Laboratory, Belleuve Hospital, New York, NY, USA
| | - Peter Calverley
- Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, UK
| | - Pedro L de Melo
- Dept of Physiology, Biomedical Instrumentation Laboratory, Institute of Biology and Faculty of Engineering, State University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Ronald Dandurand
- Lakeshore General Hospital, Pointe-Claire, QC, Canada.,Montreal Chest Institute, Meakins-Christie Labs, Oscillometry Unit of the Centre for Innovative Medicine, McGill University Health Centre and Research Institute, and McGill University, Montreal, QC, Canada
| | - Raffaele L Dellacà
- Dipartimento di Elettronica, Informazione e Bioingegneria - DEIB, Politecnico di Milano University, Milan, Italy
| | - Claude S Farah
- Dept of Respiratory Medicine, Concord Repatriation General Hospital, Sydney, Australia
| | - Ramon Farré
- Unitat de Biofísica i Bioenginyeria, Facultat de Medicina, Universitat de Barcelona-IDIBAPS, Barcelona, Spain.,CIBER de Enfermedades Respiratorias, Madrid, Spain
| | - Graham L Hall
- Children's Lung Health, Telethon Kids Institute, School of Allied Health, Curtin University, Perth, Australia
| | - Iulia Ioan
- Dept of Paediatric Lung Function Testing, Children's Hospital, Vandoeuvre-lès-Nancy, France.,EA 3450 DevAH - Laboratory of Physiology, Faculty of Medicine, University of Lorraine, Vandoeuvre-lès-Nancy, France
| | - Charles G Irvin
- Dept of Medicine, Pulmonary and Critical Care Medicine, University of Vermont, Larner College of Medicine, Burlington, VT, USA
| | - David W Kaczka
- Depts of Anaesthesia, Biomedical Engineering and Radiology, University of Iowa, Iowa City, IA, USA
| | - Gregory G King
- Dept of Respiratory Medicine and Airway Physiology and Imaging Group, Royal North Shore Hospital, St Leonards, Australia.,Woolcock Institute of Medical Research, The University of Sydney, Sydney, Australia
| | - Hajime Kurosawa
- Dept of Occupational Health, Tohoku University School of Medicine, Sendai, Japan
| | - Enrico Lombardi
- Paediatric Pulmonary Unit, Meyer Paediatric University Hospital, Florence, Italy
| | - Geoffrey N Maksym
- School of Biomedical Engineering, Dalhousie University, Halifax, NS, Canada
| | - François Marchal
- Dept of Paediatric Lung Function Testing, Children's Hospital, Vandoeuvre-lès-Nancy, France.,EA 3450 DevAH - Laboratory of Physiology, Faculty of Medicine, University of Lorraine, Vandoeuvre-lès-Nancy, France
| | - Ellie Oostveen
- Dept of Respiratory Medicine, Antwerp University Hospital and University of Antwerp, Belgium
| | - Beno W Oppenheimer
- Division of Pulmonary, Critical Care, and Sleep Medicine, NYU School of Medicine and André Cournand Pulmonary Physiology Laboratory, Belleuve Hospital, New York, NY, USA
| | - Paul D Robinson
- Woolcock Institute of Medical Research, Children's Hospital at Westmead, Sydney, Australia
| | - Maarten van den Berge
- Dept of Pulmonary Diseases, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands
| | - Cindy Thamrin
- Woolcock Institute of Medical Research, The University of Sydney, Sydney, Australia
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Martínez-Luna N, Orea-Tejeda A, González-Islas D, Flores-Cisneros L, Keirns-Davis C, Sánchez-Santillán R, Pérez-García I, Gastelum-Ayala Y, Martínez-Vázquez V, Martínez-Reyna Ó. Association between body composition, sarcopenia and pulmonary function in chronic obstructive pulmonary disease. BMC Pulm Med 2022; 22:106. [PMID: 35346135 PMCID: PMC8962175 DOI: 10.1186/s12890-022-01907-1] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 03/21/2022] [Indexed: 12/25/2022] Open
Abstract
Background Chronic Obstructive Pulmonary Disease (COPD) is characterized by progressive and irreversible airflow limitation. Different factors that modify pulmonary function include age, sex, muscular strength, and a history of exposure to toxic agents. However, the impact of body composition compartments and sarcopenia on pulmonary function is not well-established. This study aimed to evaluate how body composition compartments and sarcopenia affect pulmonary function in COPD patients. Methods In a cross-sectional study, patients with a confirmed diagnosis of COPD, > 40 years old, and forced expiratory volume in the first second /forced vital capacity ratio (FEV1/FVC) < 0.70 post-bronchodilator were included. Patients with cancer, HIV, and asthma were excluded. Body composition was measured with bioelectrical impedance. Sarcopenia was defined according to EWGSOP2, and pulmonary function was assessed by spirometry. Results 185 patients were studied. The mean age was 72.20 ± 8.39 years; 55.14% were men. A linear regression adjusted model showed associations between body mass index, fat-free mass, skeletal muscle mass index, appendicular skeletal muscle mass index, and phase angle (PhA), and sarcopenia with FEV1 (%). As regards FVC (%), PhA and exercise tolerance had positive associations. Conclusion Body composition, especially PhA, SMMI, ASMMI, and sarcopenia, has a significant impact on pulmonary function. Early detection of disturbances of these indexes enables the early application of such therapeutic strategies in COPD patients.
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Affiliation(s)
- Nathalie Martínez-Luna
- Heart Failure and Respiratory Distress Clinic, Cardiology Service, Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas", Calzada de Tlalpan 4502 Col Sec XVI CP, 14080, Del Tlalpan, Mexico City, Mexico
| | - Arturo Orea-Tejeda
- Heart Failure and Respiratory Distress Clinic, Cardiology Service, Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas", Calzada de Tlalpan 4502 Col Sec XVI CP, 14080, Del Tlalpan, Mexico City, Mexico
| | - Dulce González-Islas
- Heart Failure and Respiratory Distress Clinic, Cardiology Service, Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas", Calzada de Tlalpan 4502 Col Sec XVI CP, 14080, Del Tlalpan, Mexico City, Mexico.
| | - Laura Flores-Cisneros
- Department of Clinical Research, Instituto Nacional de Cancerología, Mexico City, Mexico
| | - Candace Keirns-Davis
- Heart Failure and Respiratory Distress Clinic, Cardiology Service, Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas", Calzada de Tlalpan 4502 Col Sec XVI CP, 14080, Del Tlalpan, Mexico City, Mexico
| | - Rocío Sánchez-Santillán
- Heart Failure and Respiratory Distress Clinic, Cardiology Service, Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas", Calzada de Tlalpan 4502 Col Sec XVI CP, 14080, Del Tlalpan, Mexico City, Mexico
| | - Ilse Pérez-García
- Heart Failure and Respiratory Distress Clinic, Cardiology Service, Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas", Calzada de Tlalpan 4502 Col Sec XVI CP, 14080, Del Tlalpan, Mexico City, Mexico
| | - Yael Gastelum-Ayala
- Heart Failure and Respiratory Distress Clinic, Cardiology Service, Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas", Calzada de Tlalpan 4502 Col Sec XVI CP, 14080, Del Tlalpan, Mexico City, Mexico
| | - Valeria Martínez-Vázquez
- Heart Failure and Respiratory Distress Clinic, Cardiology Service, Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas", Calzada de Tlalpan 4502 Col Sec XVI CP, 14080, Del Tlalpan, Mexico City, Mexico
| | - Óscar Martínez-Reyna
- Heart Failure and Respiratory Distress Clinic, Cardiology Service, Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas", Calzada de Tlalpan 4502 Col Sec XVI CP, 14080, Del Tlalpan, Mexico City, Mexico
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Predictive Equations for Adult Pulmonary Function in Zhejiang Province, China. J Trop Med 2022; 2022:5500899. [PMID: 35378900 PMCID: PMC8976640 DOI: 10.1155/2022/5500899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Revised: 01/28/2022] [Accepted: 03/14/2022] [Indexed: 11/18/2022] Open
Abstract
Background Accurate interpretation of lung function tests requires appropriate spirometry reference values derived from large-scale population-specific epidemiological surveys. The aim of this cross-sectional study was to establish normal spirometric values for the population of healthy, nonsmoking Han Chinese adults residing in Zhejiang province, China. Methods We measured lung function parameters such as forced expiratory volume in 1 s, forced vital capacity, peak expiratory flow, maximal midexpiratory flow, and diffusion capacity for carbon monoxide and considered age, height, and weight as independent factors that may modify these parameters. The clinical data were divided into the study arm and validation group. The study arms were used to construct predictive equations using stepwise multiple linear regression, and data from the validation group were used to assess the robustness of the equations. Results The 3866 participants were randomized into a study arm (n = 1,949) and a validation arm (n = 1,917). Lung function parameters had a negative association with age and a positive association with height. Data from the two groups were similar. Predictive equations were constructed from the study arm, and the validation group was used to test the feasibility of the reference equations. Conclusions The reference values we derived can be used to evaluate lung function in this cohort in both epidemiological studies and clinical practice.
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Hagenburg J, Bertin E, Salmon JH, Thierry A, Perotin JM, Dormoy V, Dury S, Gaubil I, Bolko L, Lebargy F, Deslee G, Launois C. Association between obesity-related dyspnea in daily living, lung function and body composition analyzed by DXA: a prospective study of 130 patients. BMC Pulm Med 2022; 22:103. [PMID: 35337302 PMCID: PMC8957162 DOI: 10.1186/s12890-022-01884-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 03/09/2022] [Indexed: 01/01/2023] Open
Abstract
Background Obesity is a risk factor for dyspnea. However, investigations of daily living obesity-related dyspnea are limited and its mechanisms remain unclear. We conducted a cross-sectional study to analyze the relationships between dyspnea in daily living, lung function, and body composition in patients with obesity. Methods One-hundred and thirty patients (103 women/27 men), candidate for bariatric surgery, with a mean ± SD Body Mass Index (BMI) of 44.8 ± 6.8 kg/m2 were included. Dyspnea was assessed by the modified Medical Research Council (mMRC) scale. Comorbidities, laboratory parameters, pulmonary function tests, arterial blood gases, six-minute walk test (6MWT), handgrip strength, and DXA body composition were analyzed. Results Thirty-one percent of patients exhibited disabling dyspnea in daily living (mMRC ≥ 2). Compared with patients without disabling dyspnea (mMRC < 2), significant dyspnea (mMRC ≥ 2) was associated with a lower 6MWT distance (395 ± 103 m vs 457 ± 73 m, p < 0.001), lower lung volumes including Expiratory Reserve Volume (42 ± 28% vs 54 ± 27%, p = 0.024), Vital Capacity (95 ± 14 vs 106 ± 15%, p < 0.001) and Forced expiratory volume in one second (95 ± 13 vs 105 ± 15%, p = 0.002), a higher BMI (48.2 ± 7.7 vs 43.2 ± 5.7 kg/m2, p = 0.001) and a higher percentage of fat mass in the trunk (46 ± 5 vs 44 ± 5 p = 0.012) and android region (52 ± 4 vs 51 ± 4%, p = 0.024). There was no difference regarding comorbidities (except hypertension), laboratory parameters, and sarcopenia markers between patients with (mMRC ≥ 2) and without (mMRC < 2) disabling dyspnea. Conclusion Dyspnea in patients with obesity is associated with a reduction in lung volumes and a higher percentage of fat mass in central body regions. How dyspnea and body composition may change with interventions like physical activity or bariatric surgery remains to be investigated. Supplementary Information The online version contains supplementary material available at 10.1186/s12890-022-01884-5.
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Affiliation(s)
- Jean Hagenburg
- Service Des Maladies Respiratoires, CHU Reims, Reims, France
| | - Eric Bertin
- Service d'Endocrinologie Diabète Nutrition, Centre Spécialisé Obésité, CHU Reims, Reims, France
| | | | | | - Jeanne-Marie Perotin
- Service Des Maladies Respiratoires, CHU Reims, Reims, France.,INSERM UMR-S 1250 "Pathologies Pulmonaires Et Plasticité Cellulaire", Reims, France
| | - Valérian Dormoy
- INSERM UMR-S 1250 "Pathologies Pulmonaires Et Plasticité Cellulaire", Reims, France
| | - Sandra Dury
- Service Des Maladies Respiratoires, CHU Reims, Reims, France
| | - Isabelle Gaubil
- Service d'Endocrinologie Diabète Nutrition, Centre Spécialisé Obésité, CHU Reims, Reims, France
| | - Lois Bolko
- Service de Rhumatologie, CHU Reims, Reims, France
| | | | - Gaëtan Deslee
- Service Des Maladies Respiratoires, CHU Reims, Reims, France.,INSERM UMR-S 1250 "Pathologies Pulmonaires Et Plasticité Cellulaire", Reims, France
| | - Claire Launois
- Service Des Maladies Respiratoires, CHU Reims, Reims, France.
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Shchepikhin EI, Shmelev EI, Zaytseva AS. Respiratory diseases and obesity: special phenotype or independent events: Review. TERAPEVT ARKH 2022; 94:442-447. [DOI: 10.26442/00403660.2022.03.201412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 02/18/2022] [Indexed: 11/22/2022]
Abstract
A combination of factors, including Western European eating habits, physical inactivity and genetic predisposition, lead to a dramatic increase in adipose tissue mass. A special place is occupied by abdominal obesity, in which there is an accumulation of adipose tissue in the mesentery of the small intestine and the omentum. Developing in conditions of visceral obesity, insulin resistance, dyslipidemia and systemic inflammation are one of the key components of the pathogenesis of type 2 diabetes mellitus, cardiovascular diseases, non-alcoholic fatty liver and pancreas disease, polycystic ovary disease, some forms of cancer (breast cancer, endometrial cancer, colonic and direct intestines). At the same time, the pathogenetic role of adipose tissue is not limited to its participation in the formation of the cardiometabolic continuum and oncogenesis. The most important role of metabolically active fat in the pathogenesis of many respiratory diseases is known, including bronchial asthma, obstructive sleep apnea and pulmonary hypertension. This paper presents an overview of current data on immunological, pathophysiological and clinical features of the phenotype of the combination of respiratory diseases with overweight and obesity.
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Yurenko AV, Antonyuk MV, Mineeva EE, Gvozdenko TA. Predictors of dysfunction of the small respiratory tract in patients with asthma. TERAPEVT ARKH 2022; 94:389-395. [DOI: 10.26442/00403660.2022.03.201400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 04/19/2022] [Indexed: 11/22/2022]
Abstract
Aim. To identify predictors of development of small respiratory tract (SRT) dysfunction in patients with asthma of mild severity, partially controlled course.
Materials and methods. One hundred and fourteen patients with asthma of mild severity, partially controlled course, were examined. The control group consisted of 27 healthy volunteers. The main risk factors for the development of AD were revealed by questioning in all patients, an ACQ-5 test was used to determine the level of disease control, functional research was carried out using spirography and bodyplethysmography methods. To assess the relative risk, the odds ratio calculation was used.
Results. 55% of all examined patients with asthma indicated 3 or more risk factors. Bronchial obstruction occurred in 26.3% of cases. According to the functional examination, patients are divided into 2 groups: 94 patients without dysfunction of the SRT and 20 patients with dysfunction of the SRT (17.5% of cases). The significance of differences in the development of dysfunction of the SRT depending on the impact of the risk factor between groups of patients was assessed. Among the traditional risk factors for asthma, the most negatively affecting the development of dysfunction of the SRT in patients were identified. It has been established that the duration of asthma disease for more than 5 years, the symptoms of bronchial obstruction diagnosed in patients increase the risk of dysfunction of the SRT by 4.95 and 4.83 times, respectively, the presence of extrapulmonary allergic diseases, namely allergic rhinitis by 4.31 times, urticaria 3.58 times.
Conclusion. It has been shown that the most significant factors affecting the occurrence of dysfunction of the SRT in patients with asthma of mild severity are the duration of asthma for more than 5 years, the presence of extrapulmonary allergic diseases in patients (allergic rhinitis and urticaria) and bronchial obstruction in patients.
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Engwa GA, Anye C, Nkeh-Chungag BN. Association between obesity and lung function in South African adolescents of African Ancestry. BMC Pediatr 2022; 22:109. [PMID: 35227223 PMCID: PMC8883698 DOI: 10.1186/s12887-022-03164-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 02/17/2022] [Indexed: 12/03/2022] Open
Abstract
Background There is a growing body of literature on the increasing prevalence of obesity in adolescents of Sub-Saharan African ancestry. However, limited data is available on the impact of obesity on pulmonary function. This study assessed the relationship between obesity and lung function in South African adolescents of African ancestry. Methods This was a cross-sectional study involving 10–14 year old adolescents recruited from middle schools of the Eastern Cape Province of South Africa. Anthropometric measurements were performed. Body mass index (BMI) was converted to percentiles for age and sex and used to classified obesity. Spirometry was performed to assess lung function. Chi-square test of association and binary regression analysis were used to assess the relationship between obesity and airway obstruction. Adjusted linear regression was used to determine the relationship between obesity and lung function parameters. Results A total of 540 adolescents were recruited for the study among which 77 (14.3%) were obese. Lung function parameters: forced vital capacity (FVC) and forced expiratory volume in 1 s (FEV1) were higher (p < 0.001) in obese than in non-obese adolescents while peak expiratory flow (PEF) % and FEV1/FVC ratio were lower (p < 0.05) in obese than non-obese adolescents. Obesity was associated (χ2 = 9.614; p < 0.01) with airway obstruction and obese adolescents were over 1.5 times more likely to have pulmonary obstruction (OR: 1.57; p < 0.05) than their non-obese counterparts. Anthropometric measures were positively associated (p < 0.05) with FVC, FEV1, PEF and/or FEV25-75 but negatively associated with FEV1/FVC ratio. Conclusions Obesity was associated with airway obstruction in South Africa adolescents of African ancestry.
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Affiliation(s)
- Godwill Azeh Engwa
- Department of Biological and Environmental Sciences, Faculty of Natural Sciences, Walter Sisulu University PBX1, Mthatha, 5117, South Africa
| | - Chungag Anye
- Dayenuel Consulting, Postnet Suites 092, Mthatha, 5099, South Africa
| | - Benedicta Ngwenchi Nkeh-Chungag
- Department of Biological and Environmental Sciences, Faculty of Natural Sciences, Walter Sisulu University PBX1, Mthatha, 5117, South Africa.
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S Z, B VDB, FJ VDE, JH V, PN D, YF H, PJ V. Adiposity increases weight-bearing exercise-induced dyspnea despite favoring resting lung hyperinflation in COPD. Chron Respir Dis 2022; 19:14799731211052305. [PMID: 35125014 PMCID: PMC8819751 DOI: 10.1177/14799731211052305] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Objectives Our aim was to study the associations between resting lung hyperinflation, weight-bearing exercise-induced dyspnea and adipose distribution in obese and normal-weight COPD patients. Methods We performed a comparison between 80 obese COPD patients (COPDOB) with 80 age- and FEV1 matched normal-weight COPD patients (COPDNW). Dyspnea was assessed by the mMRC scale and the Borg dyspnea score before and after a 6 min walk test. Further characterization included spirometry, body plethysmography and metronome paced tachypnea (MPT) to estimate dynamic hyperinflation. Body composition was assessed with bioelectrical impedance analysis. Associations between dyspnea scores and BMI and body composition groups were studied using logistic regression models. Results COPDOB patients had attenuated increases in TLC, FRC and RV compared to COPDNW patients ( p < 0.01). The groups had comparable 6 min walking distance and ΔFRC upon MPT ( p > 0.05). Compared to COPDNW, COPDOB patients reported more often a mMRC ≥ 2 (65 vs 46%; p = 0.02; OR 3.0, 95% CI 1.4–6.2, p < 0.01) and had higher ΔBorg upon 6MWT: 2.0 (SEM 0.20) vs. 1.4 (SEM 0.16), p = 0.01; OR for ΔBorg ≥ 2: 2.4, 95% CI 1.1–5.2, p = 0.03. Additional logistic regression analyses on the associations between body composition and dyspnea indicated that increased body fat percentage, fat mass index and waist-to-hip ratio were associated with higher ORs for mMRC ≥ 2 and ΔBorg upon 6MWT ≥ 2. Conclusion Despite its beneficial effect on resting lung hyperinflation, adiposity is associated with increased weight-bearing exercise-induced dyspnea in COPD.
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Affiliation(s)
- Zewari S
- Department of Pulmonary Disease, Rijnstate Hospital, Arnhem, The Netherlands
| | - van den Borst B
- Department of Pulmonary Disease, Radboud University Medical Center, Nijmegen, The Netherlands
| | - van den Elshout FJ
- Department of Pulmonary Disease, Rijnstate Hospital, Arnhem, The Netherlands
| | - Vercoulen JH
- Department of Medical Psychology and Department of Pulmonary Diseases, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Dekhuijzen PN
- Department of Pulmonary Disease, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Heijdra YF
- Department of Pulmonary Disease, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Vos PJ
- Department of Pulmonary Disease, Rijnstate Hospital, Arnhem, The Netherlands
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Guo X, Sunil C, Qian G. Obesity and the Development of Lung Fibrosis. Front Pharmacol 2022; 12:812166. [PMID: 35082682 PMCID: PMC8784552 DOI: 10.3389/fphar.2021.812166] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 12/16/2021] [Indexed: 12/20/2022] Open
Abstract
Obesity is an epidemic worldwide and the obese people suffer from a range of respiratory complications including fibrotic changes in the lung. The influence of obesity on the lung is multi-factorial, which is related to both mechanical injury and various inflammatory mediators produced by excessive adipose tissues, and infiltrated immune cells. Adiposity causes increased production of inflammatory mediators, for example, cytokines, chemokines, and adipokines, both locally and in the systemic circulation, thereby rendering susceptibility to respiratory diseases, and altered responses. Lung fibrosis is closely related to chronic inflammation in the lung. Current data suggest a link between lung fibrosis and diet-induced obesity, although the mechanism remains incomplete understood. This review summarizes findings on the association of lung fibrosis with obesity, highlights the role of several critical inflammatory mediators (e.g., TNF-α, TGF-β, and MCP-1) in obesity related lung fibrosis and the implication of obesity in the outcomes of idiopathic pulmonary fibrosis patients.
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Affiliation(s)
- Xia Guo
- Department of Cellular and Molecular Biology, The University of Texas Health Science Center at Tyler, The University of Texas at Tyler, Tyler, TX, United States
| | - Christudas Sunil
- Department of Cellular and Molecular Biology, The University of Texas Health Science Center at Tyler, The University of Texas at Tyler, Tyler, TX, United States
| | - Guoqing Qian
- Department of Cellular and Molecular Biology, The University of Texas Health Science Center at Tyler, The University of Texas at Tyler, Tyler, TX, United States
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Czubaj-Kowal M, Nowicki GJ, Kurzawa R, Polak M, Ślusarska B. Factors Influencing the Concentration of Exhaled Nitric Oxide (FeNO) in School Children Aged 8–9-Years-Old in Krakow, with High FeNO Values ≥ 20 ppb. Medicina (B Aires) 2022; 58:medicina58020146. [PMID: 35208470 PMCID: PMC8877257 DOI: 10.3390/medicina58020146] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Revised: 01/10/2022] [Accepted: 01/17/2022] [Indexed: 11/21/2022] Open
Abstract
Background and Objectives: Measurement of fractional exhaled nitric oxide (FeNO) concentration is currently used as a non-invasive biomarker to assess airway inflammation. Many factors can influence the FeNO level. However, there have been no reports concerning factors attributed to FeNO levels in different age groups of children, especially those with high FeNO values. Therefore, this study aimed to assess the influence of selected factors on nitric oxide concentration in exhaled air in children aged 8–9 attending class 3 of public primary schools in Krakow with high FeNO values ≥ 20 ppb. Materials and Methods: The population-based study covered all third-grade pupils attending primary schools in the city of Krakow. Five thousand, four hundred and sixty children participated in the first screening stage, conducted from October 2017 to January 2018. Then, 792 participants with an FeNO level ≥ 20 ppb were selected. Finally, those selected pupils were invited to participate in the second stage, diagnostic, in April 2018. Four hundred and fifty-four children completed the diagnostic stage of the study, and their data was included in the presented analysis. Results and Conclusions: Significantly higher FeNO levels were observed in children diagnosed with the following diseases: asthma, allergic rhinitis, atopic dermatitis, and allergy (p < 0.05). In addition, it was observed that a higher FeNO concentration characterised children taking antihistamines compared to children not taking those medications (p = 0.008). In multivariate models, we observed that regardless of sex, age, BMI value, home smoking, and whether they were taking medications, children who had allergic rhinitis, or atopic dermatitis, or allergies had significantly higher FeNO levels. The strongest relationship was noted with allergic diseases. The results of our study may be of importance to clinicians when interpreting FeNO results, for example, when making a therapeutic decision.
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Affiliation(s)
- Marta Czubaj-Kowal
- Department of Paediatrics, Stefan Zeromski Specialist Hospital in Krakow, Na Skarpie 66 Str., 31-913 Krakow, Poland
- Department of Pediatrics, Faculty of Medicine and Health Sciences, Andrzej Frycz Modrzewski Krakow University, Gustawa Herlinga-Grudzińskiego 1 Str., 30-705 Krakow, Poland
- Correspondence: ; Tel.: +48-604-433-42
| | - Grzegorz Józef Nowicki
- Department of Family and Geriatric Nursing, Medical University of Lublin, Staszica 6 Str., 20-081 Lublin, Poland; (G.J.N.); (B.Ś.)
| | - Ryszard Kurzawa
- Department of Alergology and Pneumonology, Institute of Tuberculosis and Lung Disorders, Prof. Jana Rudnika 3B Str., 34-700 Rabka-Zdrój, Poland;
| | - Maciej Polak
- Department of Epidemiology and Population Studies, Jagiellonian University Medical College, Grzegórzecka 20 Str., 31-531 Krakow, Poland;
| | - Barbara Ślusarska
- Department of Family and Geriatric Nursing, Medical University of Lublin, Staszica 6 Str., 20-081 Lublin, Poland; (G.J.N.); (B.Ś.)
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Habrial P, Léger M, Costerousse F, Debiasi J, Breheret R, Vacheron CH, Rineau E, Lasocki S. Spontaneous Breathing for Panendoscopy? Retrospective Cohort and Results of a French Practice Survey. OTO Open 2022; 6:2473974X211065015. [PMID: 35005334 PMCID: PMC8738874 DOI: 10.1177/2473974x211065015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 11/08/2021] [Indexed: 11/16/2022] Open
Abstract
Objective Avoiding tracheal intubation by using general anesthesia with spontaneous breathing (GASB) is attractive for upper airway panendoscopy. The aim of this study was to estimate the incidence of adverse events during panendoscopy under GASB and to assess the practices of French anesthesiologists. Study Design Two-phase study: monocentric retrospective study and national survey. Setting University hospital center. Methods Patients who underwent a panendoscopy under GASB at the University Hospital of Angers between January 1 and December 31, 2014, were reviewed. Failure of GASB was defined as an episode of hypoxemia (SpO2 ≤88%) or the need for face mask ventilation with or without tracheal intubation. Then, we sent an electronic survey to all members of the French Society of Anaesthesia and Intensive Care. Results Among the 95 included patients, 22 (23%) experienced a failure of GASB: 3 tolerated hypoxemia, 15 had face mask ventilation episodes, and 4 were intubated. Three factors were associated with failure: obesity (odds ratio, 11.94; 95% CI, 3.20-44.64), history of difficult intubation defined as a Cormack score ≥3 (odds ratio, 6.20; 95% CI, 1.51-25.41), and laryngeal tumor (odds ratio, 2.81; 95% CI, 1.04-7.56). Among the 3930 members of the French Society of Anaesthesia and Intensive Care in 2018, 662 (16.8%) responded to the survey. The 2 preferred techniques to perform panendoscopy were intubation (62%) and intravenous sedation with spontaneous breathing (37%). Conclusion Although general anesthesia with orotracheal intubation remains the preferred technique for panendoscopy in France, GASB is an attractive alternative with a low failure rate. Risk factors for failure are obesity, history of difficult intubation, and laryngeal tumor.
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Affiliation(s)
- Pierre Habrial
- Department of Anaesthesia and Intensive Care, Angers University Hospital, Angers, France
| | - Maxime Léger
- Department of Anaesthesia and Intensive Care, Angers University Hospital, Angers, France
| | - Fabienne Costerousse
- Department of Anaesthesia and Intensive Care, Angers University Hospital, Angers, France
| | - Julie Debiasi
- Department of Anaesthesia and Intensive Care, Angers University Hospital, Angers, France
| | - Renaud Breheret
- Department of Otorhinolaryngology-Head and Neck Surgery, Angers University Hospital, Angers, France
| | - Charles-Hervé Vacheron
- Department of Anaesthesia and Intensive Care, Centre Hospitalier Lyon Sud, Pierre-Bénite, France
| | - Emmanuel Rineau
- Department of Anaesthesia and Intensive Care, Angers University Hospital, Angers, France
| | - Sigismond Lasocki
- Department of Anaesthesia and Intensive Care, Angers University Hospital, Angers, France
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Fan X, He M, Tong C, Nie X, Zhong Y, Lu M. Development and Comparison of Predictive Models Based on Different Types of Influencing Factors to Select the Best One for the Prediction of OSAHS Prevalence. Front Psychiatry 2022; 13:892737. [PMID: 35923456 PMCID: PMC9340571 DOI: 10.3389/fpsyt.2022.892737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 05/02/2022] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE This study aims to retrospectively analyze numerous related clinical data to identify three types of potential influencing factors of obstructive sleep apnea-hypopnea syndrome (OSAHS) for establishing three predictive nomograms, respectively. The best performing one was screened to guide further clinical decision-making. METHODS Correlation, difference and univariate logistic regression analysis were used to identify the influencing factors of OSAHS. Then these factors are divided into three different types according to the characteristics of the data. Lasso regression was used to filter out three types of factors to construct three nomograms, respectively. Compare the performance of the three nomograms evaluated by C-index, ROC curve and Decision Curve Analysis to select the best one. Two queues were obtained by randomly splitting the whole queue, and similar methods are used to verify the performance of the best nomogram. RESULTS In total, 8 influencing factors of OSAHS have been identified and divided into three types. Lasso regression finally determined 6, 3 and 4 factors to construct mixed factors nomogram (MFN), baseline factors nomogram (BAFN) and blood factors nomogram (BLFN), respectively. MFN performed best among the three and also performed well in multiple queues. CONCLUSION Compared with BAFN and BLFN constructed by single-type factors, MFN constructed by six mixed-type factors shows better performance in predicting the risk of OSAHS.
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Affiliation(s)
- Xin Fan
- Department of Emergency, Shangrao Hospital Affiliated to Nanchang University, Shangrao People's Hospital, Shangrao, China.,Department of Otolaryngology-Head and Neck Surgery, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Mu He
- School of Stomatology, Nanchang University, Nanchang, China
| | - Chang Tong
- Pediatric Medical School, Nanchang University, Nanchang, China
| | - Xiyi Nie
- Department of Neurosurgery, Yichun People's Hospital, Yichun, China
| | - Yun Zhong
- The First Clinical Medical College of Nanchang University, Nanchang, China
| | - Min Lu
- Department of Emergency, Shangrao Hospital Affiliated to Nanchang University, Shangrao People's Hospital, Shangrao, China
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Hou P, Pi Y, Jiao Z, Tian X, Hu W, Zhang Y, Zhao Y, Wang F. Association of Body Composition with Pulmonary Function in Ningxia: The China Northwest Cohort. Diabetes Metab Syndr Obes 2022; 15:3243-3254. [PMID: 36304482 PMCID: PMC9594934 DOI: 10.2147/dmso.s383098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Accepted: 10/16/2022] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND In recent decades, obesity has become an epidemic worldwide and is a risk factor for many chronic diseases. Lung function is also a predictor of various chronic diseases. However, research results on the association between obesity and lung function are inconsistent and few studies have evaluated the association between central obesity indicators and lung function. Therefore, this study explored the correlation between central obesity and lung function. METHODS This study is a cross-sectional study. The basic participant characteristics were collected by questionnaire. A tape measure was used to measure waist circumference (WC) and hip circumference (HC). Body fat percentage was measured using an InBody370. Lung function parameters were measured using a digital spirometer connected to a computer (Chestgraph HI-101). R (R4.0.5) software was used for data analysis. A generalized linear model was used to analyze the association between obesity and lung function. RESULTS This study found that body mass index (BMI) adjusted for WC was negatively correlated with forced vital capacity (FVC) (β=-0.05 [-0.06, -0.03] in men, β=-0.05 [-0.07, -0.04] in women) and forced expiratory volume in 1 s (FEV1)(β=-0.02 [-0.03, -0.00] in men, β=-0.03 [-0.04, -0.02] in women). Body fat percentage was negatively correlated with FVC (β=-0.01 [-0.01, -0.01] in men, β=-0.01 [-0.01, -0.00] in women). CONCLUSION Central obesity and combined central and general obesity were more strongly positively correlated with lung function. WC-adjusted BMI was negatively correlated with lung function. Body fat percentage was negatively correlated with lung function.
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Affiliation(s)
- Pengyi Hou
- School of Public Health and Management, Ningxia Medical University, Yinchuan, People’s Republic of China
- Laboratory of Environmental Factors and Chronic Disease Control, Ningxia Medical University, Yinchuan, People’s Republic of China
| | - Yangyang Pi
- School of Public Health and Management, Ningxia Medical University, Yinchuan, People’s Republic of China
- Laboratory of Environmental Factors and Chronic Disease Control, Ningxia Medical University, Yinchuan, People’s Republic of China
| | - Ziming Jiao
- School of Public Health and Management, Ningxia Medical University, Yinchuan, People’s Republic of China
| | - Xueyan Tian
- School of Public Health and Management, Ningxia Medical University, Yinchuan, People’s Republic of China
| | - Wenxuan Hu
- School of Public Health and Management, Ningxia Medical University, Yinchuan, People’s Republic of China
| | - Yuhong Zhang
- School of Public Health and Management, Ningxia Medical University, Yinchuan, People’s Republic of China
- Laboratory of Environmental Factors and Chronic Disease Control, Ningxia Medical University, Yinchuan, People’s Republic of China
| | - Yi Zhao
- School of Public Health and Management, Ningxia Medical University, Yinchuan, People’s Republic of China
- Laboratory of Environmental Factors and Chronic Disease Control, Ningxia Medical University, Yinchuan, People’s Republic of China
| | - Faxuan Wang
- School of Public Health and Management, Ningxia Medical University, Yinchuan, People’s Republic of China
- Laboratory of Environmental Factors and Chronic Disease Control, Ningxia Medical University, Yinchuan, People’s Republic of China
- Correspondence: Faxuan Wang, Email
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Lagier D, Zeng C, Fernandez-Bustamante A, Melo MFV. Perioperative Pulmonary Atelectasis: Part II. Clinical Implications. Anesthesiology 2022; 136:206-236. [PMID: 34710217 PMCID: PMC9885487 DOI: 10.1097/aln.0000000000004009] [Citation(s) in RCA: 50] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
The development of pulmonary atelectasis is common in the surgical patient. Pulmonary atelectasis can cause various degrees of gas exchange and respiratory mechanics impairment during and after surgery. In its most serious presentations, lung collapse could contribute to postoperative respiratory insufficiency, pneumonia, and worse overall clinical outcomes. A specific risk assessment is critical to allow clinicians to optimally choose the anesthetic technique, prepare appropriate monitoring, adapt the perioperative plan, and ensure the patient's safety. Bedside diagnosis and management have benefited from recent imaging advancements such as lung ultrasound and electrical impedance tomography, and monitoring such as esophageal manometry. Therapeutic management includes a broad range of interventions aimed at promoting lung recruitment. During general anesthesia, these strategies have consistently demonstrated their effectiveness in improving intraoperative oxygenation and respiratory compliance. Yet these same intraoperative strategies may fail to affect additional postoperative pulmonary outcomes. Specific attention to the postoperative period may be key for such outcome impact of lung expansion. Interventions such as noninvasive positive pressure ventilatory support may be beneficial in specific patients at high risk for pulmonary atelectasis (e.g., obese) or those with clinical presentations consistent with lung collapse (e.g., postoperative hypoxemia after abdominal and cardiothoracic surgeries). Preoperative interventions may open new opportunities to minimize perioperative lung collapse and prevent pulmonary complications. Knowledge of pathophysiologic mechanisms of atelectasis and their consequences in the healthy and diseased lung should provide the basis for current practice and help to stratify and match the intensity of selected interventions to clinical conditions.
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Affiliation(s)
- David Lagier
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Congli Zeng
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | | | - Marcos F. Vidal Melo
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
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74
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Zhang H, Chen Y, Zheng T, Zhang M, Li X, Shi L. Factors Affecting the Exercise Capacity in Pediatric Primary Hypertension. Front Pediatr 2022; 10:882223. [PMID: 35692974 PMCID: PMC9174901 DOI: 10.3389/fped.2022.882223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 04/28/2022] [Indexed: 11/18/2022] Open
Abstract
PURPOSE Exercise training is crucial to the early intervention of pediatric primary hypertension (PHT). However, much less is known about exercise capacity in this disease. This work investigated the exercise capacity in pediatric PHT and analyzed the factors affecting exercise capacity. METHODS The study enrolled children with PHT at the Children's Hospital Capital Institute of Pediatrics between July 2017 and July 2020. The Bruce protocol of the treadmill exercise test (TET) was used to assess exercise capacity. Multivariate ordinal logistic regression and generalized linear models were used to analyze factors affecting exercise capacity. RESULTS Of 190 patients, 146 (76.8%) were male, and the median age was 13 (11, 14). Most children accomplished TET and achieved the submaximal heart rates (189 [99.5%]). Children with lower resting diastolic blood pressure (DBP) and 24 h average diastolic blood pressure (ADBP) could achieve a TET stage of 6 or more, whereas children with higher DBP and ADBP could only achieve a TET stage of 3 (P all < 0.05). Children with lower DBP and 24 h ADBP were also associated with greater metabolic equivalents (METs; r = -0.237, r = -0.179, P all < 0.05). The completion of TET stages was negatively associated with female (OR = 0.163), younger age (OR = 1.198), greater body mass index (BMI, OR = 0.921), and higher 24 h ADBP (OR = 0.952, P all < 0.05). In addition, METs were negatively associated with female (β = -1.909), younger age (β = 0.282), greater BMI (β = -0.134), and higher 24 h ADBP (β = -0.063, P all < 0.05). CONCLUSIONS Exercise capacity was impaired among pediatric PHT patients. Female gender, younger age, greater BMI, and higher 24 h ADBP are independently associated with the exercise capacity in pediatric PHT. These findings may help developing scientific exercise prescriptions for pediatric PHT.
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Affiliation(s)
- Hui Zhang
- Department of Cardiovascular Medicine, Children's Hospital Capital Institute of Pediatrics, Peking Union Medical College Graduate School, Beijing, China
| | - Yeshi Chen
- Capital Institute of Pediatrics-Peking University Teaching Hospital, Beijing, China
| | - Tong Zheng
- Department of Cardiovascular Medicine, Children's Hospital Capital Institute of Pediatrics, Beijing, China
| | - Mingming Zhang
- Department of Cardiovascular Medicine, Children's Hospital Capital Institute of Pediatrics, Beijing, China
| | - Xiaohui Li
- Department of Cardiovascular Medicine, Children's Hospital Capital Institute of Pediatrics, Peking Union Medical College Graduate School, Beijing, China.,Capital Institute of Pediatrics-Peking University Teaching Hospital, Beijing, China.,Department of Cardiovascular Medicine, Children's Hospital Capital Institute of Pediatrics, Beijing, China
| | - Lin Shi
- Department of Cardiovascular Medicine, Children's Hospital Capital Institute of Pediatrics, Beijing, China
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75
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Kim JW, Shin J, Lee K, Won TB, Rhee CS, Cho SW. Prediction of Oxygen Desaturation by Using Sound Data From a Noncontact Device: A Proof-of-Concept Study. Laryngoscope 2021; 132:901-905. [PMID: 34873695 DOI: 10.1002/lary.29971] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 11/04/2021] [Accepted: 11/24/2021] [Indexed: 11/11/2022]
Abstract
OBJECTIVES/HYPOTHESIS Prediction of the apnea-hypopnea index (AHI) from breathing sounds during sleep could be used to prescreen for obstructive sleep apnea (OSA). In addition, the oxygen desaturation index (ODI) is a known risk factor for developing cardiovascular disease in OSA patients. This study focused on estimation of ODI from a noncontact manner from sleep breathing sounds. STUDY DESIGN Retrospective study. METHODS Patients who visited the sleep center due to snoring or sleep apnea underwent polysomnography in lab overnight. Sound recordings were made during polysomnography using a microphone. After noise reduction, the sound data were segmented into 5 seconds windows and features were extracted. Binary classification and regression analyses were performed to estimate the ODI during sleep (model 1). This was re-tested after inclusion of body mass index (BMI) and age as additional features (model 2: BMI only, model 3: BMI and age). RESULTS We included 116 patients. The mean age and AHI of all patients were 50.4 ± 16.7 years and 23.0 ± 24.0 events/hr. In binary classification, for ODI cutoff values of 5, 15, and 30 events/hr, the areas under the curve were 0.88, 0.93, 0.91, respectively, and accuracies were 85.34, 86.21, and 87.07, respectively. In regression analysis, the correlation coefficient and mean absolute error were 0.80 and 9.60 events/hr, respectively. In models 2 and 3, the correlation coefficient and mean absolute error were 0.82, 9.44 events/hr and 0.81, 9.6 events/hr, respectively. CONCLUSION Prediction of ODI from sleep sound seems to be feasible. Additional clinical feature such as BMI may increase overall predictability. LEVEL OF EVIDENCE IV Laryngoscope, 2021.
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Affiliation(s)
- Jeong-Whun Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea.,Sensory Organ Research Institute, Seoul National University Medical Research Center, Seoul National University Medical Research Center, Seoul, Korea
| | - Jaeyoung Shin
- Music and Audio Research Group, Graduate School of Convergence Science and Technology, Seoul National University, Suwon, South Korea
| | - Kyogu Lee
- Music and Audio Research Group, Graduate School of Convergence Science and Technology, Seoul National University, Suwon, South Korea
| | - Tae-Bin Won
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea.,Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea
| | - Chae-Seo Rhee
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea.,Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea.,Sensory Organ Research Institute, Seoul National University Medical Research Center, Seoul National University Medical Research Center, Seoul, Korea
| | - Sung-Woo Cho
- Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea
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76
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Association between Dietary Patterns and Chronic Obstructive Pulmonary Disease in Korean Adults: The Korean Genome and Epidemiology Study. Nutrients 2021; 13:nu13124348. [PMID: 34959900 PMCID: PMC8707827 DOI: 10.3390/nu13124348] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 11/30/2021] [Accepted: 12/01/2021] [Indexed: 02/07/2023] Open
Abstract
In addition to smoking, dietary habits may contribute to the development of chronic obstructive pulmonary disease (COPD). This study aimed to examine the association between dietary patterns and lung function in a Korean community cohort. A total of 5436 participants were included from the Ansan–Ansung cohort study. To identify the dietary patterns, we performed principal component factor analysis using the results of a semi-quantitative food frequency questionnaire. The forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC), and FEV1/FVC ratio were measured by spirometry. Multiple logistic regression models were used to evaluate the association between dietary patterns and lung function after adjusting for confounders. We identified four major dietary patterns; ‘prudent’, ‘coffee, fat, and sweet’, ‘westernized’, and ‘white rice’. After adjusting for potential confounders, the ‘coffee, fat, and sweet’ dietary pattern was negatively associated with lung function, particularly the FEV1/FVC ratio. Participants with high scores for the ‘coffee, fat and sweet’ pattern had a higher risk of COPD among men but not women. Therefore, these results indicate that the ‘coffee, fat and sweet’ dietary pattern is inversely related to lung function in Korean adults. Our results indicate that dietary habits may be modifiable risk factors for COPD.
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77
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Huang L, Wang ST, Kuo HP, Delclaux C, Jensen ME, Wood LG, Costa D, Nowakowski D, Wronka I, Oliveira PD, Chen YC, Chen YC, Lee YL. Effects of obesity on pulmonary function considering the transition from obstructive to restrictive pattern from childhood to young adulthood. Obes Rev 2021; 22:e13327. [PMID: 34322972 DOI: 10.1111/obr.13327] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 07/11/2021] [Accepted: 07/11/2021] [Indexed: 12/25/2022]
Abstract
Adults with obesity exhibit a restrictive pattern, whereas children with obesity exhibit an obstructive pattern. However, the transition process remains unclear. We performed a systematic search for studies reporting on body mass index and pulmonary function in children. The main outcomes were forced expiratory volume in 1 s (FEV1 ), forced vital capacity (FVC), and their ratio (FEV1 /FVC). We compared individuals with overweight or with obesity with individuals with normal weight. Random-effects models were used to calculate pooled estimates. A total of 17 studies were included. Individuals with obesity had a lower FEV1 /FVC ratio (mean difference [MD] = -3.61%; 95% confidence interval [CI] = -4.58%, -2.64%) and a higher percent-predicted FVC (MD = 3.33%; 95% CI = 0.79%, 5.88%) than those with normal weight. Obesity impaired pulmonary function in the obstructive pattern during childhood to young adulthood, and the maximum obstruction was observed at the age of 16 years in boys and 20 years in girls. The effects attenuated at approximately 30 years and then shifted to the restrictive pattern after 35 years of age in men and 40 years in women. The effects of obesity on pulmonary function change from the obstructive pattern in childhood to the restrictive pattern in adulthood.
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Affiliation(s)
- Li Huang
- Department of Family Medicine, Taipei Medical University Hospital, Taipei, Taiwan
| | - Sen-Te Wang
- Department of Family Medicine, Taipei Medical University Hospital, Taipei, Taiwan.,Department of Family Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Han-Pin Kuo
- Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Christophe Delclaux
- Department of Pediatric Physiology and Sleep Center, AP-HP, Robert Debré Hospital, Paris, France
| | - Megan E Jensen
- Priority Research Centre Grow Up Well and School of Medicine & Public Health, University of Newcastle, Newcastle, Australia
| | - Lisa G Wood
- Priority Research Centre for Healthy Lungs, School of Biomedical Science and Pharmacy, University of Newcastle, Newcastle, Australia
| | - Dirceu Costa
- Rehabilitation Sciences Postgraduate Program, University Nove de Julho, Sao Paulo, Brazil
| | - Dariusz Nowakowski
- Department of Anthropology, Wroclaw University of Environmental and Life Science, Wroclaw, Poland
| | - Iwona Wronka
- Laboratory of Anthropology, Institute of Zoology and Biomedical Research, Jagiellonian University, Krakow, Poland
| | - Paula D Oliveira
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Yi-Chun Chen
- Department of Health Management, I-Shou University, Kaohsiung, Taiwan
| | - Yang-Ching Chen
- Department of Family Medicine, Taipei Medical University Hospital, Taipei, Taiwan.,Department of Family Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, Taipei, Taiwan.,Graduate Institute of Metabolism and Obesity Sciences, College of Nutrition, Taipei Medical University, Taipei, Taiwan
| | - Yungling L Lee
- Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan.,College of Public Health, China Medical University, Taichung, Taiwan
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78
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Park HK, Lee SH, Lee SY, Kim SS, Park HW. Relationships between lung function decline and skeletal muscle and fat mass changes: a longitudinal study in healthy individuals. J Cachexia Sarcopenia Muscle 2021; 12:2145-2153. [PMID: 34612015 PMCID: PMC8718064 DOI: 10.1002/jcsm.12821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 08/17/2021] [Accepted: 08/31/2021] [Indexed: 11/07/2022] Open
Abstract
BACKGROUND The associations between long-term changes in body mass composition and decline in lung function in healthy adults are unknown. METHODS Using a well-defined health check-up database, we first assessed individual longitudinal changes in muscle mass (MM) and fat mass (FM) measured via bioelectrical impedance analyses. Then we classified the enrolled individuals into five body composition groups according to their MM index (MMI) [MM (kg)/height (m)2 ] or FM index (FMI) [FM (kg)/height (m)2 ] change rate quartiles. Linear mixed models adjusted for age, smoking status, height, and body mass index were used to analyse the rate of forced expiratory volume in 1 s (FEV1) decline and body composition groups. RESULTS A total of 15 476 middle-aged individuals (6088 women [mean age ± standard deviation: 50.74 ± 7.44] and 9388 men [mean age ± standard deviation: 49.36 ± 6.99]) were enrolled. The mean number of measurements was 6.96 (interquartile range [IQR]: 5-9) over an average follow-up period of 8.95 years (IQR: 6.73-11.10). Decrease in MMI was significantly associated with accelerated FEV1 decline in men only (P = 1.7 × 10-9 ), while increase in FMI was significantly associated with accelerated FEV1 decline in both women and men (P = 7.9 × 10-10 and P < 2.0 × 10-16 respectively). Linear mixed model analyses indicated that annual increase of 0.1 kg/m2 in MMI was related to accelerated FEV1 decline by 30.79 mL/year (95% confidence interval [CI]: 26.10 to 35.48 mL/year) in men. Annual increase of 0.1 kg/m2 in FMI was related to accelerated FEV1 decline by 59.65 mL/year in men (95% CI: 56.84 to 62.28 mL/year) and by 22.84 mL/year in women (95% CI: 18.95 to 26.74 mL/year). In body composition analysis, we found increase in MMI was significantly associated with attenuated FEV1 decline in men only (P = 1.7 × 10-9 ), while increase in FMI was significantly associated with accelerated FEV1 decline in both women and men (P = 7.9 × 10-10 and P < 2.0 × 10-16 respectively). Individuals characterized with gain MM combined with loss of FM were associated with the most favourable outcome (i.e. the smallest rate of decline in FEV1) in both women and men. In men, loss of FM over time is more closely related with attenuated FEV1 decline than change in MM (gain or loss). CONCLUSIONS Change in body composition over time can be used to identify healthy middle-aged individuals at high risk for rapid FEV1 decline.
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Affiliation(s)
- Han-Ki Park
- Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Korea.,Department of Internal Medicine, Kyungpook National University Chilgok Hospital, Daegu, Korea
| | - So-Hee Lee
- Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Korea
| | - Suh-Young Lee
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Sun-Sin Kim
- Seoul National University Hospital Healthcare System Gangnam Center, Seoul, Korea
| | - Heung-Woo Park
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea.,Institute of Allergy and Clinical Immunology, Seoul National University Medical Research Center, Seoul, Korea.,Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
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79
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Sabaz MS, Aşar S, Sertçakacılar G, Sabaz N, Çukurova Z, Hergünsel GO. The effect of body mass index on the development of acute kidney injury and mortality in intensive care unit: is obesity paradox valid? Ren Fail 2021; 43:543-555. [PMID: 33745415 PMCID: PMC7993374 DOI: 10.1080/0886022x.2021.1901738] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 03/03/2021] [Accepted: 03/03/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND The conflicting results of studies on intensive care unit (ICU) mortality of obese patients and obese patients with acute kidney injury (AKI) reveal a paradox within a paradox. The aim of this study was to determine the effects of body mass index and obesity on AKI development and ICU mortality. METHODS The 4,459 patients treated between January 2015 and December 2019 in the ICU at a Tertiary Care Center in Turkey were analyzed retrospectively. RESULTS AKI developed more in obese patients with 69.8% (620). AKI development rates were similar in normal-weight (65.1%; 1172) and overweight patients (64.9%; 1149). The development of AKI in patients who presented with cerebrovascular diseases was higher in obese patients (81; 76.4%) than in normal-weight (158; 62.7%) and overweight (174; 60.8%) patients (p < 0.05). The risk of developing AKI was approximately 1.4 times (CI 95% = 1.177-1.662) higher in obese patients than in normal-weight patients. Dialysis was used more frequently in obese patients (24.3%, p < 0.001), who stayed longer in the ICU (p < 0.05). It was determined that the development of AKI in normal-weight and overweight patients increased mortality (p < 0.001) and that there was not a difference in mortality rates between obese patients with and without AKI. CONCLUSION The risk of AKI development was higher in obese patients but not in those who were in serious conditions. Another paradox was that the development of AKI was associated with a higher mortality rate in normal-weight and overweight patients, but not in obese patients. Cerebrovascular diseases as a cause of admission pose additional risks for AKI.
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Affiliation(s)
- Mehmet Süleyman Sabaz
- Department of Anesthesiology and Reanimation, Marmara University Pendik Training and Research Hospital, Istanbul, Turkey
| | - Sinan Aşar
- Department of Anesthesiology and Reanimation, Health Sciences University, Bakırköy Dr Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Gökhan Sertçakacılar
- Department of Anesthesiology and Reanimation, Health Sciences University, Bakırköy Dr Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Nagihan Sabaz
- Division of Nursing, Department of Pediatric Nursing, Faculty of Health Sciences, Marmara University, Istanbul, Turkey
| | - Zafer Çukurova
- Department of Anesthesiology and Reanimation, Health Sciences University, Bakırköy Dr Sadi Konuk Training and Research Hospital, Istanbul, Turkey
| | - Gülsüm Oya Hergünsel
- Department of Anesthesiology and Reanimation, Health Sciences University, Bakırköy Dr Sadi Konuk Training and Research Hospital, Istanbul, Turkey
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80
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Khramova RN, Tush EV, Khramov AA, Ovsyannikov DY, Popov KS, Dolbin IV, Khaletskaya OV, Stroganov AB, Kubysheva NI, Eliseeva TI. Relationship of Nutritional Status and Spirometric Parameters in Children with Bronchial Asthma. Sovrem Tekhnologii Med 2021; 12:12-23. [PMID: 34795975 PMCID: PMC8596246 DOI: 10.17691/stm2020.12.3.02] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Indexed: 12/23/2022] Open
Abstract
The potential mechanisms of bronchial asthma (BA) negative modification under the influence of obesity are currently being actively studied. However, at present, the effect of nutritional status on bronchial obstruction in children with BA cannot be considered established. In this regard, the purpose of this work was to study the relationship of spirometric parameters reflecting bronchial patency with nutritional status in children with asthma.
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Affiliation(s)
- R N Khramova
- Medical Resident, Department of Hospital Pediatrics; Privolzhsky Research Medical University, 10/1 Minin and Pozharsky Square, Nizhny Novgorod, 603005, Russia
| | - E V Tush
- Associate Professor, Department of Hospital Pediatrics; Privolzhsky Research Medical University, 10/1 Minin and Pozharsky Square, Nizhny Novgorod, 603005, Russia
| | - A A Khramov
- Medical Resident, Department of Hospital Pediatrics; Privolzhsky Research Medical University, 10/1 Minin and Pozharsky Square, Nizhny Novgorod, 603005, Russia
| | - D Yu Ovsyannikov
- Professor, Head of the Department of Children's Diseases; Peoples' Friendship University of Russia, 6 Miklukho-Maklaya St., Moscow, 117198, Russia
| | - K S Popov
- Medical Resident, Department of Hospital Pediatrics; Privolzhsky Research Medical University, 10/1 Minin and Pozharsky Square, Nizhny Novgorod, 603005, Russia
| | - I V Dolbin
- Consultant; City Clinical Hospital No.38, 22 Chernyshevskogo St., Nizhny Novgorod, 603000, Russia
| | - O V Khaletskaya
- Professor, Head of the Department of Hospital Pediatrics; Privolzhsky Research Medical University, 10/1 Minin and Pozharsky Square, Nizhny Novgorod, 603005, Russia
| | - A B Stroganov
- Associate Professor, Department of Faculty Surgery and Transplantology; Privolzhsky Research Medical University, 10/1 Minin and Pozharsky Square, Nizhny Novgorod, 603005, Russia
| | - N I Kubysheva
- Senior Researcher, Research Laboratory "Clinical Linguistics"; Kazan Federal University, 18 Kremlyovskaya St., Kazan, Republic of Tatarstan, 420008, Russia
| | - T I Eliseeva
- Professor, Department of Hospital Pediatrics; Privolzhsky Research Medical University, 10/1 Minin and Pozharsky Square, Nizhny Novgorod, 603005, Russia
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81
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Xia Y, You K, Xiong Y. Interaction effects between characteristics of obstructive sleep apnea and obesity on dyslipidemia. Auris Nasus Larynx 2021; 49:437-444. [PMID: 34789392 DOI: 10.1016/j.anl.2021.10.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 10/17/2021] [Accepted: 10/27/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Obstructive sleep apnea (OSA) and obesity often coexist, and both can increase the risk of dyslipidemia. However, the interaction effects between the characteristics of OSA and obesity on dyslipidemia are not yet known. This study was performed to investigate this issue. METHODS Basic characteristics, polysomnography data, and biochemical markers of patients with suspected OSA seen at the First Affiliated Hospital of Nanchang University were collected. Serum lipid levels were compared after adjusting for multiple confounders. We used binary logistic regression models to assess the interaction effects of the oxygen desaturation index (ODI) and obesity, and the apnea-hypopnea index (AHI) and obesity, on dyslipidemia. RESULTS A total of 343 patients were included in the study. After adjusting for multiple confounders, there were no differences in serum lipid levels between non-obese or obese patients with an AHI ≤ 30 and AHI > 30, and no interaction effect between the AHI and obesity on dyslipidemia. Obese patients, but not non-obese ones, with an ODI > 37.5 had significantly higher total cholesterol (TC) levels, and higher TC/high-density lipoprotein cholesterol (HDL-C) ratios, than patients with an ODI ≤ 37.5. In addition, a significant positive multiplicative interaction effect between obesity and the ODI was found on hyper-TC (odds ratio [OR] = 3.459; 95% confidence interval [CI] = 1.104, 10.838; p = 0.03). CONCLUSION A positive interaction effect was detected between obesity and intermittent hypoxia on dyslipidemia. Therefore, further attention should be paid to dyslipidemia in obese patients with intermittent hypoxia.
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Affiliation(s)
- Yunyan Xia
- Department of Otorhinolaryngology-Head and Neck Surgery, First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Kai You
- Department of Anesthesiology, First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Yuanping Xiong
- Department of Otorhinolaryngology-Head and Neck Surgery, First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.
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82
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Kwon S, Lee M, Crowley G, Schwartz T, Zeig-Owens R, Prezant DJ, Liu M, Nolan A. Dynamic Metabolic Risk Profiling of World Trade Center Lung Disease: A Longitudinal Cohort Study. Am J Respir Crit Care Med 2021; 204:1035-1047. [PMID: 34473012 DOI: 10.1164/rccm.202006-2617oc] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Rationale: Metabolic syndrome (MetSyn) increases the risk of World Trade Center (WTC) lung injury (LI). However, the temporal relationship of MetSyn, exposure intensity, and lung dysfunction is not well understood. Objective: To model the association of longitudinal MetSyn characteristics with WTC lung disease to define modifiable risk. Methods: Firefighters, for whom consent was obtained (N = 5,738), were active duty on September 11, 2001 (9/11). WTC-LI (n = 1,475; FEV1% predicted <lower limit of normal [LLN]) and non-WTC-LI (n = 4,263; FEV1% predicted ⩾LLN at all exams) was the primary outcome, and FVC% predicted <LLN and FEV1/FVC <0.70 were secondary outcomes. We assessed 1) the effect of concurrent MetSyn on longitudinal lung function by linear mixed models, 2) the temporal effect of MetSyn and exposure by Weibull proportional hazards, 3) the effects of MetSyn's rate of change by two-stage models, and 4) the nonlinear joint effect of longitudinal MetSyn components by a partially linear single-index model (PLSI). Measurements and Main Results: WTC-LI cases were more often ever-smokers, arrived in the morning (9/11), and had MetSyn. Body mass index ⩾30 kg/m2 and high-density lipoprotein <40 mg/dl were most contributory to concurrent loss of FEV1% predicted and FVC% predicted while conserving FEV1/FVC. Body mass index ⩾30 kg/m2 and dyslipidemia significantly predicted WTC-LI, FVC% predicted <LLN in a Weibull proportional hazards model. Dynamic risk assessment of WTC-LI on the basis of MetSyn and exposure showed how reduction of MetSyn factors further reduces WTC-LI likelihood in susceptible populations. PLSI demonstrates that MetSyn has a nonlinear relationship with WTC lung disease, and increases in cumulative MetSyn risk factors exponentially increase WTC-LI risk. An interactive metabolic-risk modeling application was developed to simplify PLSI interpretation. Conclusions: MetSyn and WTC exposure contribute to the development of lung disease. Dynamic risk assessment may be used to encourage treatment of MetSyn in susceptible populations. Future studies will focus on dietary intervention as a disease modifier.
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Affiliation(s)
- Sophia Kwon
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine
| | - Myeonggyun Lee
- Division of Biostatistics, Department of Population Health, and
| | - George Crowley
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine
| | - Theresa Schwartz
- Bureau of Health Services and Office of Medical Affairs, Fire Department of New York, Brooklyn, New York; and
| | - Rachel Zeig-Owens
- Bureau of Health Services and Office of Medical Affairs, Fire Department of New York, Brooklyn, New York; and.,Department of Epidemiology and Population Health and
| | - David J Prezant
- Bureau of Health Services and Office of Medical Affairs, Fire Department of New York, Brooklyn, New York; and.,Pulmonary Medicine Division, Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York
| | - Mengling Liu
- Division of Biostatistics, Department of Population Health, and.,Department of Environmental Medicine, New York University School of Medicine, New York, New York
| | - Anna Nolan
- Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine.,Department of Environmental Medicine, New York University School of Medicine, New York, New York.,Bureau of Health Services and Office of Medical Affairs, Fire Department of New York, Brooklyn, New York; and
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83
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Pediatric Obesity-Related Asthma: The Role of Nutrition and Nutrients in Prevention and Treatment. Nutrients 2021; 13:nu13113708. [PMID: 34835964 PMCID: PMC8620690 DOI: 10.3390/nu13113708] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 09/30/2021] [Accepted: 10/20/2021] [Indexed: 12/31/2022] Open
Abstract
Childhood obesity rates have dramatically risen in numerous countries worldwide. Obesity is likely a factor in increased asthma risk, which is already one of the most widespread chronic respiratory pathologies. The pathogenic mechanism of asthma risk has still not yet been fully elucidated. Moreover, the role of obesity-related inflammation and pulmonary overreaction to environmental triggers, which ultimately result in asthma-like symptoms, and the importance of dietary characteristics is well recognized. Diet is an important adjustable element in the asthma development. Food-specific composition of the diet, in particular fat, sugar, and low-quality nutrients, is likely to promote the chronic inflammatory state seen in asthmatic patients with obesity. An unbalanced diet or supplementation as a way to control asthma more efficiently has been described. A personalized dietary intervention may improve respiratory symptoms and signs and therapeutic response. In this narrative review, we presented and discussed more recent literature on asthma associated with obesity among children, focusing on the risk of asthma among children with obesity, asthma as a result of obesity focusing on the role of adipose tissue as a mediator of systemic and local airway inflammation implicated in asthma regulation, and the impact of nutrition and nutrients in the development and treatment of asthma. Appropriate early nutritional intervention could possibly be critical in preventing and managing asthma associated with obesity among children.
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Zhu Z, Li J, Si J, Ma B, Shi H, Lv J, Cao W, Guo Y, Millwood IY, Walters RG, Lin K, Yang L, Chen Y, Du H, Yu B, Hasegawa K, Camargo CA, Moffatt MF, Cookson WOC, Chen J, Chen Z, Li L, Yu C, Liang L. A large-scale genome-wide association analysis of lung function in the Chinese population identifies novel loci and highlights shared genetic aetiology with obesity. Eur Respir J 2021; 58:2100199. [PMID: 33766948 PMCID: PMC8513692 DOI: 10.1183/13993003.00199-2021] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Accepted: 03/02/2021] [Indexed: 01/25/2023]
Abstract
BACKGROUND Lung function is a heritable complex phenotype with obesity being one of its important risk factors. However, knowledge of their shared genetic basis is limited. Most genome-wide association studies (GWASs) for lung function have been based on European populations, limiting the generalisability across populations. Large-scale lung function GWASs in other populations are lacking. METHODS We included 100 285 subjects from the China Kadoorie Biobank (CKB). To identify novel loci for lung function, single-trait GWAS analyses were performed on forced expiratory volume in 1 s (FEV1), forced vital capacity (FVC) and FEV1/FVC in the CKB. We then performed genome-wide cross-trait analysis between lung function and obesity traits (body mass index (BMI), BMI-adjusted waist-to-hip ratio and BMI-adjusted waist circumference) to investigate the shared genetic effects in the CKB. Finally, polygenic risk scores (PRSs) of lung function were developed in the CKB and their interaction with BMI's association on lung function were examined. We also conducted cross-trait analysis in parallel with the CKB using up to 457 756 subjects from the UK Biobank (UKB) for replication and investigation of ancestry-specific effects. RESULTS We identified nine genome-wide significant novel loci for FEV1, six for FVC and three for FEV1/FVC in the CKB. FEV1 and FVC showed significant negative genetic correlation with obesity traits in both the CKB and UKB. Genetic loci shared between lung function and obesity traits highlighted important biological pathways, including cell proliferation, embryo, skeletal and tissue development, and regulation of gene expression. Mendelian randomisation analysis suggested significant negative causal effects of BMI on FEV1 and on FVC in both the CKB and UKB. Lung function PRSs significantly modified the effect of change in BMI on change in lung function during an average follow-up of 8 years. CONCLUSION This large-scale GWAS of lung function identified novel loci and shared genetic aetiology between lung function and obesity. Change in BMI might affect change in lung function differently according to a subject's polygenic background. These findings may open new avenues for the development of molecular-targeted therapies for obesity and lung function improvement.
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Affiliation(s)
- Zhaozhong Zhu
- Program in Genetic Epidemiology and Statistical Genetics, Dept of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Dept of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- These four authors contributed equally to this article
| | - Jiachen Li
- Dept of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
- These four authors contributed equally to this article
| | - Jiahui Si
- Program in Genetic Epidemiology and Statistical Genetics, Dept of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Dept of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
- These four authors contributed equally to this article
| | - Baoshan Ma
- College of Information Science and Technology, Dalian Maritime University, Dalian, China
- These four authors contributed equally to this article
| | - Huwenbo Shi
- Program in Genetic Epidemiology and Statistical Genetics, Dept of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Jun Lv
- Dept of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
- Key Laboratory of Molecular Cardiovascular Sciences (Peking University), Ministry of Education, Beijing, China
- Peking University Institute of Environmental Medicine, Beijing, China
| | - Weihua Cao
- Dept of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Yu Guo
- Chinese Academy of Medical Sciences, Beijing, China
| | - Iona Y Millwood
- Medical Research Council Population Health Research Unit at the University of Oxford, Oxford, UK
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Dept of Population Health, University of Oxford, Oxford, UK
| | - Robin G Walters
- Medical Research Council Population Health Research Unit at the University of Oxford, Oxford, UK
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Dept of Population Health, University of Oxford, Oxford, UK
| | - Kuang Lin
- Medical Research Council Population Health Research Unit at the University of Oxford, Oxford, UK
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Dept of Population Health, University of Oxford, Oxford, UK
| | - Ling Yang
- Medical Research Council Population Health Research Unit at the University of Oxford, Oxford, UK
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Dept of Population Health, University of Oxford, Oxford, UK
| | - Yiping Chen
- Medical Research Council Population Health Research Unit at the University of Oxford, Oxford, UK
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Dept of Population Health, University of Oxford, Oxford, UK
| | - Huaidong Du
- Medical Research Council Population Health Research Unit at the University of Oxford, Oxford, UK
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Dept of Population Health, University of Oxford, Oxford, UK
| | - Bo Yu
- NCDs Prevention and Control Dept, Nangang CDC, Harbin, China
| | - Kohei Hasegawa
- Dept of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Carlos A Camargo
- Program in Genetic Epidemiology and Statistical Genetics, Dept of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Dept of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Miriam F Moffatt
- Section of Genomic Medicine, National Heart and Lung Institute, Imperial College London, London, UK
| | - William O C Cookson
- Section of Genomic Medicine, National Heart and Lung Institute, Imperial College London, London, UK
| | - Junshi Chen
- China National Center for Food Safety Risk Assessment, Beijing, China
| | - Zhengming Chen
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Dept of Population Health, University of Oxford, Oxford, UK
| | - Liming Li
- Dept of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Canqing Yu
- Dept of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
- These two authors contributed equally to this article as lead authors and supervised the work
| | - Liming Liang
- Program in Genetic Epidemiology and Statistical Genetics, Dept of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Dept of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- These two authors contributed equally to this article as lead authors and supervised the work
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85
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Stockley JA, Alhuthail EA, Coney AM, Parekh D, Geberhiwot T, Gautum N, Madathil SC, Cooper BG. Lung function and breathing patterns in hospitalised COVID-19 survivors: a review of post-COVID-19 Clinics. Respir Res 2021; 22:255. [PMID: 34579722 PMCID: PMC8474952 DOI: 10.1186/s12931-021-01834-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Accepted: 08/29/2021] [Indexed: 12/15/2022] Open
Abstract
INTRODUCTION There is relatively little published on the effects of COVID-19 on respiratory physiology, particularly breathing patterns. We sought to determine if there were lasting detrimental effect following hospital discharge and if these related to the severity of COVID-19. METHODS We reviewed lung function and breathing patterns in COVID-19 survivors > 3 months after discharge, comparing patients who had been admitted to the intensive therapy unit (ITU) (n = 47) to those who just received ward treatments (n = 45). Lung function included spirometry and gas transfer and breathing patterns were measured with structured light plethysmography. Continuous data were compared with an independent t-test or Mann Whitney-U test (depending on distribution) and nominal data were compared using a Fisher's exact test (for 2 categories in 2 groups) or a chi-squared test (for > 2 categories in 2 groups). A p-value of < 0.05 was taken to be statistically significant. RESULTS We found evidence of pulmonary restriction (reduced vital capacity and/or alveolar volume) in 65.4% of all patients. 36.1% of all patients has a reduced transfer factor (TLCO) but the majority of these (78.1%) had a preserved/increased transfer coefficient (KCO), suggesting an extrapulmonary cause. There were no major differences between ITU and ward lung function, although KCO alone was higher in the ITU patients (p = 0.03). This could be explained partly by obesity, respiratory muscle fatigue, localised microvascular changes, or haemosiderosis from lung damage. Abnormal breathing patterns were observed in 18.8% of subjects, although no consistent pattern of breathing pattern abnormalities was evident. CONCLUSIONS An "extrapulmonary restrictive" like pattern appears to be a common phenomenon in previously admitted COVID-19 survivors. Whilst the cause of this is not clear, the effects seem to be similar on patients whether or not they received mechanical ventilation or had ward based respiratory support/supplemental oxygen.
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Affiliation(s)
- James A Stockley
- Lung Function and Sleep, Outpatient Department Area 3, University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital, Mindelsohn Way, Edgbaston, Birmingham, B15 2GW, UK.
| | - Eyas A Alhuthail
- School of Biomedical Sciences, Institute of Clinical Sciences, University of Birmingham, Birmingham, UK
- College of Sciences and Health Professions, Basic Sciences Department, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Andrew M Coney
- School of Biomedical Sciences, Institute of Clinical Sciences, University of Birmingham, Birmingham, UK
| | - Dhruv Parekh
- Critical Care, Queen Elizabeth Hospital, University Hospitals Birmingham, Birmingham, UK
- Birmingham Acute Care Research Group, Institute of Inflammation and Ageing, UoB, Birmingham, UK
| | - Tarekegn Geberhiwot
- Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK
| | - Nandan Gautum
- Critical Care, Queen Elizabeth Hospital, University Hospitals Birmingham, Birmingham, UK
| | - Shyam C Madathil
- Respiratory Medicine, Queen Elizabeth Hospital, University Hospitals Birmingham, Birmingham, UK
| | - Brendan G Cooper
- Lung Function and Sleep, Outpatient Department Area 3, University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital, Mindelsohn Way, Edgbaston, Birmingham, B15 2GW, UK
- School of Biomedical Sciences, Institute of Clinical Sciences, University of Birmingham, Birmingham, UK
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86
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Shang L, Wang L, Zhou F, Li J, Liu Y, Yang S. Long-term effects of obesity on COVID-19 patients discharged from hospital. IMMUNITY INFLAMMATION AND DISEASE 2021; 9:1678-1685. [PMID: 34499804 PMCID: PMC8589408 DOI: 10.1002/iid3.522] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 08/17/2021] [Accepted: 08/19/2021] [Indexed: 01/03/2023]
Abstract
Introduction Obesity has been reported as a risk factor for COVID‐19 prognosis. However, the long‐term effects of obesity on patients discharged from the hospital are unclear, and the present study aims to address this issue. Methods A cohort study was conducted using data from patients diagnosed with COVID‐19 who were discharged from Wuhan Union Hospital between February 20, 2020, and March 20, 2020. The 118 patients with COVID‐19 were divided into the non‐obesity group and the obesity group according to their body mass index (BMI). All the patients were invited to fill out a series of scales to assess cardiopulmonary function. Data on population baseline characteristics, clinical manifestations, laboratory examinations, chest computed tomography (CT), and lung function were collected and analyzed. Results The clinical manifestations and pathological changes on CT images of obese patients were more serious after discharge than those of non‐obese patients. In addition, we found significant abnormalities in metabolic indicators such as blood lipids, uric acid, and liver function in obese patients. Most importantly, the antibody titer of COVID‐19 obese patients was inversely correlated with BMI. Conclusion In the long term, obesity affects clinical manifestations, immune function and endocrine metabolism in patients discharged after recovering from COVID‐19.
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Affiliation(s)
- Luorui Shang
- Department of Integrated Traditional Chinese and Western Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Li Wang
- Department of Emergency Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Fangyuan Zhou
- Department of Integrated Traditional Chinese and Western Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jinxiao Li
- Department of Integrated Traditional Chinese and Western Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yuhan Liu
- Department of Integrated Traditional Chinese and Western Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shenglan Yang
- Department of Integrated Traditional Chinese and Western Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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87
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Lopes ACR, Zavan B, Corrêa YJC, Vieira TM, Severs LJ, Oliveira LM, Soncini R. Impact of obesity and ovariectomy on respiratory function in female mice. Respir Physiol Neurobiol 2021; 294:103775. [PMID: 34416380 DOI: 10.1016/j.resp.2021.103775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 08/03/2021] [Accepted: 08/09/2021] [Indexed: 10/20/2022]
Abstract
Obesity and the corresponding variations in female sex hormones are associated with severe lung disease. We determined the potential effects of obesity and sex hormones in female mice by investigating changes in lung structure and respiratory function in an obesity model induced by postnatal overnutrition. Obese female mice exhibited pronounced weight gain, abdominal fat accumulation and collagen type I deposition in the airways. However, neither elastic tissue nor estrogen receptors-α/-β were affected in obese female mice after ovariectomy or sham-operated mice. Bronchoconstriction in response to methacholine challenge in obese sham-operated mice was higher than in the obese group after ovariectomy. Our results suggest that the coexistence of obesity and ovariectomy impacted on respiratory system and airway resistance (attenuates bronchoconstriction after methacholine), on collagen I deposition and on airway estrogen β-receptors of mice.
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Affiliation(s)
- Ana C R Lopes
- Department of Physiology, Institute of Biomedical Science, Federal University of Alfenas, 37130-000, Alfenas, MG, Brazil
| | - Bruno Zavan
- Integrative Animal Biology Laboratory, Institute of Biomedical Science, Federal University of Alfenas, 37130-000, Alfenas, MG, Brazil
| | - Yuri J C Corrêa
- Department of Physiology, Institute of Biomedical Science, Federal University of Alfenas, 37130-000, Alfenas, MG, Brazil
| | - Tânia M Vieira
- Department of Physiology, Institute of Biomedical Science, Federal University of Alfenas, 37130-000, Alfenas, MG, Brazil
| | - Liza J Severs
- Center for Integrative Brain Research, Seattle Children's Research Institute, 1900 9th Avenue, JMB10, Seattle, WA, 98101, USA
| | - Luiz M Oliveira
- Center for Integrative Brain Research, Seattle Children's Research Institute, 1900 9th Avenue, JMB10, Seattle, WA, 98101, USA
| | - Roseli Soncini
- Department of Physiology, Institute of Biomedical Science, Federal University of Alfenas, 37130-000, Alfenas, MG, Brazil.
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88
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Zeng X, Liu D, An Z, Li H, Song J, Wu W. Obesity parameters in relation to lung function levels in a large Chinese rural adult population. Epidemiol Health 2021; 43:e2021047. [PMID: 34353001 PMCID: PMC8602009 DOI: 10.4178/epih.e2021047] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 08/03/2021] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES The association between obesity parameters and lung function indicators in the general Chinese rural adult population remains unclear. METHODS In total, 8,284 Chinese adults aged 20 years to 80 years old from Xinxiang were recruited. Obesity-related parameters, including body mass index (BMI), waist circumference (WC), hip circumference (HC), waist-to-hip ratio (WHR), waistto-height ratio (WHtR), body fat percentage (BFP), basal metabolism, and visceral fat index, and lung function parameters such as forced vital capacity and forced expiratory volume in first second were measured. RESULTS The total prevalence of obesity defined by BMI, WC, WHR, WHtR, and BFP was 23.2%, 58.2%, 66.7%, 69.2%, and 56.5%, respectively. Spearman correlation analyses showed significant correlations between all obesity-related parameters and lung function. Linear regression analyses further demonstrated that BMI, WHtR, BFP, and general obesity defined using those indicators were negatively associated with lung function, while WC, WHR, and central obesity defined accordingly were positively associated with lung function. The relationship between general obesity and lung function was more evident in women than in men, while the link between central obesity and lung function was more obvious in men than in women. CONCLUSIONS Obesity is closely related to lung function in the general Chinese adult population. Weight control and loss are important strategies to improve lung function and respiratory health.
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Affiliation(s)
- Xiang Zeng
- School of Public Health, Xinxiang Medical University, 601 Jinsui Road, Xinxiang 453003, Henan, China.,Laboratory of Environmental Medicine and Developmental Toxicology, Guangdong Key Laboratory of Environmental Pollution and Health, School of Environment, Jinan University, Guangzhou 511443, Guangdong, China
| | - Dongling Liu
- Henan Key Laboratory of Medical Tissue Regeneration, Xinxiang Medical University, 601 Jinsui Road, Xinxiang 453003, China
| | - Zhen An
- School of Public Health, Xinxiang Medical University, 601 Jinsui Road, Xinxiang 453003, Henan, China
| | - Huijun Li
- School of Public Health, Xinxiang Medical University, 601 Jinsui Road, Xinxiang 453003, Henan, China
| | - Jie Song
- School of Public Health, Xinxiang Medical University, 601 Jinsui Road, Xinxiang 453003, Henan, China
| | - Weidong Wu
- School of Public Health, Xinxiang Medical University, 601 Jinsui Road, Xinxiang 453003, Henan, China
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Lorenzetti Branco JH, Lorenzetti Branco RL, Ponte Souza Filho VP, da Silveira B, Monteiro Pause KT, Dos Santos Artismo R, Matte DL. Can optoelectronic plethysmography be used to evaluate the thoracoabdominal kinematics of people with morbidly obesity? A systematic review. Heart Lung 2021; 50:838-844. [PMID: 34325181 DOI: 10.1016/j.hrtlng.2021.07.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 07/06/2021] [Accepted: 07/08/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Optoelectronic Plethysmography (OEP) is an effective method for evaluating thoracoabdominal kinematics. However, little is known about the viability and use the OEP in people with obesity. OBJECTIVE Summarize information on the use and feasibility of OEP in the assessment of thoracoabdominal kinematics in people with obesity. METHODS Studies were identified through PubMed, EMBASE, Science Direct, Web of Science and Scopus databases in the February 2021. RESULTS Six studies met the inclusion criteria. The studies used the OEP to assess abdominal and thoracic mobility in obese people of different BMI, using the default setting. No study reported the impossibility of using OEP in people with obesity. CONCLUSION Has been shown that it is possible to use the OEP in people with obesity with a BMI of up to 50 kg/m2. More studies are needed to demonstrate the feasibility of the method in people with a BMI greater than this value.
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Affiliation(s)
- Joaquim Henrique Lorenzetti Branco
- Núcleo de Ensino Pesquisa e Extensão em Fisioterapia no Pré e no Pós-Operatório de Cirurgias de Grande Porte da UDESC (PREPARA/UDESC), Brazil; Programa de Pós-Graduação em Fisioterapia da UDESC (PPGFT/UDESC), Brazil; Programa de Pós Graduação em Ciência do Movimento Humano da UDESC (PPGCMH/UDESC), Brazil
| | - Ruy Luiz Lorenzetti Branco
- Núcleo de Ensino Pesquisa e Extensão em Fisioterapia no Pré e no Pós-Operatório de Cirurgias de Grande Porte da UDESC (PREPARA/UDESC), Brazil; Programa de Pós Graduação em Ciência do Movimento Humano da UDESC (PPGCMH/UDESC), Brazil
| | - Vicente Paulo Ponte Souza Filho
- Núcleo de Ensino Pesquisa e Extensão em Fisioterapia no Pré e no Pós-Operatório de Cirurgias de Grande Porte da UDESC (PREPARA/UDESC), Brazil; Programa de Pós-Graduação em Fisioterapia da UDESC (PPGFT/UDESC), Brazil
| | - Bruna da Silveira
- Núcleo de Ensino Pesquisa e Extensão em Fisioterapia no Pré e no Pós-Operatório de Cirurgias de Grande Porte da UDESC (PREPARA/UDESC), Brazil; Programa de Pós-Graduação em Fisioterapia da UDESC (PPGFT/UDESC), Brazil
| | - Kethlyn Tamara Monteiro Pause
- Núcleo de Ensino Pesquisa e Extensão em Fisioterapia no Pré e no Pós-Operatório de Cirurgias de Grande Porte da UDESC (PREPARA/UDESC), Brazil; Programa de Pós Graduação em Ciência do Movimento Humano da UDESC (PPGCMH/UDESC), Brazil
| | - Regiana Dos Santos Artismo
- Núcleo de Ensino Pesquisa e Extensão em Fisioterapia no Pré e no Pós-Operatório de Cirurgias de Grande Porte da UDESC (PREPARA/UDESC), Brazil; Programa de Pós-Graduação em Fisioterapia da UDESC (PPGFT/UDESC), Brazil; Programa de Pós Graduação em Ciência do Movimento Humano da UDESC (PPGCMH/UDESC), Brazil
| | - Darlan Laurício Matte
- Núcleo de Ensino Pesquisa e Extensão em Fisioterapia no Pré e no Pós-Operatório de Cirurgias de Grande Porte da UDESC (PREPARA/UDESC), Brazil; Programa de Pós-Graduação em Fisioterapia da UDESC (PPGFT/UDESC), Brazil; Programa de Pós Graduação em Ciência do Movimento Humano da UDESC (PPGCMH/UDESC), Brazil; Universidade do Estado de Santa Catarina (UDESC) - Florianópolis (SC), Paschoal Simone, 358, Coqueiros, Florianópolis 88080-350, Brazil.
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90
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Galinski M, Chouteau M, Lunghi G, Vinurel M, Blazy B, Cher M, Alouane B, Bento H, Germain JL, Barrat C, Catineau J, Gil-Jardiné C, Baillard C. Multivariate Analysis of the Failure Risk of First Tracheal Intubation Attempt in a Population of Patients Scheduled for Bariatric Surgery. Obes Surg 2021; 31:4392-4398. [PMID: 34297257 DOI: 10.1007/s11695-021-05586-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 07/03/2021] [Accepted: 07/09/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Airway management during the administration of anesthesia to patients undergoing bariatric surgery is challenging. The goal is to avoid multiple intubation attempts because the risk of complications increases with the number of attempts. The objective of this study was to determine the failed first intubation attempt rate, as well as variables associated with this failure, in patients undergoing bariatric surgery. METHODS We enrolled patients scheduled for bariatric surgery in this prospective, observational, single-center study. We determined predictive criteria for difficult intubation at the preoperative anesthesia consultation. All patients were evaluated for obstructive sleep apnea by polygraphy. The primary study endpoint was a failed first intubation attempt. RESULTS We enrolled 519 patients between December 2012 and January 2015. The cohort consisted of 425 women (82%), with a median (interquartile range [IQR]) age of 39 (30-50) years and a body mass index of 42 (39-46) kg/m2. The first intubation attempt failed in 60 patients, with an incidence rate of 11.5% (95% confidence interval [CI], 8.8-14.2%). We included nine variables in the final multivariate model. Two variables were associated with failed first intubation attempt: male sex (odds ratio [OR] [95% CI], 6.9% [2.5-18.7%]) and Mallampati score 3-4 (OR [95% CI], 2.2% [1.0-4.7%]). CONCLUSIONS In this morbidly obese population, the first intubation attempt failed in 11.5% of patients, and the risk factors for failure were male sex and a high Mallampati score.
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Affiliation(s)
- Michel Galinski
- Emergency Department - SAMU, Pellegrin Hospital, Bordeaux University Hospital, CHU de Bordeaux, F-33076, Bordeaux Cedex, France.
- Inserm, ISPED, Bordeaux Population Health Research Center INSERM U1219-"Injury Epidemiology Transport Occupation" Team, Bordeaux University, Bordeaux, France.
| | - Marine Chouteau
- Department of Anesthesiology and Critical Care Medicine, Cochin University Hospital, Paris Descartes University, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Gessica Lunghi
- Department of Anesthesiology, Jean Verdier University Hospital, Paris 13 University, Assistance Publique-Hôpitaux de Paris, Bondy, Paris, France
| | - Marianne Vinurel
- Department of Anesthesiology, Jean Verdier University Hospital, Paris 13 University, Assistance Publique-Hôpitaux de Paris, Bondy, Paris, France
| | - Béatrice Blazy
- Department of Anesthesiology, Jean Verdier University Hospital, Paris 13 University, Assistance Publique-Hôpitaux de Paris, Bondy, Paris, France
| | - Mouni Cher
- Department of Anesthesiology, Jean Verdier University Hospital, Paris 13 University, Assistance Publique-Hôpitaux de Paris, Bondy, Paris, France
| | - Bruno Alouane
- Department of Anesthesiology, Jean Verdier University Hospital, Paris 13 University, Assistance Publique-Hôpitaux de Paris, Bondy, Paris, France
| | - Hélène Bento
- Department of Anesthesiology, Jean Verdier University Hospital, Paris 13 University, Assistance Publique-Hôpitaux de Paris, Bondy, Paris, France
| | - Jean-Louis Germain
- Department of Anesthesiology, Jean Verdier University Hospital, Paris 13 University, Assistance Publique-Hôpitaux de Paris, Bondy, Paris, France
| | - Christophe Barrat
- Department of Digestive and Metabolic Surgery, Jean Verdier University Hospital, Paris 13 University, Assistance Publique-Hôpitaux de Paris, Bondy, Paris, France
| | - Jean Catineau
- Department of Anesthesiology and Critical Care Medicine, Princesse Grace Hospital, 98010, Monaco, Monaco
| | - Cédric Gil-Jardiné
- Emergency Department - SAMU, Pellegrin Hospital, Bordeaux University Hospital, CHU de Bordeaux, F-33076, Bordeaux Cedex, France
| | - Christophe Baillard
- Department of Anesthesiology and Critical Care Medicine, Cochin University Hospital, Paris Descartes University, Assistance Publique-Hôpitaux de Paris, Paris, France
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91
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Intraoperative Positive End-expiratory Pressure for Obese Patients: A Step Forward, a Long Road Still Ahead. Anesthesiology 2021; 134:838-840. [PMID: 33909874 DOI: 10.1097/aln.0000000000003806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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92
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Liang XL, Gao Y, Guan WJ, Du J, Chen L, Han W, Liu JM, Lu Y, Peng Y, Zhao BR, Wang T, Zheng JP. Reference values of respiratory impedance with impulse oscillometry in healthy Chinese adults. J Thorac Dis 2021; 13:3680-3691. [PMID: 34277060 PMCID: PMC8264702 DOI: 10.21037/jtd-20-3376] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Accepted: 05/22/2021] [Indexed: 02/04/2023]
Abstract
Background Impulse oscillometry (IO) is a non-invasive pulmonary function test for measuring respiratory impedance. Available reference equations of IO indices for adults are limited. The aim of this study was to develop reference equations of IO indices for Chinese adults. Methods In a multicentral, cross-sessional study of IO in Chinese adults, IO data from healthy subjects were collected from 19 general hospitals across China between 2016 and 2018. Oscillometry measurements were conducted in accordance with recommendations of the European Respiratory Society (ERS). Multiple linear regression was performed to develop sex-specific reference equations of IO indices. Results IO measurements were performed in 1,318 subjects, of which 567 subjects were defined as healthy individuals with acceptable IO data and were included in the final analysis. Reference equations and limits of normal [lower limit of normal (LLN)/upper limit of normal (ULN)] of IO indices were developed separately for males and females. Height but not age was shown to be the most influential contributor to IO indices. The reference equations currently used in lung function laboratories predicted higher R5 and X5. Normal ranges of R5 and X5 recommended by the equipment manufacturer were clearly different from the ULN/LLN derived from the reference equations. Conclusions Reference equations of IO indices for Chinese adults from a wide region were provided in this study. It is necessary to update new IO reference equations and adopt ULN/LLN as normal ranges of IO indices. Trial Registration This study was registered at www.clinicaltrials.gov as part of a larger study NCT03467880.
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Affiliation(s)
- Xiao-Lin Liang
- National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Yi Gao
- National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Wei-Jie Guan
- National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Jing Du
- Department of Respiratory and Critical Care, West China Hospital, Sichuan University, Chengdu, China
| | - Li Chen
- Department of Respiratory Medicine, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Wen Han
- Department of Respiratory and Critical Care Medicine, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, China
| | - Jin-Ming Liu
- Department of Pulmonary Function Test, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Yong Lu
- Department of Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine and Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China
| | - Yi Peng
- Department of Respiratory Medicine, Union Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Bing-Rong Zhao
- Department of Respiratory Medicine, National Key Clinical Specialty, Branch of National Clinical Research Center for Respiratory Disease, Xiangya Hospital, Central South University, Changsha, China
| | - Tao Wang
- Department of Respiratory and Critical Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Jin-Ping Zheng
- National Clinical Research Center for Respiratory Disease, State Key Laboratory of Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
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93
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Zhou C, Li S, Liu J, Chu Q, Miao L, Cai L, Cai X, Chen Y, Cui F, Dong Y, Dong W, Fang W, He Y, Li W, Li M, Liang W, Lin G, Lin J, Lin X, Liu H, Liu M, Mu X, Hu Y, Hu J, Jin Y, Li Z, Qin Y, Ren S, Sun G, Shen Y, Su C, Tang K, Wu L, Wang M, Wang H, Wang K, Wang Y, Wang P, Wang H, Wang Q, Wang Z, Xie X, Xie Z, Xu X, Xu F, Yang M, Yang B, Yi X, Ye X, Ye F, Yu Z, Yue D, Zhang B, Zhang J, Zhang J, Zhang X, Zhang W, Zhao W, Zhu B, Zhu Z, Zhong W, Bai C, Chen L, Han B, Hu C, Lu S, Li W, Song Y, Wang J, Zhou C, Zhou J, Zhou Y, Saito Y, Ichiki Y, Igai H, Watanabe S, Bravaccini S, Fiorelli A, Petrella F, Nakada T, Solli P, Tsoukalas N, Kataoka Y, Goto T, Berardi R, He J, Zhong N. International consensus on severe lung cancer-the first edition. Transl Lung Cancer Res 2021; 10:2633-2666. [PMID: 34295668 PMCID: PMC8264326 DOI: 10.21037/tlcr-21-467] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 06/17/2021] [Indexed: 02/05/2023]
Affiliation(s)
- Chengzhi Zhou
- State Key Laboratory of Respiratory Disease, National Clinical Research Centre for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, China
| | - Shiyue Li
- State Key Laboratory of Respiratory Disease, National Clinical Research Centre for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, China
| | - Jun Liu
- State Key Laboratory of Respiratory Disease, National Clinical Research Centre for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, China
| | - Qian Chu
- Department of Oncology, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China
| | - Liyun Miao
- Department of Respiratory and Critical Care Medicine, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - Linbo Cai
- Department of Oncology, Guangdong Sanjiu Brain Hospital, Guangzhou, China
| | - Xiuyu Cai
- Department of General Internal Medicine, State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Yu Chen
- State Key Laboratory of Respiratory Disease, National Clinical Research Centre for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, China
| | - Fei Cui
- State Key Laboratory of Respiratory Disease, National Clinical Research Centre for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, China
| | - Yuchao Dong
- Department of Pulmonary and Critical Care Medicine, Shanghai Changhai Hospital, Second Military Medical University, Shanghai, China
| | - Wen Dong
- Department of Oncology, Hainan Cancer Hospital, Haikou, China
| | - Wenfeng Fang
- Department of Medical Oncology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Yong He
- Department of Respiratory Medicine, Daping Hospital, Army Medical University, Chongqing, China
| | - Weifeng Li
- Department of Respiratory Medicine, General Hospital of Guangzhou Military Command of PLA, Guangzhou, China
| | - Min Li
- Department of Respiratory Medicine, Xiangya Cancer Center, Xiangya Hospital, Central South University, Changsha, China
| | - Wenhua Liang
- State Key Laboratory of Respiratory Disease, National Clinical Research Centre for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, China
| | - Gen Lin
- Department of Thoracic Oncology, Fujian Cancer Hospital and Fujian Medical University Cancer Hospital, Fuzhou, China
| | - Jie Lin
- Department of Medical Oncology, the Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Xinqing Lin
- State Key Laboratory of Respiratory Disease, National Clinical Research Centre for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, China
| | - Hongbing Liu
- Department of Respiratory Medicine, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China
| | - Ming Liu
- State Key Laboratory of Respiratory Disease, National Clinical Research Centre for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, China
| | - Xinlin Mu
- Department of Respiratory and Critical Care Medicine, Peking University People's Hospital, Beijing, China
| | - Yi Hu
- Department of Medical Oncology, Chinese People's Liberation Army (PLA) General Hospital, Beijing, China
| | - Jie Hu
- Department of Respiratory Medicine, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Yang Jin
- Department of Respiratory and Critical Care Medicine, NHC Key Laboratory of Pulmonary Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ziming Li
- Shanghai Lung Cancer Center, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Yinyin Qin
- State Key Laboratory of Respiratory Disease, National Clinical Research Centre for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, China
| | - Shengxiang Ren
- Department of Medical Oncology, Shanghai Pulmonary Hospital, Thoracic Cancer Institute, Tongji University School of Medicine, Shanghai, China
| | - Gengyun Sun
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Anhui Medical University, Hefei, China
| | - Yihong Shen
- Department of Respiratory Disease, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Chunxia Su
- Department of Medical Oncology, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Kejing Tang
- Division of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Sun Yat-sen University, Institute of Pulmonary Diseases, Sun Yat-sen University, Guangzhou, China
| | - Lin Wu
- Thoracic Medicine Department II, Hunan Cancer Hospital, Changsha, China
| | - Mengzhao Wang
- Department of Respiratory and Critical Care Medicine, Peking Union Medical College Hospital, Beijing, China
| | - Huijuan Wang
- Department of Medical Oncology, The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, China
| | - Kai Wang
- Department of Respiratory Medicine, Fourth Affiliated Hospital Zhejiang University School of Medicine, Hangzhou, China
| | - Yuehong Wang
- Department of Respiratory Disease, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China
| | - Ping Wang
- Department of Respiratory and Critical Care Medicine, the Eighth Medical Center of PLA General Hospital, Beijing, China
| | - Hongmei Wang
- Department of Respiratory and Critical Care Medicine, The Affiliated Hospital of Qingdao University, Qingdao, China
| | - Qi Wang
- Department of Respiratory Medicine, The Second Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Zhijie Wang
- National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiaohong Xie
- State Key Laboratory of Respiratory Disease, National Clinical Research Centre for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, China
| | - Zhanhong Xie
- State Key Laboratory of Respiratory Disease, National Clinical Research Centre for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, China
| | - Xin Xu
- State Key Laboratory of Respiratory Disease, National Clinical Research Centre for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, China
| | - Fei Xu
- Department of Respiratory Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Meng Yang
- Department of Respiratory Disease, China-Japan Friendship Hospital, Beijing, China
| | - Boyan Yang
- Department of Comprehensive Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen, China.,Department of Comprehensive Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Xiangjun Yi
- Department of Medical Oncology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Xiaoqun Ye
- Department of Respiratory Diseases, The Second Affiliated Hospital of Nanchang University, Nanchang, China
| | - Feng Ye
- Department of Medical Oncology, The first affiliated hospital of Xiamen University, Xiamen, China
| | - Zongyang Yu
- Department of Pulmonary and Critical Care Medicine, The th Hospital of Joint Logistic Support Force, PLA, Fuzhou, China
| | - Dongsheng Yue
- Department of Lung Cancer, Tianjin Lung Cancer Center, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin's Clinical Research Center for Cancer, Tianjin, China
| | - Bicheng Zhang
- Cancer Center, Renmin Hospital of Wuhan University, Wuhan, China
| | - Jian Zhang
- Department of Pulmonary and Critical Care Medicine, Xijing Hospital, Fourth Military Medical University, Xi'an, China
| | - Jianqing Zhang
- Second Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Xiaoju Zhang
- Department of Respiratory and Critical Care Medicine, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, China
| | - Wei Zhang
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Wei Zhao
- Department of Pulmonary and Critical Care Medicine, The General Hospital of People's Liberation Army, Beijing, China
| | - Bo Zhu
- Institute of Cancer, Xinqiao Hospital, Army Medical University, Chongqing, China
| | - Zhengfei Zhu
- Department of Radiation Oncology, Fudan University Shanghai Cancer Center, Shanghai, China
| | - Wenzhao Zhong
- Guangdong Lung Cancer Institute, Guangdong General Hospital, and Guangdong Academy of Medical Sciences, Guangzhou, China
| | - Chunxue Bai
- Department of Pulmonary Medicine, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Liangan Chen
- Department of Respiratory, Chinese People's Liberation Army (PLA) General Hospital, Beijing, China
| | - Baohui Han
- Department of Pulmonology, Shanghai Chest Hospital, Shanghai, China
| | - Chengping Hu
- Department of Pulmonary Medicine, Xiangya Hospital, Central South University, Changsha, China
| | - Shun Lu
- Department of Oncology, Shanghai Lung Cancer Center, Shanghai Chest Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Weimin Li
- Department of Respiratory and Critical Care Medicine, Clinical Research Center for Respiratory Disease, West China Hospital, Sichuan University, Chengdu, China
| | - Yong Song
- Department of Respiratory and Critical Care Medicine, Jinling Hospital, Nanjing, China
| | - Jie Wang
- Key Laboratory of Respiratory Disease Pathogenomics, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Caicun Zhou
- Department of Oncology, Shanghai Pulmonary Hospital, Tongji University School of Medicine, Shanghai, China
| | - Jianying Zhou
- Department of Respiratory Diseases, The First Affiliated Hospital of College of Medicine, Zhejiang University, Hangzhou, China
| | - Yanbin Zhou
- Department of Internal Medicine, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yuichi Saito
- Department of Surgery, Teikyo University School of Medicine, Tokyo, Japan
| | - Yoshinobu Ichiki
- Department of General Thoracic Surgery, National Hospital Organization, Saitama Hospital, Wako, Japan
| | - Hitoshi Igai
- Department of General Thoracic Surgery, Japanese Red Cross Maebashi Hospital, Maebashi, Gunma, Japan
| | - Satoshi Watanabe
- Department of Respiratory Medicine and Infectious Diseases, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Sara Bravaccini
- IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", Meldola, Italy
| | - Alfonso Fiorelli
- Thoracic Surgery Unit, Universitàdella Campania Luigi Vanvitelli, Naples, Italy
| | - Francesco Petrella
- Division of Thoracic Surgery, IRCCS European Institute of Oncology, Milan, Italy.,Department of Oncology and Hemato-oncology, University of Milan, Milan, Italy
| | - Takeo Nakada
- Division of Thoracic Surgery, Department of Surgery, the Jikei University School of Medicine, Tokyo, Japan
| | - Piergiorgio Solli
- Department of Cardio-Thoracic Surgery and Hearth & Lung Transplantation, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | | | - Yuki Kataoka
- Department of Internal Medicine, Kyoto Min-Iren Asukai Hospital, Kyoto, Japan
| | - Taichiro Goto
- Lung Cancer and Respiratory Disease Center, Yamanashi Central Hospital, Yamanashi, Japan
| | - Rossana Berardi
- Clinica Oncologica, Università Politecnica delle Marche, Azienda Ospedaliero-Universitaria Ospedali Riuniti Umberto I, GM Lancisi, G Salesi di Ancona, Italy
| | - Jianxing He
- State Key Laboratory of Respiratory Disease, National Clinical Research Centre for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, China
| | - Nanshan Zhong
- State Key Laboratory of Respiratory Disease, National Clinical Research Centre for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, China
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94
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Ha TW, Jung HU, Kim DJ, Baek EJ, Lee WJ, Lim JE, Kim HK, Kang JO, Oh B. Association Between Environmental Factors and Asthma Using Mendelian Randomization: Increased Effect of Body Mass Index on Adult-Onset Moderate-to-Severe Asthma Subtypes. Front Genet 2021; 12:639905. [PMID: 34093643 PMCID: PMC8172971 DOI: 10.3389/fgene.2021.639905] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2020] [Accepted: 04/07/2021] [Indexed: 11/22/2022] Open
Abstract
Although asthma is one of the most common chronic diseases throughout all age groups, its etiology remains unknown, primarily due to its heterogeneous characteristics. We examined the causal effects of various environmental factors on asthma using Mendelian randomization and determined whether the susceptibility to asthma due to the causal effect of a risk factor differs between asthma subtypes, based on age of onset, severity of asthma, and sex. We performed Mendelian randomization analyses (inverse variance weighted, weighted median, and generalized summary-data-based Mendelian randomization) using UK Biobank data to estimate the causal effects of 69 environmental factors on asthma. Additional sensitivity analyses (MR-Egger regression, Cochran’s Q test, clumping, and reverse Mendelian randomization) were performed to ensure minimal or no pleiotropy. For confirmation, two-sample setting analyses were replicated using BMI SNPs that had been reported by a meta-genome-wide association study in Japanese and European (GIANT) populations and a genome-wide association study in control individuals from the UK Biobank. We found that BMI causally affects the development of asthma and that the adult-onset moderate-to-severe asthma subtype is the most susceptible to causal inference by BMI. Further, it is likely that the female subtype is more susceptible to BMI than males among adult asthma cases. Our findings provide evidence that obesity is a considerable risk factor in asthma patients, particularly in adult-onset moderate-to-severe asthma cases, and that weight loss is beneficial for reducing the burden of asthma.
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Affiliation(s)
- Tae-Woong Ha
- Department of Biochemistry and Molecular Biology, School of Medicine, Kyung Hee University, Seoul, South Korea
| | - Hae-Un Jung
- Department of Biomedical Science, Graduate School, Kyung Hee University, Seoul, South Korea
| | - Dong Jun Kim
- Department of Biomedical Science, Graduate School, Kyung Hee University, Seoul, South Korea
| | - Eun Ju Baek
- Department of Biomedical Science, Graduate School, Kyung Hee University, Seoul, South Korea
| | - Won Jun Lee
- Department of Biochemistry and Molecular Biology, School of Medicine, Kyung Hee University, Seoul, South Korea
| | - Ji Eun Lim
- Department of Biochemistry and Molecular Biology, School of Medicine, Kyung Hee University, Seoul, South Korea
| | - Han Kyul Kim
- Department of Biochemistry and Molecular Biology, School of Medicine, Kyung Hee University, Seoul, South Korea
| | - Ji-One Kang
- Department of Biochemistry and Molecular Biology, School of Medicine, Kyung Hee University, Seoul, South Korea
| | - Bermseok Oh
- Department of Biochemistry and Molecular Biology, School of Medicine, Kyung Hee University, Seoul, South Korea
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95
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Probst-Hensch N, Jeong A, Stolz D, Pons M, Soccal PM, Bettschart R, Jarvis D, Holloway JW, Kronenberg F, Imboden M, Schindler C, Lovison GF. Causal Effects of Body Mass Index on Airflow Obstruction and Forced Mid-Expiratory Flow: A Mendelian Randomization Study Taking Interactions and Age-Specific Instruments Into Consideration Toward a Life Course Perspective. Front Public Health 2021; 9:584955. [PMID: 34046380 PMCID: PMC8144328 DOI: 10.3389/fpubh.2021.584955] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 04/01/2021] [Indexed: 11/22/2022] Open
Abstract
Obesity has complex links to respiratory health. Mendelian randomization (MR) enables assessment of causality of body mass index (BMI) effects on airflow obstruction and mid-expiratory flow. In the adult SAPALDIA cohort, recruiting 9,651 population-representative samples aged 18–60 years at baseline (female 51%), BMI and the ratio of forced expiratory volume in 1 second (FEV1) to forced vital capacity (FVC) as well as forced mid-expiratory flow (FEF25–75%) were measured three times over 20 follow-up years. The causal effects of BMI in childhood and adulthood on FEV1/FVC and FEF25–75% were assessed in predictive (BMI averaged over 1st and 2nd, lung function (LF) averaged over 2nd and 3rd follow-up; N = 2,850) and long-term cross-sectional models (BMI and LF averaged over all follow-ups; N = 2,728) by Mendelian Randomization analyses with the use of weighted BMI allele score as an instrument variable and two-stage least squares (2SLS) method. Three different BMI allele scores were applied to specifically capture the part of BMI in adulthood that likely reflects tracking of genetically determined BMI in childhood. The main causal effects were derived from models containing BMI (instrumented by BMI genetic score), age, sex, height, and packyears smoked as covariates. BMI interactions were instrumented by the product of the instrument (BMI genetic score) and the relevant concomitant variable. Causal effects of BMI on FEV1/FVC and FEF25–75% were observed in both the predictive and long-term cross-sectional models. The causal BMI- LF effects were negative and attenuated with increasing age, and stronger if instrumented by gene scores associated with childhood BMI. This non-standard MR approach interrogating causal effects of multiplicative interaction suggests that the genetically rooted part of BMI patterns in childhood may be of particular relevance for the level of small airway function and airflow obstruction later in life. The methodological relevance of the results is first to point to the importance of a life course perspective in studies on the etiological role of BMI in respiratory health, and second to point out novel methodological aspects to be considered in future MR studies on the causal effects of obesity related phenotypes.
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Affiliation(s)
- Nicole Probst-Hensch
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland.,Department of Public Health, University of Basel, Basel, Switzerland
| | - Ayoung Jeong
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland.,Department of Public Health, University of Basel, Basel, Switzerland
| | - Daiana Stolz
- Clinic of Pulmonary Medicine and Respiratory Cell Research, University Hospital Basel, Basel, Switzerland
| | - Marco Pons
- Division of Pulmonary Medicine, Regional Hospital of Lugano, Lugano, Switzerland
| | - Paola M Soccal
- Division of Pulmonary Medicine, Geneva University Hospitals, Geneva, Switzerland
| | | | - Deborah Jarvis
- Medical Research Council-Public Health England, Centre for Environment and Health, Imperial College London, London, United Kingdom.,Population Health and Occupational Disease, National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - John W Holloway
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Florian Kronenberg
- Division of Genetic Epidemiology, Department of Medical Genetics, Molecular and Clinical Pharmacology, Medical University of Innsbruck, Innsbruck, Austria
| | - Medea Imboden
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland.,Department of Public Health, University of Basel, Basel, Switzerland
| | - Christian Schindler
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland.,Department of Public Health, University of Basel, Basel, Switzerland
| | - Gianfranco F Lovison
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland.,Department of Public Health, University of Basel, Basel, Switzerland.,Department of Economics, Business and Statistics, University of Palermo, Palermo, Italy
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96
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Liu GY, Kalhan R. Impaired Respiratory Health and Life Course Transitions From Health to Chronic Lung Disease. Chest 2021; 160:879-889. [PMID: 33865834 DOI: 10.1016/j.chest.2021.04.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 04/06/2021] [Accepted: 04/11/2021] [Indexed: 12/21/2022] Open
Abstract
Primary prevention and interception of chronic lung disease are essential in the effort to reduce the morbidity and mortality caused by respiratory conditions. In this review, we apply a life course approach that examines exposures across the life span to identify risk factors that are associated with not only chronic lung disease but also an intermediate phenotype between ideal lung health and lung disease, termed "impaired respiratory health." Notably, risk factors such as exposure to tobacco smoke and air pollution, as well as obesity and physical fitness, affect respiratory health across the life course by being associated with both abnormal lung growth and lung function decline. We then discuss the importance of disease interception and identifying those at highest risk of developing chronic lung disease. This work begins with understanding and detecting impaired respiratory health, and we review several promising molecular biomarkers, predictive symptoms, and early imaging findings that may lead to a better understanding of this intermediate phenotype.
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Affiliation(s)
- Gabrielle Y Liu
- Division of Pulmonary and Critical Care Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL; Department of Preventative Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL.
| | - Ravi Kalhan
- Department of Preventative Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL
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97
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Bosso JR, Tavares ELM, Rodrigues SA, Martins RHG. Does Abrupt Weight Loss Caused by Bariatric Surgery Compromise the Voice in Women? J Voice 2021:S0892-1997(21)00105-3. [PMID: 33832785 DOI: 10.1016/j.jvoice.2021.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 03/01/2021] [Accepted: 03/03/2021] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To evaluate vocal symptoms, voice characteristics and videolaryngoscopy in obese women before and after bariatric surgery. METHODS Obese patients (18 to 59 years old), candidates for bariatric surgery were recruited. Evaluation times: T1 (preoperative), T2 (after six months), T3 (after 12 months). Evaluated parameters: weight, height, body mass index, abdominal and neck circumference, vocal self-assessment, perceptual and acoustic vocal assessment, and videolaryngoscopy. RESULTS A total of 37 obese women were included, average age 40.8 years. There was a decrease in anthropometric measurements between the preoperative assessment and after 12 months: weight (121.18 ± 15.4 kg; 77.1 ± 11.6 kg), BMI (46.6 ± 6.95 kg/m2; 30 ± kg/m2), abdominal circumference (128 ± 16.1; 99.1 ± 12.1), and neck circumference (41.1 ± 5.85; 36.6 ± 3.02). Gastroesophageal (21.6%) and vocal symptoms (27%) prevailed. No difference was identified in vocal self-assessment between the evaluations. In the acoustic analysis, f0 increased and the soft phonation index decreased. The perceptual analysis registered lower scores for the degree of dysphonia (G) and voice instability (I). The maximum phonation time values increased without changing the s/z ratio. Videolaryngoscopies showed a posterior middle cleft and improvement in the signs of reflux. CONCLUSIONS Bariatric surgery led to an important and gradual decrease in anthropometric parameters. The voice became less hoarse, with higher pitch and more stable, with an improvement in maximum phonation time, however with slight breathiness. Such changes were not noticed by the patients.
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Affiliation(s)
- Janaina Regina Bosso
- Department of Ophthalmology, Otorhinolaryngology, Head and Neck Surgery, São Paulo State University, Botucatu, SP, Brazil
| | - Elaine Lara Mendes Tavares
- Department of Ophthalmology, Otorhinolaryngology, Head and Neck Surgery, São Paulo State University, Botucatu, SP, Brazil
| | | | - Regina Helena Garcia Martins
- Department of Ophthalmology, Otorhinolaryngology, Head and Neck Surgery, São Paulo State University, Botucatu, SP, Brazil.
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98
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Abd-Elaleem NA, Mohamed SAA, Wagdy WM, Abd-Elaleem RA, Abdelhafeez AS, Bayoumi HA. Changes in spirometric parameters with position in asymptomatic Egyptian young males with central obesity. Multidiscip Respir Med 2021; 16:745. [PMID: 33936592 PMCID: PMC8054763 DOI: 10.4081/mrm.2021.745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Accepted: 02/19/2021] [Indexed: 11/23/2022] Open
Abstract
Background Central obesity is a chronic condition that can contribute to impairments in lung functions. Body position is an important technique that effectively restores and increases lung functions. We aimed to address the possible changes in spirometric parameters in asymptomatic overweight individuals with central obesity with a change in posture from sitting to supine in comparison to normal weight non-obese ones. Methods Enrolled subjects were healthy Egyptian males, aged between 20–45 years old, asymptomatic and nonsmokers. They underwent spirometry. The following parameters were measured; forced expiratory volume in one second (FEV1), forced vital capacity (FVC), FEV1/FVC ratio, and forced expiratory flow (FEF)25-75%. They were classified into overweight with central obesity (n=40) and healthy control (n=40) groups based on their body mass index (BMI), weight-hip ratio (WHR), and waist circumference (WC). Spirometric parameters were compared between the 2 groups and in both setting and supine positions. Results The central obesity group showed significantly lower all spirometric parameters in comparison to the control one. All measured spirometric parameters had a significant reduction with supine position. There were negative correlations between both the WC and WHR and spirometric parameters. Conclusion In this study of young Egyptian males, individuals with central obesity had reduced spirometric parameters in comparison to healthy ones. Change in position from sitting to supine has significant effects on spirometric parameters in both healthy middle age males with normal weight and those with overweight and central obesity. These results could have important clinical implications.
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Affiliation(s)
- Nermeen A Abd-Elaleem
- Department of Chest Diseases and Tuberculosis, Faculty of Medicine, Assiut University, Assiut
| | - Sherif A A Mohamed
- Department of Chest Diseases and Tuberculosis, Faculty of Medicine, Assiut University, Assiut
| | - Wael M Wagdy
- Department of Radiology, Faculty of Medicine, South Valley University, Qena
| | | | - Azza S Abdelhafeez
- Department of Medical Physiology, Faculty of Medicine, Assiut University, Assiut, Egypt
| | - Hassan A Bayoumi
- Department of Chest Diseases and Tuberculosis, Faculty of Medicine, Assiut University, Assiut
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99
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Berger KI, Wohlleber M, Goldring RM, Reibman J, Farfel MR, Friedman SM, Oppenheimer BW, Stellman SD, Cone JE, Shao Y. Respiratory impedance measured using impulse oscillometry in a healthy urban population. ERJ Open Res 2021; 7:00560-2020. [PMID: 33816605 PMCID: PMC8005688 DOI: 10.1183/23120541.00560-2020] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 12/02/2020] [Indexed: 11/12/2022] Open
Abstract
This study derives normative prediction equations for respiratory impedance in a healthy asymptomatic urban population using an impulse oscillation system (IOS). In addition, this study uses body mass index (BMI) in the equations to describe the effect of obesity on respiratory impedance. Data from an urban population comprising 472 healthy asymptomatic subjects that resided or worked in lower Manhattan, New York City were retrospectively analysed. This population was the control group from a previously completed case–control study of the health effects of exposure to World Trade Center dust. Since all subjects underwent spirometry and oscillometry, these previously collected data allowed a unique opportunity to derive normative prediction equations for oscillometry in an urban, lifetime non-smoking, asymptomatic population without underlying respiratory disease. Normative prediction equations for men and women were successfully developed for a broad range of respiratory oscillometry variables with narrow confidence bands. Models that used BMI as an independent predictor of oscillometry variables (in addition to age and height) demonstrated equivalent or better fit when compared with models that used weight. With increasing BMI, resistance and reactance increased compatible with lung and airway compression from mass loading. This study represents the largest cohort of healthy urban subjects assessed with an IOS device. Normative prediction equations were derived that should facilitate application of IOS in the clinical setting. In addition, the data suggest that modelling of lung function may be best performed using height and BMI as independent variables rather than the traditional approach of using height and weight. Prediction equations for respiratory impedance were derived in an urban cohort incorporating the effects of mass loading from obesity. Urban exposures had minimal effect on impedance allowing application of the equations to a broad range of populations.https://bit.ly/3a3zZvd
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Affiliation(s)
- Kenneth I Berger
- Dept of Medicine, NYU Grossman School of Medicine, New York, NY, USA.,André Cournand Pulmonary Physiology Laboratory, Bellevue Hospital, New York, NY, USA
| | - Margaret Wohlleber
- Dept of Medicine, NYU Grossman School of Medicine, New York, NY, USA.,André Cournand Pulmonary Physiology Laboratory, Bellevue Hospital, New York, NY, USA
| | - Roberta M Goldring
- Dept of Medicine, NYU Grossman School of Medicine, New York, NY, USA.,André Cournand Pulmonary Physiology Laboratory, Bellevue Hospital, New York, NY, USA
| | - Joan Reibman
- Dept of Medicine, NYU Grossman School of Medicine, New York, NY, USA.,Dept of Environmental Medicine, NYU Grossman School of Medicine, New York, NY, USA
| | - Mark R Farfel
- World Trade Center Health Registry, New York City Department of Health and Mental Hygiene, New York, NY, USA
| | - Stephen M Friedman
- World Trade Center Health Registry, New York City Department of Health and Mental Hygiene, New York, NY, USA
| | - Beno W Oppenheimer
- Dept of Medicine, NYU Grossman School of Medicine, New York, NY, USA.,André Cournand Pulmonary Physiology Laboratory, Bellevue Hospital, New York, NY, USA
| | - Steven D Stellman
- World Trade Center Health Registry, New York City Department of Health and Mental Hygiene, New York, NY, USA.,Mailman School of Public Health, Columbia University, New York, NY, USA
| | - James E Cone
- World Trade Center Health Registry, New York City Department of Health and Mental Hygiene, New York, NY, USA
| | - Yongzhao Shao
- Dept of Population Health, NYU Grossman School of Medicine, New York, NY, USA
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100
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Hochart A, Nève V, Drumez E, Pigeyre M, Mallart A, Monaca C, Le Rouzic O, Gueorguieva I, Matran R. Dramatic impact of morbid obesity on child lung development. Arch Pediatr 2021; 28:186-190. [PMID: 33714673 DOI: 10.1016/j.arcped.2021.02.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 10/07/2020] [Accepted: 02/13/2021] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To assess the respiratory function and sleep characteristics of obese adults and children. METHODS All patients with non-syndromic, severe obesity (BMI ≥3 z-scores for children and ≥40.00kg/m2 for adults), referred for pulmonary function tests at Lille University Hospital, were retrospectively included. RESULTS A total of 69 children (mean±SD BMI 36.8±6.7 and mean BMI z-score 4.7±1.0) and 70 adults were included (mean BMI 45.7±6.2). Metabolic syndrome was diagnosed in 13 children (26%) and 40 adults (80%). Reduced lung volumes were observed in 34 children (50.0%) and 16 adults (24.0%) and both the mean functional residual capacity (FRC) and the mean residual volume (RV) were lower in children than in adults (FRC: -1.7±2.1 z-score in children vs. -1.0±1.1 in adults, P=0.026; and RV: -0.8±1.2 z-score in children vs. -0.1±1.1 in adults, P=0.002). The prevalence of severe obstructive sleep apnea syndrome was greater in adults (40.7% vs. 18.8%, P=0.007). Children had a higher average oxygen saturation (median of 96.0% [91.0-98.0] vs. 93.0% [76.0-97.0] in adults, P<0.0001). CONCLUSION Obesity has consequences for lung volumes in children; however, a longitudinal study is needed to determine the impact on pulmonary expansion and growth.
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Affiliation(s)
- A Hochart
- Pediatric department, CHU of Lille, 59000 Lille, France.
| | - V Nève
- University of Lille, CHU of Lille, EA4483, Pulmonary function test unit, 59000 Lille, France
| | - E Drumez
- Department of biostatistics, University of Lille, CHU Lille, EA 2694 - Santé publique: épidémiologie et qualité des soins, 59000 Lille, France
| | - M Pigeyre
- Department of nutrition, University of Lille, CHU of Lille, Centre intégré d'obésité, 59000 Lille, France
| | - A Mallart
- Pulmonology department, CHU of Lille, 59000 Lille, France
| | - C Monaca
- Neurophysiology department, University of Lille, CHU of Lille, 59000 Lille, France
| | - O Le Rouzic
- Pneumology department, University of Lille, CHU of Lille, 59000 Lille, France
| | - I Gueorguieva
- Pediatric department, CHU of Lille, centre intégré d'obésité, 59000 Lille, France
| | - R Matran
- University of Lille, CHU of Lille, EA4483, Pulmonary function test unit, 59000 Lille, France
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