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Huang P, Tang Q, Yang X, Li M, Li S. Effects of oropharyngeal exercises on CPAP compliance: A prospective intervention study. Am J Otolaryngol 2024; 45:104274. [PMID: 38593552 DOI: 10.1016/j.amjoto.2024.104274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 03/26/2024] [Indexed: 04/11/2024]
Abstract
PURPOSE To investigate the effects of oropharyngeal exercise on continuous positive airway pressure (CPAP) compliance in patients with moderate to severe obstructive sleep apnea over a period of 6 months. MATERIALS AND METHODS This study was conducted as a prospective, observational, and interventional investigation. A total of 70 patients with moderate to severe obstructive sleep apnea were randomly assigned to either the oropharyngeal exercise group (n = 44) or the sham-therapy group (n = 26). The compliance of the enrolled patients with CPAP therapy was assessed at baseline, 3-month follow-up and 6-month follow-up. Objective sleep data, questionnaire and CPAP use time were collected over a half-year period (i.e., baseline, 6 months, and 12 months). RESULTS The study found that the average use time of CPAP within one month was significantly longer in the oropharyngeal exercises group compared to the sham-therapy group at the 3-month assessment (5.5 ± 1.2 vs 4.8 ± 1.3 h per night; p=0.030), and much significantly longer at 6-months assessment (6.0 ± 1.4 vs 4.9 ± 1.3 h per night; p=0.001). Furthermore, the average use time of CPAP increased over time, with the oropharyngeal exercises group exhibiting a more pronounced growth from baseline to the six-month follow-up (4.8 ± 1.0 h per night to 6.0 ± 1.3 h per night, p < 0.001) compared to the sham-therapy group (4.8 ± 1.3 h per night to 4.9 ± 1.3 h per night, p=0.952). Additionally, the oropharyngeal exercise group demonstrated an improvement in the Epworth sleepiness scale compared to the sham-therapy group at the 3-month follow-up (6.0 ± 2.0 vs 8.8 ± 3.2; p < 0.001), as well as decreased significantly at 6-month follow-up (p = 0.032). CONCLUSIONS CPAP adherence can be improved with oropharyngeal exercises therapy among moderate to severe OSA patients. Notably, the average duration of CPAP usage and reduction in daytime sleepiness were maintained even after six months of oropharyngeal exercise therapy.
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Affiliation(s)
- Peiying Huang
- Department of Otolaryngology Head and Neck Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China
| | - Qinglai Tang
- Department of Otolaryngology Head and Neck Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China
| | - Xinming Yang
- Department of Otolaryngology Head and Neck Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China
| | - Mengmeng Li
- Department of Otolaryngology Head and Neck Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China
| | - Shisheng Li
- Department of Otolaryngology Head and Neck Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan 410011, China.
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Zhu L, Wu Z, Liu Y, Ming Y, Xie P, Jiang M, Qi Y. Acod1/itaconate activates Nrf2 in pulmonary microvascular endothelial cells to protect against the obesity-induced pulmonary microvascular endotheliopathy. Respir Res 2024; 25:205. [PMID: 38730297 PMCID: PMC11088094 DOI: 10.1186/s12931-024-02827-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 04/29/2024] [Indexed: 05/12/2024] Open
Abstract
BACKGROUND Obesity is the main risk factor leading to the development of various respiratory diseases, such as asthma and pulmonary hypertension. Pulmonary microvascular endothelial cells (PMVECs) play a significant role in the development of lung diseases. Aconitate decarboxylase 1 (Acod1) mediates the production of itaconate, and Acod1/itaconate axis has been reported to play a protective role in multiple diseases. However, the roles of Acod1/itaconate axis in the PMVECs of obese mice are still unclear. METHODS mRNA-seq was performed to identify the differentially expressed genes (DEGs) between high-fat diet (HFD)-induced PMVECs and chow-fed PMVECs in mice (|log2 fold change| ≥ 1, p ≤ 0.05). Free fatty acid (FFA) was used to induce cell injury, inflammation and mitochondrial oxidative stress in mouse PMVECs after transfection with the Acod1 overexpressed plasmid or 4-Octyl Itaconate (4-OI) administration. In addition, we investigated whether the nuclear factor erythroid 2-like 2 (Nrf2) pathway was involved in the effects of Acod1/itaconate in FFA-induced PMVECs. RESULTS Down-regulated Acod1 was identified in HFD mouse PMVECs by mRNA-seq. Acod1 expression was also reduced in FFA-treated PMVECs. Acod1 overexpression inhibited cell injury, inflammation and mitochondrial oxidative stress induced by FFA in mouse PMVECs. 4-OI administration showed the consistent results in FFA-treated mouse PMVECs. Moreover, silencing Nrf2 reversed the effects of Acod1 overexpression and 4-OI administration in FFA-treated PMVECs, indicating that Nrf2 activation was required for the protective effects of Acod1/itaconate. CONCLUSION Our results demonstrated that Acod1/Itaconate axis might protect mouse PMVECs from FFA-induced injury, inflammation and mitochondrial oxidative stress via activating Nrf2 pathway. It was meaningful for the treatment of obesity-caused pulmonary microvascular endotheliopathy.
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Affiliation(s)
- Li Zhu
- Department of Pulmonary and Critical Care Medicine, Zhengzhou University People's Hospital, Henan Provincial People's Hospital, Zhengzhou, Henan, People's Republic of China
- Academy of Medical Science, Zhengzhou University, Zhengzhou, Henan, People's Republic of China
| | - Zhuhua Wu
- Department of Pulmonary and Critical Care Medicine, Zhengzhou University People's Hospital, Henan Provincial People's Hospital, Zhengzhou, Henan, People's Republic of China
| | - Yingli Liu
- Department of Pulmonary and Critical Care Medicine, Zhengzhou University People's Hospital, Henan Provincial People's Hospital, Zhengzhou, Henan, People's Republic of China
| | - Yue Ming
- Department of Pulmonary and Critical Care Medicine, Zhengzhou University People's Hospital, Henan Provincial People's Hospital, Zhengzhou, Henan, People's Republic of China
| | - Pei Xie
- Department of Pulmonary and Critical Care Medicine, Zhengzhou University People's Hospital, Henan Provincial People's Hospital, Zhengzhou, Henan, People's Republic of China
| | - Miao Jiang
- Department of Pulmonary and Critical Care Medicine, Henan University People's Hospital, Henan Provincial People's Hospital, Zhengzhou, Henan, People's Republic of China
| | - Yong Qi
- Department of Pulmonary and Critical Care Medicine, Henan Provincial People's Hospital, Zhengzhou University People's Hospital, Henan University People's Hospital, Zhengzhou, Henan, People's Republic of China.
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Mathieu L, Rabec C, Beltramo G, Aho S, Tankere P, Schenesse D, Chorvoz J, Bonniaud P, Georges M. Real-life evaluation of NIV to CPAP switch in patients with chronic respiratory failure. A case control study. Respir Med Res 2024; 86:101114. [PMID: 38875850 DOI: 10.1016/j.resmer.2024.101114] [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: 09/20/2023] [Revised: 04/29/2024] [Accepted: 04/29/2024] [Indexed: 06/16/2024]
Abstract
BACKGROUND Non-invasive ventilation (NIV) is a standard of care for hypercapnic chronic respiratory failure (CRF). Obstructive sleep apnea syndrome (OSA) frequently contributes to hypoventilation in CRF patients. CPAP improves hypercapnia in selected COPD and obese patients, like NIV. We aimed to describe the profile of patients switching from NIV to CPAP in a cohort of patients on long-term ventilation and to identify the factors associated with a successful switch. METHODS In this case-control study, 88 consecutive patients who were candidates for a NIV-CPAP switch were compared with 266 controls among 394 ventilated patients treated at the Dijon University Hospital between 2015 and 2020. They followed a standardized protocol including a poly(somno)graphy recorded after NIV withdrawal for three nights. CPAP trial was performed if severe OSA was confirmed. Patients were checked for recurrent hypoventilation after 1 and 23[14-46] nights under CPAP. RESULTS Patients were 53% males, median age 65 [56-74] years, and median BMI 34 [25-38.5] kg/m2. Sixty four percent of patients were safely switched and remained on long-term CPAP. In multivariate analysis, the probability of a NIV-CPAP switch was correlated to older age (OR: 1.3 [1.01-1.06]), BMI (OR: 1.7 [1.03-1.12]), CRF etiology (OR for COPD: 20.37 [4.2-98,72], OR for obesity: 7.31 [1.58-33.74]), circumstances of NIV initiation (OR for acute exacerbation: 11.64 [2.03-66.62]), lower pressure support (OR: 0.90 [0.73-0.92]), lower baseline PaCO2 (OR: 0.85 [0.80-0.91]) and lower compliance (OR: 0.76 [0.64-0.90]). Among 72 patients who went home under CPAP, pressure support level was the only factor associated with the outcome of the NIV-CPAP switch, even after adjustment for BMI and age (p=0.01) with a non-linear correlation. Etiology of chronic respiratory failure, age, BMI, baseline PaCO2, circumstances of NIV initiation, time under home NIV or NIV compliance were not predictive of the outcome of the NIV-CPAP switch. CONCLUSIONS A NIV-CPAP switch is possible in real life conditions in stable obese and COPD patients with underlying OSA.
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Affiliation(s)
- Louise Mathieu
- Department of Respiratory Diseases and Intensive Care, Reference Center for Adult Rare Pulmonary Diseases, University Hospital of Dijon-Bourgogne, Dijon, France; University of Bourgogne Franche-Comté, Dijon, France
| | - Claudio Rabec
- Department of Respiratory Diseases and Intensive Care, Reference Center for Adult Rare Pulmonary Diseases, University Hospital of Dijon-Bourgogne, Dijon, France; University of Bourgogne Franche-Comté, Dijon, France
| | - Guillaume Beltramo
- Department of Respiratory Diseases and Intensive Care, Reference Center for Adult Rare Pulmonary Diseases, University Hospital of Dijon-Bourgogne, Dijon, France; University of Bourgogne Franche-Comté, Dijon, France; INSERM LNC-UMR 1231, Dijon, France
| | - Serge Aho
- Department of Epidemiology, Dijon University Hospital, Dijon, France
| | - Pierre Tankere
- Department of Respiratory Diseases and Intensive Care, Reference Center for Adult Rare Pulmonary Diseases, University Hospital of Dijon-Bourgogne, Dijon, France; University of Bourgogne Franche-Comté, Dijon, France
| | - Déborah Schenesse
- Department of Respiratory Diseases and Intensive Care, Reference Center for Adult Rare Pulmonary Diseases, University Hospital of Dijon-Bourgogne, Dijon, France; University of Bourgogne Franche-Comté, Dijon, France
| | - Jade Chorvoz
- Department of Respiratory Diseases and Intensive Care, Reference Center for Adult Rare Pulmonary Diseases, University Hospital of Dijon-Bourgogne, Dijon, France; University of Bourgogne Franche-Comté, Dijon, France
| | - Philippe Bonniaud
- Department of Respiratory Diseases and Intensive Care, Reference Center for Adult Rare Pulmonary Diseases, University Hospital of Dijon-Bourgogne, Dijon, France; University of Bourgogne Franche-Comté, Dijon, France; INSERM LNC-UMR 1231, Dijon, France
| | - Marjolaine Georges
- Department of Respiratory Diseases and Intensive Care, Reference Center for Adult Rare Pulmonary Diseases, University Hospital of Dijon-Bourgogne, Dijon, France; University of Bourgogne Franche-Comté, Dijon, France; Centre des Sciences du Goût et de l'Alimentation, UMR 6265 CNRS 1234 INRA, University of Bourgogne Franche-Comté, Dijon, France.
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Zewari S, van den Borst B, van den Heuvel M, van den Elshout F, Sastry M, Vos P. Sleep Hypoventilation is Common in Diurnal Normocapnic COPD Patients with Severe or Very Severe Obstruction and is Not Associated with Body Mass Index. COPD 2023; 20:210-215. [PMID: 37486242 DOI: 10.1080/15412555.2023.2215324] [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: 06/17/2022] [Revised: 05/10/2023] [Accepted: 05/14/2023] [Indexed: 07/25/2023]
Abstract
Sleep hypoventilation (SH) is common in COPD patients with diurnal hypercapnia, however there are little data on the presence of SH in COPD patients with diurnal normocapnia. In this study the prevalence of SH in stable normocapnic COPD patients with severe or very severe obstruction (GOLD stages III and IV) was evaluated across body mass index (BMI) classes and associations between SH and body composition measures were explored. A total of 56 diurnal normocapnic COPD patients, of whom 17 normal-weight (COPDNW), 18 overweight (COPDOW) and 21 obese (COPDOB), underwent polysomnography to objectify SH and bioelectrical impedance analysis to assess body composition. The overall prevalence of SH was 66.1% and was not different across BMI classes. Logistic regression models indicated that SH was not associated with waist-to-hip ratio, body fat percentage and fat-free mass index. Our data indicate that SH is common in diurnal normocapnic COPD patients with severe or very severe obstruction and is not associated with BMI or body composition.
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Affiliation(s)
- Safir Zewari
- Department of Pulmonary Disease, Rijnstate hospital, Arnhem, The Netherlands
- Department of Pulmonary Disease, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Bram van den Borst
- Department of Pulmonary Disease, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Michel van den Heuvel
- Department of Pulmonary Disease, Radboud University Medical Center, Nijmegen, The Netherlands
| | | | - Manu Sastry
- Academic Sleep Center, CIRO, Horn, The Netherlands
| | - Petra Vos
- Department of Pulmonary Disease, Rijnstate hospital, Arnhem, The Netherlands
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Perossi L, Holtz M, dos Santos DO, Perossi J, de Souza HCD, Salgado Junior W, Gastaldi AC. Increased airway resistance can be related to the decrease in the functional capacity in obese women. PLoS One 2022; 17:e0267546. [PMID: 35671283 PMCID: PMC9173605 DOI: 10.1371/journal.pone.0267546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 04/12/2022] [Indexed: 11/19/2022] Open
Abstract
Background and objective
Obesity can increase the airways resistance, mainly in the periphery, leading to dyspnea perception that can impair the functional capacity. This study aimed to analyze if airways resistance could be related to the walking capacity of women with morbid obesity.
Methods
Thirty-seven women with grade III obesity in preoperative bariatric surgery were evaluated using the spirometry test, impulse oscillometry system (IOS), and six-minute walk test (6MWT). Additionally, data about their daily dyspnea perception and physical activity level were collected.
Results
Variables of the spirometry test did not detect ventilator disorders. Compared to the predicted values, the IOS identified significant increase in airways resistance (kPa/L/s) (R5: 0.36 (0.34; 0.36) and 0.53 (0.47; 0.61); R20: 0.30 (0.28; 0.30) and 0.41 (0.35; 0.45); R5-20: 0.06 (0.06; 0.06) and 0.14 (0.10; 0.15); X5: -0.03 (-0.04; -0.01) and -0.20 (-0.27; -0.18), respectively). The distance walked in the 6MWT, 491.4±60.4m was significantly correlated to R5 (rho = -0.41, p = 0.01), R5-20 (rho = -0.52, p = 0.001), and X5 (rho = 0.54, p = 0.0006).
Conclusion
The IOS is able to identify changes in airway resistance even before the onset of symptoms. When evaluated by IOS women with severe obesity and normal spirometry exhibited central and peripheral airways obstruction. The correlations between the IOS and six-minute walk distance suggest that increased peripheral airways resistance could be related to worsening functional capacity.
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Affiliation(s)
- Larissa Perossi
- Health Sciences Department, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Mayara Holtz
- Health Sciences Department, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Daniele Oliveira dos Santos
- Health Sciences Department, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Jéssica Perossi
- Health Sciences Department, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Hugo Celso Dutra de Souza
- Health Sciences Department, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Wilson Salgado Junior
- Surgery Department, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Bazil
| | - Ada Clarice Gastaldi
- Health Sciences Department, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
- * E-mail:
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Martinez-Arnau FM, Buigues C, Fonfría-Vivas R, Cauli O. Respiratory function correlates with fat mass index and blood triglycerides in institutionalized older individuals. Endocr Metab Immune Disord Drug Targets 2022; 22:1029-1039. [PMID: 35352657 DOI: 10.2174/1871530322666220329150813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 01/09/2022] [Accepted: 01/19/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND We investigated the relationship between respiratory function measured by spirometry analysis and anthropometric variables (skeletal and fat mass) and nutritional status in the institutionalized elderly, particularly at high risk of adverse outcomes after respiratory infections and malnutrition. DESIGN A multicenter cross-sectional study with quantitative approach among older people institutionalized living in nursing homes. METHODS Respiratory function was assessed by measuring the forced vital capacity, forced expiratory volume in the first second, the ratio between FEV1 and FVC (FEV1/FVC), and peak expiratory flow in percentage by means of spirometric analysis (values of the forced expiratory volume measured during the first second of the forced breath (FEV1) and forced vital capacity (FVC)). Nutritional assessment and anthropometry analysis were done to evaluate under or over nutrition/weight. RESULTS There was a significant (p<0.05) and positive correlation between FEV1 and skeletal muscle mass index, whereas fat mass index correlated significantly (p<0.01) with the FEV1/FVC index. FEV1/FVC values were both significantly (p<0.05) associated with high body mass index and triglyceride levels in blood. The prevalence of individuals with ventilator restrictive pattern (FEV1/FVC>70% with FEV1 and FVC<80%) was 27.6% and 12 individuals (21.1%) receive daily bronchodilators as part of the pharmacological treatment for respiratory disorders. A logistic regression was performed to identify predictors of restrictive respiratory pattern. The following variables were entered into the model: age group, female gender, Charlson comorbidity index, body-mass index (BMI), fat mass index, skeletal muscle mass index, total cholesterol and triglycerides concentration. The model was statistically significant (p < 0.05; R2 = 0.39), correctly classifying 70.0% of cases, with a sensitivity of 89.3% and a specificity of 50.0%. Area under curve was 0.71 (IC95% 0.54-0.88; p=0.023). The highest OR for restrictive respiratory pattern were for BMI (OR=5.09) and triglycerides concentration in blood (>150 mg/dl) (OR=5.59). CONCLUSION The relationship between a restrictive pattern of respiratory function and fat mass which deserves future investigation to manage these parameters as possible modifiable factor of altered respiratory function in overweight institutionalized older individuals.
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Affiliation(s)
- Francisco Miguel Martinez-Arnau
- Department of Physiotherapy, University of Valencia, Valencia, Spain
- Frailty and Cognitive Impairment Research Group (FROG), University of Valencia, Valencia, Spain
| | - Cristina Buigues
- Frailty and Cognitive Impairment Research Group (FROG), University of Valencia, Valencia, Spain
- Department of Medicine and Nursing, University of Valencia, Spain
| | - Rosa Fonfría-Vivas
- Frailty and Cognitive Impairment Research Group (FROG), University of Valencia, Valencia, Spain
- Department of Medicine and Nursing, University of Valencia, Spain
| | - Omar Cauli
- Frailty and Cognitive Impairment Research Group (FROG), University of Valencia, Valencia, Spain
- Department of Medicine and Nursing, University of Valencia, Spain
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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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Fernández-Prada M, García-González P, García-Morán A, Ruiz-Álvarez I, Ramas-Diez C, Calvo-Rodríguez C. [Personal and vaccination history as factors associated with SARS-CoV-2 infection]. Med Clin (Barc) 2021; 157:226-233. [PMID: 33966881 PMCID: PMC7972666 DOI: 10.1016/j.medcli.2021.02.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 01/27/2021] [Accepted: 02/01/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND AND OBJECTIVE SARS-CoV-2 has been and is a major global Public Health challenge. Since the beginning of the pandemic, different comorbidities have been postulated and associated with spectra of increased severity and mortality. The objectives of this research are: 1) to analyse the factors associated with SARS-CoV-2 infection (COVID-19) in a health area in northern Spain; 2) to understand the possible role of influenza vaccination and pneumococcal vaccination in the development of COVID-19. MATERIALS AND METHOD A test-negative case-control study was conducted. Variables related to personal and vaccination history were considered. Although the epidemiological definition of the case varied over time, the reference definition was that corresponding to 31/01/2020 in Spain. A bivariate and multivariate analysis was performed. RESULTS The sample included 188 patients, of which 63 were cases and 125 controls. The results show that obesity increases the risk 2.4-fold of suffering this infection (IC 95% 1,301-4,521) and ARA-2 increases it 2.2-fold (95% CI 1,256-6,982). On the other hand, anti-pneumococcal vaccination of 13 serotypes showed results close to statistical significance (OR = 0.4; 95% CI 0.170-1,006). CONCLUSION Obesity and the use of ARA-2 increases the risk of COVID-19. Scientific knowledge about factors associated with COVID-19 should be expanded. The authors consider that the present research raises the need further investigate the role of vaccines in this infection and their possible heterologous properties.
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Affiliation(s)
- María Fernández-Prada
- Servicio de Medicina Preventiva y Salud Pública, Hospital Vital Álvarez Buylla, Servicio de Salud del Principado de Asturias, Asturias, España,Autor para correspondencia
| | - Paula García-González
- Servicio Medicina Interna, Hospital Vital Álvarez Buylla, Servicio de Salud del Principado de Asturias, Asturias, España
| | - Alejandro García-Morán
- Servicio Medicina Interna, Hospital Vital Álvarez Buylla, Servicio de Salud del Principado de Asturias, Asturias, España
| | - Inés Ruiz-Álvarez
- Servicio Medicina Interna, Hospital Vital Álvarez Buylla, Servicio de Salud del Principado de Asturias, Asturias, España
| | - Covadonga Ramas-Diez
- Servicio Medicina Interna, Hospital Vital Álvarez Buylla, Servicio de Salud del Principado de Asturias, Asturias, España
| | - Carmen Calvo-Rodríguez
- Servicio Medicina Interna, Hospital Vital Álvarez Buylla, Servicio de Salud del Principado de Asturias, Asturias, España
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Li S, Cao S, Duan X, Zhang Y, Gong J, Xu X, Guo Q, Meng X, Bertrand M, Zhang JJ. Children's lung function in relation to changes in socioeconomic, nutritional, and household factors over 20 years in Lanzhou. J Thorac Dis 2021; 13:4574-4588. [PMID: 34422383 PMCID: PMC8339784 DOI: 10.21037/jtd-20-2232] [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: 06/17/2020] [Accepted: 04/15/2021] [Indexed: 11/15/2022]
Abstract
Background Lanzhou has experienced rapid urbanization, leading to changes in socioeconomic, nutritional, and household factors. These changes may affect children’s lung function. Methods Two cross-sectional studies of school-age children (6–13 years of age) from the urban (Chengguan) (Period 1 in 1996 with n=390; Period 2 in 2017 with n=192) and the suburban (Xigu) (Period 1 n=344; Period 2 n=492) district were conducted. Demographic information, household factors, and nutrition status were obtained via a questionnaire survey. Forced vital capacity (FVC) and forced expiratory volume in the first second (FEV1) were measured in each period. Student’s t-test analysis of variance was used to assess the differences in FVC and FEV1 between Periods 1 and 2. Generalized linear models were used to analyze the associations between questionnaire derived factors and lung function. Analyses were done separately for girls and boys. Results Children had significantly lower mean FEV1 and FVC measures in Period 2 than in Period 1. This reduction was greater in children living in the urban area than those living in the suburban area. Obese children had significantly lower lung function but this was only statistically significant in Period 1. Conclusions Children’s lung function (FVC and FEV1) were lower in 2017 than in 1996. Rapid urbanization may have contributed to the decline of lung function. Obesity may be a risk factor for impaired lung function in children living in Lanzhou and possibly elsewhere.
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Affiliation(s)
- Sai Li
- School of Energy and Environmental Engineering, University of Science and Technology Beijing, Beijing, China
| | - Suzhen Cao
- School of Energy and Environmental Engineering, University of Science and Technology Beijing, Beijing, China
| | - Xiaoli Duan
- School of Energy and Environmental Engineering, University of Science and Technology Beijing, Beijing, China
| | - Yaqun Zhang
- Gansu Provincial Design and Research Institute of Environmental Science, Lanzhou, China
| | - Jicheng Gong
- Beijing Innovation Center for Engineering Science and Advanced Technology, State Key Joint Laboratory for Environmental Simulation and Pollution Control, College of Environmental Sciences and Engineering, And Center for Environment and Health, Peking University, Beijing, China
| | - Xiangyu Xu
- School of Energy and Environmental Engineering, University of Science and Technology Beijing, Beijing, China
| | - Qian Guo
- School of Energy and Environmental Engineering, University of Science and Technology Beijing, Beijing, China
| | - Xin Meng
- Beijing Innovation Center for Engineering Science and Advanced Technology, State Key Joint Laboratory for Environmental Simulation and Pollution Control, College of Environmental Sciences and Engineering, And Center for Environment and Health, Peking University, Beijing, China
| | - Mcswain Bertrand
- School of Energy and Environmental Engineering, University of Science and Technology Beijing, Beijing, China
| | - Junfeng Jim Zhang
- Global Health Research Center, Duke Kunshan University, Kunshan, China.,Nicholas School of the Environment and Duke Global Health Institute, Duke University, Durham, USA.,Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
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10
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Fernández-Prada M, García-González P, García-Morán A, Ruiz-Álvarez I, Ramas-Diez C, Calvo-Rodríguez C. Personal and vaccination history as factors associated with SARS-CoV-2 infection. ACTA ACUST UNITED AC 2021; 157:226-233. [PMID: 34395910 PMCID: PMC8349685 DOI: 10.1016/j.medcle.2021.02.007] [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: 07/13/2020] [Accepted: 02/01/2021] [Indexed: 11/01/2022]
Abstract
Background and objective SARS-CoV-2 has been and is a major global Public Health challenge. Since the beginning of the pandemic, different comorbidities have been postulated and associated with spectra of increased severity and mortality. The objectives of this research are: 1) to analyse the factors associated with SARS-CoV-2 infection (COVID-19) in a health area in northern Spain; 2) to understand the possible role of influenza vaccination and pneumococcal vaccination in the development of COVID-19. Materials and method A test-negative case-control study was conducted. Variables related to personal and vaccination history were considered. Although the epidemiological definition of the case varied over time, the reference definition was that corresponding to 31/01/2020 in Spain. A bivariate and multivariate analysis was performed. Results The sample included 188 patients, of which 63 were cases and 125 controls. The results show that obesity increases the risk 2.4-fold of suffering this infection (IC 95% 1,301-4,521) and ARA-2 increases it 2.2-fold (95% CI 1,256-6,982). On the other hand, anti-pneumococcal vaccination of 13 serotypes showed results close to statistical significance (OR = 0.4; 95% CI 0.170-1,006). Conclusion Obesity and the use of ARA-2 increases the risk of COVID-19. Scientific knowledge about factors associated with COVID-19 should be expanded. The authors consider that the present research raises the need further investigate the role of vaccines in this infection and their possible heterologous properties.
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Affiliation(s)
- María Fernández-Prada
- Servicio de Medicina Preventiva y Salud Pública, Hospital Vital Álvarez Buylla, Servicio de Salud del Principado de Asturias, Asturias, Spain
| | - Paula García-González
- Servicio Medicina Interna, Hospital Vital Álvarez Buylla, Servicio de Salud del Principado de Asturias, Asturias, Spain
| | - Alejandro García-Morán
- Servicio Medicina Interna, Hospital Vital Álvarez Buylla, Servicio de Salud del Principado de Asturias, Asturias, Spain
| | - Inés Ruiz-Álvarez
- Servicio Medicina Interna, Hospital Vital Álvarez Buylla, Servicio de Salud del Principado de Asturias, Asturias, Spain
| | - Covadonga Ramas-Diez
- Servicio Medicina Interna, Hospital Vital Álvarez Buylla, Servicio de Salud del Principado de Asturias, Asturias, Spain
| | - Carmen Calvo-Rodríguez
- Servicio Medicina Interna, Hospital Vital Álvarez Buylla, Servicio de Salud del Principado de Asturias, Asturias, Spain
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11
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Uysal P, Anik A, Anik A. School-Age Obese Asthmatic Children have Distinct Lung Function Measures From Lean Asthmatics and Obese Children. J Asthma 2021; 59:1548-1559. [PMID: 34328388 DOI: 10.1080/02770903.2021.1959925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Background: The lung functions of children with obese asthma seem to be distinct from those of obese children or lean asthmatics.Aim: To measure baseline lung function, exercise-induced bronchoconstriction (EIB), and bronchial hyperreactivity (BHR) in school-age obese asthmatics (OA group) and to compare the data with obese children (O group), lean asthmatics (A group), and healthy controls (H group).Methods: One hundred seventy school-age children were enrolled in this prospective cross-sectional study. Baseline fractionated exhaled nitric oxide (FeNO), and baseline, post-exercise (post-E), and post-bronchodilation (post-BD) impulse oscillometry (IOS) and spirometry tests were performed. EIB and BHR were evaluated based on the difference (Δ) in post-E - baseline, and post-BD - baseline values.Results: The mean FeNO level was higher in the OA group than in the other groups (p = 0.002). Baseline zR5 and R5-20 were higher (p = 0.013 and p = 0.044), but zFEF25-75 was lower (p < 0.01), in the OA group. ΔPost-E - baseline zFEV1 was lower in the A group (p = 0.003) but was higher in the OA group (p = 0.014) than the other groups. ΔPost-BD - baseline zFEV1 was lower in the H group compared to the other three groups (p = 0.004), but no significant difference was observed among the O, A, and OA groups (p > 0.05).Conclusion: A higher airway inflammation (high FeNO), peripheral airway resistance (high zR5 and zR5-20) and a lower peripheral airway flow (low FEF25-75) were observed at baseline measurement in school-age obese asthmatics compared to lean asthmatics and obese children. Obese asthmatics had no EIB but exhibited a similar BHR to that of asthmatics.
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Affiliation(s)
- Pinar Uysal
- Aydin Adnan Menderes University, School of Medicine, Department of Pediatrics, Division of Allergy and Immunology, Aydin, Turkey
| | - Ayse Anik
- Aydin Adnan Menderes University, School of Medicine, Department of Pediatrics, Division of Neonatology, Aydin, Turkey
| | - Ahmet Anik
- Aydin Adnan Menderes University, School of Medicine, Department of Pediatrics, Division of Pediatric Endocrinology, Aydin, Turkey
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12
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Gómez-Zorita S, Queralt M, Vicente MA, González M, Portillo MP. Metabolically healthy obesity and metabolically obese normal weight: a review. J Physiol Biochem 2021; 77:175-189. [PMID: 33704694 DOI: 10.1007/s13105-020-00781-x] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 12/23/2020] [Indexed: 02/07/2023]
Abstract
Despite the general relationship between obesity and its co-morbidities, there are both obese individuals who scarcely present the associated pathologies (metabolically healthy obese; MHO) and individuals who present obesity alterations despite having normal weight (metabolically obese normal weight; MONW). It is still difficult to define metabolically MHO and MONW individuals because different classifications have been used in the studies reported. Indeed, different inclusion criteria have been used to discriminate between metabolically healthy and metabolically unhealthy subjects. Due to this and other reasons, such as differences in ethnicity, genetics, and lifestyle of the populations, data concerning the prevalence of MHO and MONW are very variable. The main determinants of MHO are type of growth (hypertrophy or hyperplasia), anatomical location, inflammation of adipose tissue, ectopic fat accumulation, genetic factors, and lifestyles factors. In the case of MONW, the main determinants are genetic background and lifestyle factors. With regard to treatment, it is not clear whether MHO subjects would benefit from traditional lifestyle interventions, based on diet energy restriction and increased physical activity. For MONW subjects, there is still no specialized treatment, and the therapies are the same as those used in obese subjects.
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Affiliation(s)
- Saioa Gómez-Zorita
- Nutrition and Obesity Group. Department of Nutrition and Food Science, University of the Basque Country (UPV/EHU) and Lucio Lascaray Research Institute, Vitoria, Spain. .,BIOARABA Health Research Institute, Vitoria, Spain. .,CIBERobn Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Vitoria, Spain.
| | - Maite Queralt
- Nutrition and Obesity Group. Department of Nutrition and Food Science, University of the Basque Country (UPV/EHU) and Lucio Lascaray Research Institute, Vitoria, Spain
| | - Maria Angeles Vicente
- BIOARABA Health Research Institute, Vitoria, Spain.,Alava University Hospital (Osakidetza), Vitoria, Spain
| | - Marcela González
- Nutrition and Food Science Department, Faculty of Biochemistry and Biological Sciences, National University of Litoral and National Scientific and Technical Research Council (CONICET), 3000, Santa Fe, Argentina
| | - María P Portillo
- Nutrition and Obesity Group. Department of Nutrition and Food Science, University of the Basque Country (UPV/EHU) and Lucio Lascaray Research Institute, Vitoria, Spain.,BIOARABA Health Research Institute, Vitoria, Spain.,CIBERobn Physiopathology of Obesity and Nutrition, Institute of Health Carlos III, Vitoria, Spain
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13
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Salahuddin M, Salamo O, Karanth S, Faiz SA, Estrada-Y-Martin RM, Cherian SV. Safety and incidence of complications associated with bronchoscopy in an obese population. CLINICAL RESPIRATORY JOURNAL 2021; 15:670-675. [PMID: 33608994 DOI: 10.1111/crj.13342] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 02/15/2021] [Indexed: 11/27/2022]
Abstract
INTRODUCTION The safety of bronchoscopy in obese patients and those with obstructive sleep apnea (OSA) is unclear. Our objective was to evaluate the incidence of complications during bronchoscopy under moderate sedation in obese patients and to assess the impact of OSA, body mass index (BMI), and duration of the procedure. METHODS We performed a retrospective study in adult patients undergoing bronchoscopy from January 2010 to August 2019. All patients with BMI > 30 kg/m2 were included. Logistic regression analyses were used to identify the factors associated with all-complications and respiratory complications. RESULTS A total of 345 obese patients were identified. The average BMI in our cohort was 35.3 ± 5.1 kg/m2 . During the pre-procedure risk assessment, 165 (47.8%) patients were labelled as "suspected OSA." The most common doses of sedation given during the bronchoscopies were fentanyl 50 mcg (34.5%) and midazolam 3 mg (33.6%). The incidence of major complications was 0.6% and minor complications were 41.2%. Minor respiratory (22.9%) and cardiac (26.4%) complications were common. No deaths occurred due to bronchoscopy. Factors that were associated with increased respiratory complications were female gender, suspected OSA, and bronchoscopy duration 20-30 minutes and bronchoscopy duration greater than 1 hour. CONCLUSION Bronchoscopy under moderate sedation performed in obese patients is safe; however, increased risk may exist with females, increased procedure time, and suspected OSA.
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Affiliation(s)
- Moiz Salahuddin
- Divisions of Critical Care, Pulmonary and Sleep Medicine, McGovern Medical School at the University of Texas Health Sciences Center, Houston, TX, USA
| | - Oriana Salamo
- Divisions of Critical Care, Pulmonary and Sleep Medicine, McGovern Medical School at the University of Texas Health Sciences Center, Houston, TX, USA
| | - Siddharth Karanth
- Divisions of Critical Care, Pulmonary and Sleep Medicine, McGovern Medical School at the University of Texas Health Sciences Center, Houston, TX, USA
| | - Saadia A Faiz
- Department of Pulmonary Medicine, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Rosa M Estrada-Y-Martin
- Divisions of Critical Care, Pulmonary and Sleep Medicine, McGovern Medical School at the University of Texas Health Sciences Center, Houston, TX, USA
| | - Sujith V Cherian
- Divisions of Critical Care, Pulmonary and Sleep Medicine, McGovern Medical School at the University of Texas Health Sciences Center, Houston, TX, USA
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14
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Leading Factors for Weight Gain during COVID-19 Lockdown in a Spanish Population: A Cross-Sectional Study. Nutrients 2021; 13:nu13030894. [PMID: 33801989 PMCID: PMC8000852 DOI: 10.3390/nu13030894] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 02/27/2021] [Accepted: 03/04/2021] [Indexed: 12/31/2022] Open
Abstract
The increase in sedentary behaviors during the COVID-19-induced lockdown may have led to a significant weight gain. To investigate this hypothesis, a representative sample of the Spanish adult population comprising 1000 subjects was enrolled in a cross-sectional study between 26 May and 10 June 2020. Computer-assisted telephone interviews were conducted consisting of 29 questions on the topic of lifestyle habits during the lockdown. The cohort comprised 51.5% women and 51% overweight or obese subjects and had a mean age of 50 ± 18 years. Of the respondents, 44.5% self-reported weight gain during the lockdown; of these, 58.0% were women, 69.9% had previous excess weight, 44.7% lived with a relative who also gained weight, and 73.5 experienced increased appetite. Further, an increased consumption of energy-dense products was found relative to respondents who did not gain weight (p ≤ 0.016 for all). Additionally, respondents were unaware that obesity is a poor prognostic factor for COVID-19 infection, lived in smaller flats, and had a lower level of education and lower monthly income. The factors independently associated with weight gain were female gender, previous overweight or obesity, lack of food care, increased appetite, and increased consumption of sugar-sweetened beverages, alcoholic beverages, and snacks (p ≤ 0.023 for all). Should another lockdown be mandated, extra caution is warranted to prevent weight gain.
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15
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Laolob T, Bunyapraphatsara N, Waranuch N, Pongcharoen S, Punyain W, Chancharunee S, Sakchaisri K, Pratuangdejkul J, Chongruchiroj S, Kielar F, Wichai U. Enhancement of Lipolysis in 3T3-L1 Adipocytes by Nitroarene Capsaicinoid Analogs. Nat Prod Commun 2021. [DOI: 10.1177/1934578x20987949] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Transient receptor potential vanilloid 1 (TRPV1) activation by capsaicin binding increased intracellular calcium influx and stimulated adipocyte-to-adipocyte communication, leading to lipolysis. Generally, enhancement of π-stacking capabilities improves certain binding interactions. Notably, nitroarenes exhibit strong binding interactions with aromatic amino acid side chains in proteins. New capsaicinoid analogs were designed by substitution of the OCH3 group with a nitrogen dioxide (NO2) group on the vanillyl ring to investigate how π-stacking interactions in capsaicinoid analogs contribute to lipolysis. Capsaicinoid analogs, nitro capsaicin (5), and nitro dihydrocapsaicin (6) were prepared in moderate yields via coupling of a nitroaromatic amine salt and fatty acids. Oil Red O staining and triglyceride assays with 10 µM loading of capsaicin (CAP), dihydrocapsaicin (DHC), 5, and 6 were performed to investigate their effect on lipolysis in 3T3-L1 adipocytes. Both assay results indicated that 5 and 6 decreased lipid accumulation by 13.6% and 14.7%, respectively, and significantly reduced triglyceride content by 26.9% and 28.4%, respectively, in comparison with the control experiment. Furthermore, the decrease in triglyceride content observed in response to nitroarene capsaicinoid analogs was approximately 2-folds higher than that of CAP and DHC. These results arose from the NO2 group augmented π-π stacking with Tyr511 and the attractive charge interaction with Glu570 affecting binding interactions with TRPV1 receptors.
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Affiliation(s)
- Thanet Laolob
- Department of Chemistry, Faculty of Science, Naresuan University, Phitsanulok, Thailand
| | | | - Neti Waranuch
- Department of Pharmaceutical Technology, Faculty of Pharmaceutical Sciences, Naresuan University, Phitsanulok, Thailand
| | - Sutatip Pongcharoen
- Department of Medicine, Faculty of Medicine, Naresuan University, Phitsanulok, Thailand
| | - Wikorn Punyain
- Department of Chemistry, Faculty of Science, Naresuan University, Phitsanulok, Thailand
| | - Sirirat Chancharunee
- Department of Chemistry, Faculty of Science, Chiang Mai University, Chiang Mai, Thailand
| | - Krisada Sakchaisri
- Department of Pharmacology, Faculty of Pharmacy, Mahidol University, Bangkok, Thailand
| | | | - Sumet Chongruchiroj
- Department of Microbiology, Faculty of Pharmacy, Mahidol University, Bangkok, Thailand
| | - Filip Kielar
- Department of Chemistry and Center of Excellence in Biomaterials, Naresuan University, Phitsanulok, Thailand
| | - Uthai Wichai
- Department of Chemistry and Center of Excellence in Biomaterials, Naresuan University, Phitsanulok, Thailand
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16
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Cortes-Telles A, Ortiz-Farias DL, Pou-Aguilar YN, Almeida-de-la-Cruz L, Perez-Padilla JR. Clinical impact of obesity on respiratory diseases: A real-life study. Lung India 2021; 38:321-325. [PMID: 34259169 PMCID: PMC8272433 DOI: 10.4103/lungindia.lungindia_701_20] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Background Obesity has become an epidemic that affects Mexico; significantly interferes with respiratory physiology by decreasing lung volumes, therefore, might be considered as a relevant risk factor associated with the development of respiratory diseases. Objective Our primary outcome was to analyze the frequency and risk factors between obesity and respiratory disease in the Mexican population. Materials and Methods An observational, single-center, descriptive study, which included the totality of patients who were referred for medical attention at the Respiratory and Thorax Surgery Unit at the Hospital Regional de Alta Especialidad de la Península de Yucatán during the period from January 2015 to December 2018. The cases were grouped based on the existence or not of respiratory disease and the presence or absence of obesity (body mass index [BMI] >30 kg/m2). Results A total of 1167 patients were included; about 39% of the population had average BMI 36.5 kg/m2. The primary respiratory diseases in obese patients were Obstructive Sleep Apnea Syndrome (OSAS, 19%) and asthma (15%). The logistic regression analysis showed a direct association between the presence of obesity with respiratory disease (odds ratio 1.58, 95% confidence interval 1.22-2.03, P < 0.001), the strength of this association was related with asthma and OSAS. Conclusion The presence of obesity is an independent risk factor for respiratory disease, primarily for OSAS and asthma.
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Affiliation(s)
- Arturo Cortes-Telles
- Respiratory and Thoracic Surgery Unit, Hospital Regional de Alta Especialidad de la Península de Yucatán, Mérida, Mexico
| | - Diana Lizbeth Ortiz-Farias
- Respiratory and Thoracic Surgery Unit, Hospital Regional de Alta Especialidad de la Península de Yucatán, Mérida, Mexico
| | - Yuri NoemI Pou-Aguilar
- Respiratory and Thoracic Surgery Unit, Hospital Regional de Alta Especialidad de la Península de Yucatán, Mérida, Mexico
| | - Luis Almeida-de-la-Cruz
- Respiratory and Thoracic Surgery Unit, Hospital Regional de Alta Especialidad de la Península de Yucatán, Mérida, Mexico
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17
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Payen F, Greil A, Caillaud D. [Obesity hypoventilation syndrome and initial compliance with non-invasive ventilation]. Rev Mal Respir 2020; 37:783-789. [PMID: 33071059 DOI: 10.1016/j.rmr.2020.09.003] [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: 05/07/2020] [Accepted: 08/06/2020] [Indexed: 11/16/2022]
Abstract
INTRODUCTION The obesity hypoventilation syndrome (OHS) has an increasing prevalence. Compliance with first-line non-invasive ventilation has not been evaluated, taking into account patients' initial comorbidities. This study consisted of identification of the factors associated with compliance with non-invasive ventilation during the first six months of use. METHODS A monocentric retrospective study, gathering patients from the pneumology department of Gabriel-Montpied hospital in Clermont-Ferrand, from April 2010 to October 2019. The analysis was carried-out through the collection of computerised medical records (age, mode of entry, patient comorbidities) and compliance reports (average daily hours of use) provided by the regional service provider for the Auvergne area (AIRRA). RESULTS Being hospitalized for an acute exacerbation and being older than seventy-five years were factors associated with an improved compliance to non-invasive ventilation, with an increase of 1.47h/d and 2.73h/d (P value: 0.018 and 0.02, respectively). Moreover, patients with obstructive sleep apnea hypopnea syndrome and recipients of therapeutic education may prove more compliant over time. CONCLUSION Age greater than seventy-five years and being hospitalized for an acute exacerbation are predictors of better use of non-invasive ventilation in OHS.
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Affiliation(s)
- F Payen
- Service de pneumologie, CHU Gabriel-Montpied, université Clermont-Auvergne, 58, rue Montalembert, 63000 Clermont-Ferrand, France.
| | - A Greil
- Service de pneumologie, CHU Gabriel-Montpied, université Clermont-Auvergne, 58, rue Montalembert, 63000 Clermont-Ferrand, France
| | - D Caillaud
- Service de pneumologie, CHU Gabriel-Montpied, université Clermont-Auvergne, 58, rue Montalembert, 63000 Clermont-Ferrand, France
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18
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Kang Z, Luo S, Gui Y, Zhou H, Zhang Z, Tian C, Zhou Q, Wang Q, Hu Y, Fan H, Hu D. Obesity is a potential risk factor contributing to clinical manifestations of COVID-19. Int J Obes (Lond) 2020; 44:2479-2485. [PMID: 32921796 PMCID: PMC7487073 DOI: 10.1038/s41366-020-00677-2] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 08/02/2020] [Accepted: 09/03/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND Since December 2019, novel coronavirus (SARS-CoV-2)-induced pneumonia (COVID-19) occurred in Wuhan, and rapidly spread throughout China. COVID-19 patients demonstrated significantly different outcomes in clinic. We aimed to figure out whether obesity is a risk factor influencing the progression and prognosis of COVID-19. METHODS 95 patients with COVID-19 were divided into obesity group and non-obesity group according to their body mass index (BMI). The demographic data, clinical characteristics, laboratory examination, and chest computed tomography (CT) were collected, analyzed and compared between two groups. RESULTS Our data showed that COVID-19 patients with obesity had more underlying diseases and higher mortality rate compared to those without obesity. Furthermore, patients with obesity also demonstrated more severe pathological change in lung and higher blood lymphocytes, triglycerides, IL-6, CRP, cystatin C, alanine aminotransferase (ALT), erythrocyte sedimentation rate (ESR), which may greatly influence disease progression and poor prognosis of COVID-19. CONCLUSIONS It suggest that obesity contributes to clinical manifestations and may influence the progression and prognosis of COVID-19 and it is considered as a potential risk factor of the prognosis of COVID-19. Special medical care and appropriate intervention should be performed in obesity patients with COVID-19 during hospitalization and later clinical follow-up, especially for those with additional other comorbidities.
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Affiliation(s)
- Zhenyu Kang
- Department of Integrated Traditional Chinese and Western Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Shanshan Luo
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Yang Gui
- Department of Integrated Traditional Chinese and Western Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Haifeng Zhou
- Department of Integrated Traditional Chinese and Western Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Zili Zhang
- Department of Integrated Traditional Chinese and Western Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Chunxia Tian
- Department of Integrated Traditional Chinese and Western Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Qiaoli Zhou
- Department of Integrated Traditional Chinese and Western Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Quansheng Wang
- Department of Integrated Traditional Chinese and Western Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Yu Hu
- Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Heng Fan
- Department of Integrated Traditional Chinese and Western Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Desheng Hu
- Department of Integrated Traditional Chinese and Western Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China. .,Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
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19
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Muscogiuri G, Pugliese G, Barrea L, Savastano S, Colao A. Commentary: Obesity: The "Achilles heel" for COVID-19? Metabolism 2020; 108:154251. [PMID: 32353356 PMCID: PMC7184987 DOI: 10.1016/j.metabol.2020.154251] [Citation(s) in RCA: 142] [Impact Index Per Article: 35.5] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Revised: 04/24/2020] [Accepted: 04/25/2020] [Indexed: 12/18/2022]
Affiliation(s)
- Giovanna Muscogiuri
- Department of Clinical Medicine and Surgery, Endocrinology Unit, University Federico II, Naples, Italy; Centro italiano per la cura e il benessere del paziente (C.I.B.O), Department of Clinical Medicine and Surgery, Endocrinology Unit, University Federico II, Naples, Italy.
| | - Gabriella Pugliese
- Department of Clinical Medicine and Surgery, Endocrinology Unit, University Federico II, Naples, Italy; Centro italiano per la cura e il benessere del paziente (C.I.B.O), Department of Clinical Medicine and Surgery, Endocrinology Unit, University Federico II, Naples, Italy
| | - Luigi Barrea
- Department of Clinical Medicine and Surgery, Endocrinology Unit, University Federico II, Naples, Italy; Centro italiano per la cura e il benessere del paziente (C.I.B.O), Department of Clinical Medicine and Surgery, Endocrinology Unit, University Federico II, Naples, Italy
| | - Silvia Savastano
- Department of Clinical Medicine and Surgery, Endocrinology Unit, University Federico II, Naples, Italy; Centro italiano per la cura e il benessere del paziente (C.I.B.O), Department of Clinical Medicine and Surgery, Endocrinology Unit, University Federico II, Naples, Italy
| | - Annamaria Colao
- Department of Clinical Medicine and Surgery, Endocrinology Unit, University Federico II, Naples, Italy; Centro italiano per la cura e il benessere del paziente (C.I.B.O), Department of Clinical Medicine and Surgery, Endocrinology Unit, University Federico II, Naples, Italy; Cattedra Unesco "Educazione alla salute e allo sviluppo sostenibile", University Federico II, Naples, Italy
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20
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Hatem AM, Ismail MS, El-Hinnawy YH. Effect of different classes of obesity on the pulmonary functions among adult Egyptians: a cross-sectional study. THE EGYPTIAN JOURNAL OF BRONCHOLOGY 2019. [DOI: 10.4103/ejb.ejb_21_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Duymaz T, Karabay O, Ural IH. The Effect of Chest Physiotherapy After Bariatric Surgery on Pulmonary Functions, Functional Capacity, and Quality of Life. Obes Surg 2019; 30:189-194. [DOI: 10.1007/s11695-019-04165-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Royer CP, Schweiger C, Manica D, Rabaioli L, Guerra V, Sbruzzi G. Reply – Letter to the editor. Sleep Med 2019; 59:99-100. [DOI: 10.1016/j.sleep.2019.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Concerns regarding the use of continuous positive airway pressure to treat stable patients with obesity hypoventilation syndrome. Sleep Med 2019; 59:98. [DOI: 10.1016/j.sleep.2019.01.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2018] [Accepted: 01/21/2019] [Indexed: 11/20/2022]
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Özbey Ü, Balaban S, Sözener ZÇ, Uçar A, Mungan D, Mısırlıgil Z. The effects of diet-induced weight loss on asthma control and quality of life in obese adults with asthma: a randomized controlled trial. J Asthma 2019; 57:618-626. [PMID: 30907198 DOI: 10.1080/02770903.2019.1590594] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Objective: While the effects of obesity on asthma are yet to be fully clarified, increased fat tissue is known to increase the severity of asthma and to impair asthma control. This study evaluated the effects of diet-induced weight loss on the characteristics of asthma in obese adults with asthma.Methods: A total of 55 obese individuals (BMI ≥ 30.0) with asthma were enrolled in the study and randomized into the diet or control groups. The anthropometric measurements, asthma control test (ACT) scores, asthma quality of life questionnaire (AQLQ) scores, pulmonary function tests (PFT) and daily food consumption of the participants were recorded and compared at the baseline and at study completion.Results: The changes recorded in body weight (diet -5.2 (4, 5); control, -0.1 (1.3)), ACT score (diet 2.0 (2.0); control 0.0 (1.7)) and AQLQ score (diet 0.8 ± 0.1; control -0.02 ± 0.5) of the participants in the diet group were significantly higher than in the control group (p = 0.00). The increases in forced expiratory volume in one second (FEV1) and the forced vital capacity (FVC) measurements of the participants with weight loss of ≥5.0 percent were significant when compared to those with weight loss of <5.0 percent (p < 0.05). While total energy uptake and carbohydrate consumption at the end of study were found to be decreased in the diet group, they had increased in the control group (p < 0.05).Conclusion: Diet intervention improved asthma control and quality of life in obese patients with controlled asthma in this study. However to generalize this finding to all asthma patients, further studies including uncontrolled asthmatics are needed.
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Affiliation(s)
- Ümüş Özbey
- Department of Nutrition and Diet, Ankara University, Ankara, Turkey
| | - Serap Balaban
- Department of Nutrition and Diet, Ankara University, Ankara, Turkey
| | - Zeynep Çelebi Sözener
- Department of Immunology and Allergy, Ankara University Medical Faculty, Ankara, Turkey
| | - Aslı Uçar
- Department of Nutrition and Diet, Ankara University, Ankara, Turkey
| | - Dilşad Mungan
- Department of Immunology and Allergy, Ankara University Medical Faculty, Ankara, Turkey
| | - Zeynep Mısırlıgil
- Department of Immunology and Allergy, Ankara University Medical Faculty, Ankara, Turkey
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Modena DAO, Moreira MM, Paschoal IA, Pereira MC, Martins LC, Cazzo E, Chaim EA. Respiratory evaluation through volumetric capnography among grade III obese and eutrophic individuals: a comparative study. SAO PAULO MED J 2019; 137:177-183. [PMID: 29340500 PMCID: PMC9721226 DOI: 10.1590/1516-3180.2017.0085011017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Accepted: 10/01/2017] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Excess trunk body fat in obese individuals influences respiratory physiological function. The aims of this study were to compare volumetric capnography findings (VCap) between severely obese patients and normal-weight subjects and to assess whether there is any association between neck circumference (NC), waist-hip ratio (WHR) and VCap among grade III obese individuals. DESIGN AND SETTING Analytical observational case-matched cross-sectional study, University of Campinas. METHODS This cross-sectional study compared VCap variables between 60 stage III obese patients and 60 normal-weight individuals. RESULTS In comparison with the normal-weight group, obese patients presented higher alveolar minute volume (8.92 ± 4.94 versus 6.09 ± 2.2; P = < 0.0001), CO2 production (278 ± 91.0 versus 209 ± 60.23; P < 0.0001), expiratory tidal volume (807 ± 365 versus 624 ± 202; P = 0.005), CO2 production per breath (21.1 ± 9.7 versus 16.7 ± 6.16; P = 0.010) and peak expiratory flow (30.9 ± 11.9 versus 25.5 ± 9.13; P = 0.004). The end-expiratory CO2 (PetCO2) concentration (33.5 ± 4.88 versus 35.9 ± 3.79; P = 0.013) and the phase 3 slope were normalized according to expired tidal volume (0.02 ± 0.05 versus 0.03 ± 0.01; P = 0.049) were lower in the obese group. CONCLUSIONS The greater the NC was, the larger were the alveolar minute volume, anatomical dead space, CO2 production per minute and per breath and expiratory volume; whereas the smaller were the phase 2 slope (P2Slp), phase 3 slope (P3Slp) and pressure drop in the mouth during inspiration.
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Affiliation(s)
| | - Marcos Mello Moreira
- PT, PhD. Professor, Universidade Estadual de Campinas (UNICAMP), Campinas (SP), Brazil.
| | - Ilma Aparecida Paschoal
- MD, PhD. Pneumologist and Professor, Universidade Estadual de Campinas (UNICAMP), Campinas (SP), Brazil.
| | - Mônica Corso Pereira
- MD, PhD. Pneumologist and Professor, Universidade Estadual de Campinas (UNICAMP), Campinas (SP), Brazil.
| | - Luiz Cláudio Martins
- MD, PhD. Pneumologist and Professor, Universidade Estadual de Campinas (UNICAMP), Campinas (SP), Brazil.
| | - Everton Cazzo
- MD, PhD. Attending Physician and Assistant Lecturer, Universidade Estadual de Campinas (UNICAMP), Campinas (SP), Brazil.
| | - Elinton Adami Chaim
- MD, PhD. General Surgeon and Professor, Universidade Estadual de Campinas (UNICAMP), Campinas (SP), Brazil.
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Abstract
Objective: While the effects of obesity on asthma are unclear, an increased body mass index (BMI) is known to enhance the symptoms and severity of asthma and to impair asthma control. The present study evaluates the effects of nutritional habits and obesity on pulmonary function and asthma control in individuals with asthma. Methods: This cross-sectional study included 60 obese respondents and 60 respondents with normal body weight, who were referred to pulmonology clinics over a period of 2 months. The anthropometric measurements and macro–micro nutrient consumption records of the patients in both groups were obtained, and the two groups were compared in terms of pulmonary function and asthma control test (ACT) scores. Results: The mean age of the normal weight and obese respondents was 39.55 ± 11.0 and 45.1 ± 10.3 years, respectively. The ACT scores of the respondents decreased significantly with increasing BMI, waist circumference (WC), and waist–hip ratio (WHR) measurements (P < 0.05). The obese respondents had a lower mean forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), midexpiratory flow (MEF) between 25% and 75% of the maximal expiration (MEF25–75), MEF75, MEF50, MEF25, and FEV1/FVC values when compared to the respondents with normal weight (P < 0.05). The total energy and carbohydrate intake was higher in the obese respondents, while their total protein intake was lower when compared to the normal weight respondents (P < 0.05), and a significant positive correlation was found between the omega 3 intake and ACT scores of the respondents (P < 0.05). Conclusions: Pulmonary functions and ACT scores decrease with increasing BMI, WC, and WHR. Obese respondents with asthma should be referred to diet clinics to improve their asthma symptoms.
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Affiliation(s)
- Ümüş Özbey
- Department of Nutrition and Diet, Health Science Faculty, Ankara University, Ankara, Turkey
| | - Uçar Ucar
- Department of Nutrition and Diet, Health Science Faculty, Ankara University, Ankara, Turkey
| | - Aliye Gamze Calis
- Department of Chest Disease, Medicine Faculty, Akdeniz University, Antalya, Turkey
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Byard RW, Omond KJ, Langlois NE. Is Obesity a Factor in Sudden Asthmatic Deaths? AUST J FORENSIC SCI 2018. [DOI: 10.1080/00450618.2017.1296188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Roger W. Byard
- Forensic Science SA , 21 Divett Place, Adelaide 5000, Australia
- Discipline of Anatomy and Pathology, The University of Adelaide , Frome Road, Level 3 Medical School North Building, Adelaide, SA, 5005, Australia
| | - Kimberley J. Omond
- Forensic Science SA , 21 Divett Place, Adelaide 5000, Australia
- Discipline of Anatomy and Pathology, The University of Adelaide , Frome Road, Level 3 Medical School North Building, Adelaide, SA, 5005, Australia
| | - Neil E.I. Langlois
- Forensic Science SA , 21 Divett Place, Adelaide 5000, Australia
- Discipline of Anatomy and Pathology, The University of Adelaide , Frome Road, Level 3 Medical School North Building, Adelaide, SA, 5005, Australia
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Zewari S, Vos P, van den Elshout F, Dekhuijzen R, Heijdra Y. Obesity in COPD: Revealed and Unrevealed Issues. COPD 2017; 14:663-673. [DOI: 10.1080/15412555.2017.1383978] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Affiliation(s)
- S. Zewari
- Department of Pulmonary Disease, Rijnstate hospital, Arnhem, The Netherlands
| | - P. Vos
- Department of Pulmonary Disease, Rijnstate hospital, Arnhem, The Netherlands
| | - F. van den Elshout
- Department of Pulmonary Disease, Rijnstate hospital, Arnhem, The Netherlands
| | - R. Dekhuijzen
- Department of Pulmonary Disease, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
| | - Y. Heijdra
- Department of Pulmonary Disease, Radboud University Nijmegen Medical Centre, Nijmegen, The Netherlands
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Porhomayon J, Pourafkari L, El-Solh A, Nader ND. Novel therapies for perioperative respiratory complications. J Cardiovasc Thorac Res 2017; 9:121-126. [PMID: 29118943 PMCID: PMC5670332 DOI: 10.15171/jcvtr.2017.21] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2017] [Accepted: 08/06/2017] [Indexed: 12/14/2022] Open
Abstract
Postoperative respiratory complications are of paramount clinical importance as they prolong the hospitalization, increase the costs of treatment and contribute to the perioperative mortality. Obesity, preexisting pulmonary disease and advanced age are known risk factors for developing postoperative respiratory complications, which affect exceeding number of patients. Hereby, we present a review on the pathogenesis of post-operative respiratory complications particularly in obese and older patients. We further focus on the standard management and emerging therapies for the post-operative respiratory complications.
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Affiliation(s)
- Jahan Porhomayon
- Clinical Professor of Anesthesiology and Critical Care Medicine, Division of Critical Care Medicine, Buffalo, NY, USA.,State University of New York at Buffalo, Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, USA
| | - Leili Pourafkari
- Cardiovascular Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ali El-Solh
- State University of New York at Buffalo, Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, USA
| | - Nader D Nader
- State University of New York at Buffalo, Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, USA
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Ohlsson MA, Kennedy LMA, Juhlin T, Melander O. Midlife risk factor exposure and incidence of cardiac arrest depending on cardiac or non-cardiac origin. Int J Cardiol 2017; 240:398-402. [PMID: 28487155 DOI: 10.1016/j.ijcard.2017.05.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Revised: 03/07/2017] [Accepted: 05/02/2017] [Indexed: 12/27/2022]
Abstract
OBJECTIVE Little is known about midlife risk factors of future cardiac arrest. Our objective was to evaluate cardiovascular risk factors in midlife in relation to the risk of cardiac arrest (CA) of cardiac and non-cardiac origin later in life. METHODS We cross-matched individuals of the population based Malmö Diet and Cancer study (n=30,447) with the local CA registry of the city of Malmö. Baseline exposures were related to incident CA. RESULTS During a mean follow-up of 17.6±4.6years, 378 CA occurred, of whom 17.2% survived to discharge. Independent midlife risk factors for CA of cardiac origin included coronary artery disease {HR 2.84 (1.86-4.34) (p<0.001)}, diabetes mellitus {HR 2.37 (1.61-3.51) (p<0.001)} and smoking {HR 1.95 (1.49-2.55) (p<0.001)}. Dyslipidemia and history of stroke were also significantly associated with an elevated risk for CA of cardiac origin. Independent midlife risk factors for CA of non-cardiac origin included obesity (BMI>30kg/m2) {HR 2.37 (1.51-3.71) (p<0.001)}, smoking {HR 2.05 (1.33-3.15) (p<0.001)} and being on antihypertensive treatment {HR 2.25 (1.46-3.46) (p<0.001)}. CONCLUSION Apart from smoking, which increases the risk of CA in general, the midlife risk factor pattern differs between CA of cardiac and non-cardiac origin. Whereas CA of cardiac origin is predicted by history of cardiovascular disease, dyslipidemia and diabetes mellitus, the main risk factors for CA of non-cardiac origin are obesity and hypertension. In addition to control of classical cardiovascular risk factors for prevention of CA, our results suggest that prevention of midlife obesity may reduce the risk of CA of non-cardiac origin.
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Affiliation(s)
- Marcus Andreas Ohlsson
- Department of Internal Medicine, Skåne University Hospital, Malmö, Sweden; Department of Clinical Sciences, Lund University, Malmö, Sweden.
| | - Linn Maria Anna Kennedy
- Department of Internal Medicine, Skåne University Hospital, Malmö, Sweden; Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Tord Juhlin
- Department of Cardiology, Lund University, Malmö, Sweden; Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Olle Melander
- Department of Internal Medicine, Skåne University Hospital, Malmö, Sweden; Department of Clinical Sciences, Lund University, Malmö, Sweden
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Ruiz AJ, Rondon Sepúlveda MA, Franco OH, Cepeda M, Hidalgo Martinez P, Amado Garzón SB, Salazar Ibarra ER, Otero Mendoza L. The associations between sleep disorders and anthropometric measures in adults from three Colombian cities at different altitudes. Maturitas 2016; 94:1-10. [DOI: 10.1016/j.maturitas.2016.08.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2016] [Revised: 07/30/2016] [Accepted: 08/19/2016] [Indexed: 12/26/2022]
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Gable BD, Gardner AK, Celik DH, Bhalla MC, Ahmed RA. Improving bariatric patient transport and care with simulation. West J Emerg Med 2015; 15:199-204. [PMID: 24672612 PMCID: PMC3966441 DOI: 10.5811/westjem.2013.12.18855] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2013] [Revised: 11/15/2013] [Accepted: 12/03/2013] [Indexed: 01/22/2023] Open
Abstract
Introduction Obesity is prevalent in the United States. Obese patients have physiologic differences from non-obese individuals. Not only does transport and maintenance of these patients require use of specialized equipment, but it also requires a distinct skill set and knowledge base. To date, there is no literature investigating simulation as a model for educating pre-hospital providers in the care of bariatric patients. The purpose of this study was to determine if a 3-hour educational course with simulation could improve paramedics’ knowledge and confidence of bariatric procedures and transport. This study also examined if prior experience with bariatric transport affected training outcomes. Methods Our study took place in August 2012 during paramedic training sessions. Paramedics completed a pre- and post-test that assessed confidence and knowledge and provided information on previous experience. They had a 30-minute didactic and participated in 2 20-minute hands-on skills portions that reviewed procedural issues in bariatric patients, including airway procedures, peripheral venous and intraosseous access, and cardiopulmonary resuscitation. Study participants took part in one of two simulated patient encounters. Paramedics were challenged with treating emergent traumatic and/or medical conditions, as well as extricating and transporting bariatric patients. Each group underwent a debriefing of the scenario immediately following their case. We measured confidence using a 5-point Likert-type response scale ranging from 1 (strongly disagree) to 5 (strongly agree) on a 7-item questionnaire. We assessed knowledge with 12 multiple choice questions. Paired-sample t-tests were used to compare pre- and post-simulation confidence and knowledge with a significance level of p≤0.05. We used analysis of covariance to examine the effect of previous experiences on pre-and post-educational activity confidence and knowledge with a significance level of p ≤0.05. Proportions and 95% confidence intervals are presented as appropriate. We determined the magnitude of significant pre-post differences with Cohen’s d. We assessed scale reliability using Cronbach’s alpha and was found to be reliable with scores of 0.83 and 0.88 across pre- and post-test responses, respectively. Results Participants exhibited a significant increase in confidence in performing procedures (p<0.01) and knowledge of bariatric patient management (p<0.001) after the simulation. The current study also found an increase in knowledge of transport, vascular access/circulation and airway management (p<0.001). Participant background showed no effects on these changes. Conclusion This study suggests that simulation paired with a didactic is an effective method of education for paramedics caring for and transporting bariatric patients. The data show a significant increase in knowledge and confidence with a 3-hour training session, irrespective of previous training or experience with bariatric patients. This is the first study of its kind to apply simulation training for the pre-hospital care of bariatric patients.
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Affiliation(s)
- Brad D Gable
- Summa Akron City Hospital, Department of Emergency Medicine, Akron, Ohio ; Ohio University Heritage College of Osteopathic Medicine, Athens, Ohio
| | - Aimee K Gardner
- University of Texas Southwestern Medical Center, Dallas, Texas
| | - Dan H Celik
- Summa Akron City Hospital, Department of Emergency Medicine, Akron, Ohio
| | - Mary Colleen Bhalla
- Summa Akron City Hospital, Department of Emergency Medicine, Akron, Ohio ; Northeast Ohio Medical University, Department of Emergency Medicine, Rootstown, Ohio
| | - Rami A Ahmed
- Summa Akron City Hospital, Department of Emergency Medicine, Akron, Ohio ; Northeast Ohio Medical University, Department of Emergency Medicine, Rootstown, Ohio
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Couillard A, Pepin JL, Rabec C, Cuvelier A, Portmann A, Muir JF. Ventilation non invasive : efficacité d’un nouveau mode ventilatoire chez les patients atteints du syndrome obésité-hypoventilation. Rev Mal Respir 2015; 32:283-90. [PMID: 25847207 DOI: 10.1016/j.rmr.2014.02.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2013] [Accepted: 02/12/2014] [Indexed: 11/26/2022]
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Noninvasive Mechanical Ventilation in Patients With Obesity Hypoventilation Syndrome. Long-term Outcome and Prognostic Factors. ACTA ACUST UNITED AC 2015. [DOI: 10.1016/j.arbr.2014.06.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Abstract
BACKGROUND Obesity is associated with reduced pulmonary function. We evaluated pulmonary function and status of asthma and obstructive sleep apnoea syndrome (OSAS) before and 5 years after bariatric surgery. METHODS Spirometry was performed at baseline and 5 years postoperatively. Information of asthma and OSAS were recorded. Of 113 patients included, 101 had undergone gastric bypass, 10 duodenal switch and 2 sleeve gastrectomy. RESULTS Eighty (71%) patients were women, mean preoperative age was 40 years and preoperative weight was 133 kg in women and 158 kg in men. Five years postoperatively, weight reduction was 31% (42 kg; p < 0.001) in women and 24% (38 kg; p < 0.001) in men. Forced expiratory volume in 1 s (FEV1) increased 4.1% (116 ml; p < 0.001) in women and 6.7% (238 ml; p = 0.003) in men. Forced vital capacity (FVC) increased 5.8% (209 ml; p < 0.001) in women and 7.6% (349 ml; p < 0.001) in men. Gender and weight loss were independently associated with the improvements in FEV1 and FVC. At follow-up, FEV1 had increased 36% of the difference towards the estimated normal FEV1, and there was a corresponding 70% recovery of FVC. These improvements occurred despite an expected decline in pulmonary function by age during the study period. Of the asthmatics and OSAS patients, 48 and 80%, respectively, were without symptoms 5 years postoperatively. CONCLUSIONS Pulmonary function measured with spirometry was significantly improved 5 years after bariatric surgery, despite an expected age-related decline during this period. Symptoms of asthma and OSAS also improved.
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Melo LC, Silva MAMD, Calles ACDN. Obesity and lung function: a systematic review. EINSTEIN-SAO PAULO 2014; 12:120-5. [PMID: 24728258 PMCID: PMC4898251 DOI: 10.1590/s1679-45082014rw2691] [Citation(s) in RCA: 127] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2012] [Accepted: 11/30/2013] [Indexed: 12/15/2022] Open
Abstract
Obesity is a chronic disease characterized by the excessive accumulation of body fat that is harmful to the individuals. Respiratory disorders are among the comorbidities associated with obesity. This study had the objective of investigating the alterations in respiratory function that affect obese individuals. A systematic review was performed, by selecting publications in the science databases MEDLINE and LILACS, using PubMed and SciELO. The articles that assessed pulmonary function by plethysmography and/or spirometry in obese individuals aged under 18 years were included. The results demonstrated that the obese individuals presented with a reduction in lung volume and capacity as compared to healthy individuals. Reduction of total lung capacity and reduction of forced vital capacity, accompanied by reduction of the forced expiratory volume after one second were the most representative findings in the samples. The articles analyzed proved the presence of a restrictive respiratory pattern associated with obesity.
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Held M, Mittnacht M, Kolb M, Karl S, Jany B. Pulmonary and cardiac function in asymptomatic obese subjects and changes following a structured weight reduction program: a prospective observational study. PLoS One 2014; 9:e107480. [PMID: 25233078 PMCID: PMC4169401 DOI: 10.1371/journal.pone.0107480] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2014] [Accepted: 08/11/2014] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND The prevalence of obesity is rising. Obesity can lead to cardiovascular and ventilatory complications through multiple mechanisms. Cardiac and pulmonary function in asymptomatic subjects and the effect of structured dietary programs on cardiac and pulmonary function is unclear. OBJECTIVE To determine lung and cardiac function in asymptomatic obese adults and to evaluate whether weight loss positively affects functional parameters. METHODS We prospectively evaluated bodyplethysmographic and echocardiographic data in asymptomatic subjects undergoing a structured one-year weight reduction program. RESULTS 74 subjects (32 male, 42 female; mean age 42±12 years) with an average BMI 42.5±7.9, body weight 123.7±24.9 kg were enrolled. Body weight correlated negatively with vital capacity (R = -0.42, p<0.001), FEV1 (R = -0.497, p<0.001) and positively with P 0.1 (R = 0.32, p = 0.02) and myocardial mass (R = 0.419, p = 0.002). After 4 months the study subjects had significantly reduced their body weight (-26.0±11.8 kg) and BMI (-8.9±3.8) associated with a significant improvement of lung function (absolute changes: vital capacity +5.5±7.5% pred., p<0.001; FEV1+9.8±8.3% pred., p<0.001, ITGV+16.4±16.0% pred., p<0.001, SR tot -17.4±41.5% pred., p<0.01). Moreover, P0.1/Pimax decreased to 47.7% (p<0.01) indicating a decreased respiratory load. The change of FEV1 correlated significantly with the change of body weight (R = -0.31, p = 0.03). Echocardiography demonstrated reduced myocardial wall thickness (-0.08±0.2 cm, p = 0.02) and improved left ventricular myocardial performance index (-0.16±0.35, p = 0.02). Mitral annular plane systolic excursion (+0.14, p = 0.03) and pulmonary outflow acceleration time (AT +26.65±41.3 ms, p = 0.001) increased. CONCLUSION Even in asymptomatic individuals obesity is associated with abnormalities in pulmonary and cardiac function and increased myocardial mass. All the abnormalities can be reversed by a weight reduction program.
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Affiliation(s)
- Matthias Held
- Medical Mission Hospital, Academic Teaching Hospital, Julius Maximilian University of Würzburg, Department of Internal Medicine, Würzburg, Germany
| | - Maria Mittnacht
- Medical Mission Hospital, Academic Teaching Hospital, Julius Maximilian University of Würzburg, Department of Internal Medicine, Würzburg, Germany
| | - Martin Kolb
- Firestone Institute for Respiratory Health, Department of Medicine, Pathology & Molecular Medicine, McMaster University, Hamilton, ON, Canada
| | - Sabine Karl
- Institute of Mathematics, Julius Maximilian University of Würzburg, Würzburg, Germany
| | - Berthold Jany
- Medical Mission Hospital, Academic Teaching Hospital, Julius Maximilian University of Würzburg, Department of Internal Medicine, Würzburg, Germany
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Noninvasive mechanical ventilation in patients with obesity hypoventilation syndrome. Long-term outcome and prognostic factors. Arch Bronconeumol 2014; 51:61-68. [PMID: 24703500 DOI: 10.1016/j.arbres.2014.02.015] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2013] [Revised: 01/12/2014] [Accepted: 02/13/2014] [Indexed: 11/23/2022]
Abstract
INTRODUCTION Obesity is associated with 2 closely related respiratory diseases: obesity hypoventilation syndrome (OHS) and obstructive sleep apnea-hypopnea syndrome (OSAHS). It has been shown that noninvasive ventilation during sleep produces clinical and functional improvement in these patients. The long-term survival rate with this treatment, and the difference in clinical progress in OHS patients with and without OSAHS are analyzed. METHODOLOGY Longitudinal, observational study with a cohort of patients diagnosed with OHS, included in a home ventilation program over a period of 12 years, divided into 2 groups: pure OHS and OSAHS-associated OHS. Bi-level positive airway pressure ventilation was administered. During the follow-up period, symptoms, exacerbations and hospitalizations, blood gas tests and pulmonary function tests, and survival rates were monitored and compared. RESULTS Eighty-three patients were eligible for analysis, 60 women (72.3%) and 23 men (27.7%), with a mean survival time of 8.47 years. Fifty patients (60.2%) were included in the group without OSAHS (OHS) and 33 (39.8%) in the OSAHS-associated OHS group (OHS-OSAHS). PaCO₂ in the OHS group was significantly higher than in the OHS-OSAHS group (P<.01). OHS patients also had a higher hospitalization rate (P<.05). There was a significant improvement in both groups in FEV₁ and FVC, and no differences between groups in PaCO₂ and PaO₂ values. There were no differences in mortality between the 2 groups, but low FVC values were predictive of mortality. CONCLUSIONS The use of mechanical ventilation in patients with OHS, with or without OSAHS, is an effective treatment for the correction of blood gases and functional alterations and can achieve prolonged survival rates.
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Genoni G, Prodam F, Marolda A, Giglione E, Demarchi I, Bellone S, Bona G. Obesity and infection: two sides of one coin. Eur J Pediatr 2014; 173:25-32. [PMID: 24146165 DOI: 10.1007/s00431-013-2178-1] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2013] [Accepted: 10/07/2013] [Indexed: 12/15/2022]
Abstract
The prevalence of obesity has exponentially risen worldwide. The etiology of obesity is multifactorial, and genetic inheritance and behavioral/environmental causes are considered the main etiological factors. Moreover, evidence that specific infections might promote the development of obesity has steadily accumulated. Only a few works investigate the impact of obesity on the immune response to infections and the risk of infections in the obese population. The aim of this paper was to review the available data regarding the various aspects of the association between obesity and infections and to highlight the possibility that infectious agents may have an etiological role in obesity, an idea known as "infectobesity". Several microbes have been considered as possible promoter of obesity, but most of the data concern adenovirus-36 that exerts an adipogenic action mainly via a direct effect on adipose tissue leading to weight gain, at least in animal models.Obesity affects the immune response leading to an increased susceptibility to infections. Obese adults and children show an increased incidence of both nosocomial and community-acquired infections. Furthermore, obesity may alter the pharmacokinetics of antimicrobial drugs and impact on vaccine response. However, the various aspects of the association of obesity infections remain poorly studied, and a call to research is necessary to better investigate the problem.In conclusion, obesity impacts millions globally, and greater understanding of its etiology and its effects on immunity, infections, and prevention and management strategies is a key public health concern.
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Affiliation(s)
- Giulia Genoni
- SCDU of Pediatrics, Department of Health Sciences, Università del Piemonte Orientale "A. Avogadro", Via Solaroli 17, Novara, 28100, Italy,
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Verbraecken J, McNicholas WT. Respiratory mechanics and ventilatory control in overlap syndrome and obesity hypoventilation. Respir Res 2013; 14:132. [PMID: 24256627 PMCID: PMC3871022 DOI: 10.1186/1465-9921-14-132] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2013] [Accepted: 11/15/2013] [Indexed: 02/07/2023] Open
Abstract
The overlap syndrome of obstructive sleep apnoea (OSA) and chronic obstructive pulmonary disease (COPD), in addition to obesity hypoventilation syndrome, represents growing health concerns, owing to the worldwide COPD and obesity epidemics and related co-morbidities. These disorders constitute the end points of a spectrum with distinct yet interrelated mechanisms that lead to a considerable health burden. The coexistence OSA and COPD seems to occur by chance, but the combination can contribute to worsened symptoms and oxygen desaturation at night, leading to disrupted sleep architecture and decreased sleep quality. Alveolar hypoventilation, ventilation-perfusion mismatch and intermittent hypercapnic events resulting from apneas and hypopneas contribute to the final clinical picture, which is quite different from the “usual” COPD. Obesity hypoventilation has emerged as a relatively common cause of chronic hypercapnic respiratory failure. Its pathophysiology results from complex interactions, among which are respiratory mechanics, ventilatory control, sleep-disordered breathing and neurohormonal disturbances, such as leptin resistance, each of which contributes to varying degrees in individual patients to the development of obesity hypoventilation. This respiratory embarrassment takes place when compensatory mechanisms like increased drive cannot be maintained or become overwhelmed. Although a unifying concept for the pathogenesis of both disorders is lacking, it seems that these patients are in a vicious cycle. This review outlines the major pathophysiological mechanisms believed to contribute to the development of these specific clinical entities. Knowledge of shared mechanisms in the overlap syndrome and obesity hypoventilation may help to identify these patients and guide therapy.
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Affiliation(s)
- Johan Verbraecken
- Department of Pulmonary Medicine and Multidisciplinary Sleep Disorders Centre, Antwerp University Hospital and University of Antwerp, Wilrijkstraat 10, Edegem 2650, Belgium.
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Dimov D, Tacheva T, Koychev A, Ilieva V, Prakova G, Vlaykova T. Obesity in Bulgarian patients with chronic obstructive pulmonary disease. Chron Respir Dis 2013; 10:215-22. [DOI: 10.1177/1479972313504940] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
It has been well defined that obesity is strongly linked with several respiratory symptoms and diseases, but no convincing evidence has been provided for chronic obstructive pulmonary disease (COPD). In the current study, we aim to assess the possible prevalence of obesity in patients with COPD in a cross-sectional case–control study of individuals from the region of Stara Zagora, Bulgaria, and to explore whether the body mass has some effect on the lung function of COPD patients. The study included 158 patients with COPD (Global Initiative for Chronic Obstructive Lung Disease (GOLD) II, III, and IV stages) and 123 individuals unaffected by the disease (control). A higher frequency of obesity compared to the controls (20.3%) was observed in patients with COPD (29.1%, p = 0.093), especially in those with GOLD II stage (37.7%, p = 0.009). Prevalence of obesity was highest in COPD GOLD II, followed by GOLD III and IV stages ( p = 0.068). When diabetes was considered as confounding factor, we found a significant prevalence of obesity in COPD patients than the controls with diabetes ( p = 0.031). Interestingly, there was a statistically significant moderate positive correlation between the body mass index and forced expiratory volume in one second as a percentage of predicted value in the whole patients’ group ( R = 0.295, p = 0.0002) as well as in the subgroups of GOLD II ( R = 0.257, p = 0.024) and GOLD III COPD ( R = 0.259, p = 0.031).The results of our study propose that the increased body mass, particularly obesity is frequent comorbidity to COPD, especially to less severe diseases. Moreover, the results suggest that the higher body weight may provide some protection against the impairment of lung functions in patients with stable COPD.
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Affiliation(s)
- Dimo Dimov
- Department of Internal Medicine, Medical Faculty, Trakia University, Stara Zagora, Bulgaria
| | - Tanya Tacheva
- Department of Chemistry and Biochemistry, Medical Faculty, Trakia University, Stara Zagora, Bulgaria
| | - Atanas Koychev
- Department of Internal Medicine, Medical Faculty, Trakia University, Stara Zagora, Bulgaria
| | - Vanya Ilieva
- Department of Internal Medicine, Medical Faculty, Trakia University, Stara Zagora, Bulgaria
| | - Gospodinka Prakova
- Department of Internal Medicine, Medical Faculty, Trakia University, Stara Zagora, Bulgaria
| | - Tatyana Vlaykova
- Department of Chemistry and Biochemistry, Medical Faculty, Trakia University, Stara Zagora, Bulgaria
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Abstract
Drug abuse may involve illicit drugs, prescription drugs, or the combination of illicit and prescription drugs, with or without the use of alcohol. Historically, illicit drugs have been responsible for many of the drug-related deaths investigated by medical examiner and coroner offices. However, in more recent years, deaths resulting from prescription drugs have become increasingly more common. This study reviewed all accidental (unintentional) drug deaths that were investigated at a medical examiner's office over a one-year time frame. The study revealed that prescription drugs made up the largest category of drug deaths, followed by prescription drug/illicit drug combinations, followed by illicit drugs. Drugs capable of causing or contributing to significant respiratory insufficiency such as opioids, benzodiazepines, relaxants (defined as muscle relaxants or sleep medications), and alcohol, or some combination thereof, were detected in 197 out of 256 (77%) of all accidental drug deaths, and were detected in 132 out of 138 (95%) of all prescription drug deaths (cases without any illicit drugs detected). These prescription drugs were most often found in combination, and their similar respiratory depressant effects can be cumulative and deadly.
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Gonzalez-Barcala F, Pertega S, Perez-Castro T, Sampedro M, Sanchez-Lastres J, San-Jose-Gonzalez M, Bamonde L, Garnelo L, Valdés-Cuadrado L, Moure J, Carreira J, Lopez-Silvarrey A. Obesity and asthma: an association modified by age. Allergol Immunopathol (Madr) 2013; 41:176-80. [PMID: 23266140 DOI: 10.1016/j.aller.2012.05.011] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2012] [Accepted: 05/22/2012] [Indexed: 12/31/2022]
Abstract
BACKGROUND Some studies indicate some causal relationship between obesity and asthma, while others show inconsistent results. Our objective was to evaluate the prevalence of asthma according to obesity in children. METHODS A cross-sectional study, following the ISAAC study methodology, was conducted on two randomly selected groups consisting of 6-7 year-old children (n=7485) and 13-14 year-old adolescents (n=8496). The asthma symptoms and potential risk factors were determined from the questionnaire. Overweight and obesity were defined based on the body mass index. Multiple logistic regression was used to obtain adjusted prevalence odds ratios (OR) and 95% confidence intervals. RESULTS Obesity was associated with an increase in wheezing ever (OR: 1.35) and exercise-induced asthma (OR: 1.62) in the 6-7 year-old group. No significant relationship was observed in the adolescent population. CONCLUSION Obesity was associated with a higher prevalence of asthma in young children, but not in adolescents.
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Neef M, Weise S, Adler M, Sergeyev E, Dittrich K, Körner A, Kiess W. Health impact in children and adolescents. Best Pract Res Clin Endocrinol Metab 2013; 27:229-38. [PMID: 23731884 DOI: 10.1016/j.beem.2013.02.007] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Obesity in children and adolescents is associated with multiple comorbidities, including metabolic, cardiovascular, gastrointestinal, pulmonary, orthopedic and psychological disorders. In fact, cardiovascular and metabolic impairments in childhood and adolescence constitute major risk factors for developing cardiovascular disease in adulthood. Thus, obesity in childhood and adolescence leads to a higher morbidity and mortality in adulthood. Therefore, strong emphasis must be laid on the prevention and therapy of childhood obesity. Treatment requires a multidisciplinary and multiphase approach including dietary management, physical activity, pharmacotherapy and bariatric surgery. This paper reviews the different comorbidities of childhood obesity supporting the notion of a multidisciplinary therapy concept.
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Affiliation(s)
- M Neef
- Department of Women and Child Health, Hospital for Children and Adolescents, University of Leipzig, Liebigstraße 20a, D-04103 Leipzig, Germany.
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Emerenziani GP, Migliaccio S, Gallotta MC, Lenzi A, Baldari C, Guidetti L. Physical exercise intensity prescription to improve health and fitness in overweight and obese subjects: A review of the literature. Health (London) 2013. [DOI: 10.4236/health.2013.56a2017] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Carrillo A, Ferrer M, Gonzalez-Diaz G, Lopez-Martinez A, Llamas N, Alcazar M, Capilla L, Torres A. Noninvasive Ventilation in Acute Hypercapnic Respiratory Failure Caused by Obesity Hypoventilation Syndrome and Chronic Obstructive Pulmonary Disease. Am J Respir Crit Care Med 2012; 186:1279-85. [DOI: 10.1164/rccm.201206-1101oc] [Citation(s) in RCA: 137] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Porhomayon J, Nader ND, Leissner KB, El-Solh AA. Respiratory perioperative management of patients with obstructive sleep apnea. J Intensive Care Med 2012; 29:145-53. [PMID: 22588375 DOI: 10.1177/0885066612446411] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Obstructive sleep apnea (OSA) has become a major public health problem in the United State and Europe. However, perioperative strategies regarding diagnostic options and management of untreated OSA remain inadequate. Preoperative screening and identification of patients with undiagnosed OSA may lead to early perioperative interventions that may alter cardiopulmonary events associated with surgery and anesthesia.(1) Hence, clinicians need to become familiar with the preoperative screening and diagnosis of OSA. Perioperative management of a patient with OSA should be modified and may include regional anesthesia and alternative analgesic techniques such as nonsteroidal anti-inflammatory drugs that may reduce the need for systemic opioids. Additionally, supplemental oxygen and continuous pulse oximetry monitoring should be utilized to maintain baseline oxygen saturation. Postoperatively patients should remain in a semi-upright position and positive pressure therapy should be used in patients with high-risk OSA.
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Affiliation(s)
- Jahan Porhomayon
- Department of Anesthesiology, Division of Critical Care Medicine, Anesthesiology, and Critical Care Medicine, VA Western New York Healthcare System, State University of New York at Buffalo, School of Medicine and Biomedical Sciences, Buffalo, NY, USA
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Byard RW. The complex spectrum of forensic issues arising from obesity. Forensic Sci Med Pathol 2012; 8:402-13. [DOI: 10.1007/s12024-012-9322-5] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/08/2012] [Indexed: 12/28/2022]
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Ventilación mecánica no invasiva en la agudización de las enfermedades respiratorias. Med Clin (Barc) 2011; 137:691-6. [DOI: 10.1016/j.medcli.2011.10.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2011] [Revised: 10/11/2011] [Accepted: 10/13/2011] [Indexed: 11/21/2022]
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