1
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Mahmoud O, Granell R, Peralta GP, Garcia-Aymerich J, Jarvis D, Henderson J, Sterne J. Early-life and health behaviour influences on lung function in early adulthood. Eur Respir J 2023; 61:13993003.01316-2020. [PMID: 36265880 PMCID: PMC9978163 DOI: 10.1183/13993003.01316-2020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 10/11/2022] [Indexed: 02/04/2023]
Abstract
RATIONALE Early-life exposures may influence lung function at different stages of the life course. However, the relative importance of characteristics at different stages of infancy and childhood are unclear. OBJECTIVES To examine the associations and relative importance of early-life events on lung function at age 24 years. METHODS We followed 7545 children from the Avon Longitudinal Study of Parents and Children from birth to 24 years. Using previous knowledge, we classified an extensive list of putative risk factors for low lung function, covering sociodemographic, environmental, lifestyle and physiological characteristics, according to timing of exposure: 1) demographic, maternal and child; 2) perinatal; 3) postnatal; 4) early childhood; and 5) adolescence characteristics. Lung function measurements (forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), FEV1/FVC and forced expiratory flow at 25-75% of FVC) were standardised for sex, age and height. The proportion of the remaining variance explained by each characteristic was calculated. The association and relative importance (RI) of each characteristic for each lung function measure was estimated using linear regression, adjusted for other characteristics in the same and previous categories. RESULTS Lower maternal perinatal body mass index (BMI), lower birthweight, lower lean mass and higher fat mass in childhood had the largest RI (0.5-7.7%) for decreased FVC. Having no siblings, lower birthweight, lower lean mass and higher fat mass were associated with decreased FEV1 (RI 0.5-4.6%). Higher lean mass and childhood asthma were associated with decreased FEV1/FVC (RI 0.6-0.8%). CONCLUSIONS Maternal perinatal BMI, birthweight, childhood lean and fat mass and early-onset asthma are the factors in infancy and childhood that have the greatest influence on early-adult lung function.
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Affiliation(s)
- Osama Mahmoud
- Dept of Mathematical Sciences, University of Essex, Colchester, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Dept of Applied Statistics, Helwan University, Cairo, Egypt
| | - Raquel Granell
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- MRC Integrative Epidemiology Unit (IEU), Bristol Medical School, University of Bristol, Bristol, UK
| | - Gabriela P Peralta
- Epidemiology, Biostatistics and Prevention Institute (EBPI), University of Zurich, Zurich, Switzerland
| | - Judith Garcia-Aymerich
- ISGlobal, Barcelona, Spain
- Universitat Pompeu Fabra (UPF), Barcelona, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Deborah Jarvis
- National Heart and Lung Institute, Imperial College, London, UK
- MRC-PHE Centre for Environment and Health, Imperial College, London, UK
| | - John Henderson
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- MRC Integrative Epidemiology Unit (IEU), Bristol Medical School, University of Bristol, Bristol, UK
- Deceased
| | - Jonathan Sterne
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- MRC Integrative Epidemiology Unit (IEU), Bristol Medical School, University of Bristol, Bristol, UK
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2
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Assessing Respiratory Activity by Using IMUs: Modeling and Validation. SENSORS 2022; 22:s22062185. [PMID: 35336355 PMCID: PMC8950860 DOI: 10.3390/s22062185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 02/23/2022] [Accepted: 03/09/2022] [Indexed: 11/17/2022]
Abstract
This study aimed to explore novel inertial measurement unit (IMU)-based strategies to estimate respiratory parameters in healthy adults lying on a bed while breathing normally. During the experimental sessions, the kinematics of the chest wall were contemporaneously collected through both a network of 9 IMUs and a set of 45 uniformly distributed reflective markers. All inertial kinematics were analyzed to identify a minimum set of signals and IMUs whose linear combination best matched the tidal volume measured by optoelectronic plethysmography. The resulting models were finally tuned and validated through a leave-one-out cross-validation approach to assess the extent to which they could accurately estimate a set of respiratory parameters related to three trunk compartments. The adopted methodological approach allowed us to identify two different models. The first, referred to as Model 1, relies on the 3D acceleration measured by three IMUs located on the abdominal compartment and on the lower costal margin. The second, referred to as Model 2, relies on only one component of the acceleration measured by two IMUs located on the abdominal compartment. Both models can accurately estimate the respiratory rate (relative error < 1.5%). Conversely, the duration of the respiratory phases and the tidal volume can be more accurately assessed by Model 2 (relative error < 5%) and Model 1 (relative error < 5%), respectively. We further discuss possible approaches to overcome limitations and improve the overall accuracy of the proposed approach.
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3
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Huang L, Wang ST, Kuo HP, Delclaux C, Jensen ME, Wood LG, Costa D, Nowakowski D, Wronka I, Oliveira PD, Chen YC, Chen YC, Lee YL. Effects of obesity on pulmonary function considering the transition from obstructive to restrictive pattern from childhood to young adulthood. Obes Rev 2021; 22:e13327. [PMID: 34322972 DOI: 10.1111/obr.13327] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 07/11/2021] [Accepted: 07/11/2021] [Indexed: 12/25/2022]
Abstract
Adults with obesity exhibit a restrictive pattern, whereas children with obesity exhibit an obstructive pattern. However, the transition process remains unclear. We performed a systematic search for studies reporting on body mass index and pulmonary function in children. The main outcomes were forced expiratory volume in 1 s (FEV1 ), forced vital capacity (FVC), and their ratio (FEV1 /FVC). We compared individuals with overweight or with obesity with individuals with normal weight. Random-effects models were used to calculate pooled estimates. A total of 17 studies were included. Individuals with obesity had a lower FEV1 /FVC ratio (mean difference [MD] = -3.61%; 95% confidence interval [CI] = -4.58%, -2.64%) and a higher percent-predicted FVC (MD = 3.33%; 95% CI = 0.79%, 5.88%) than those with normal weight. Obesity impaired pulmonary function in the obstructive pattern during childhood to young adulthood, and the maximum obstruction was observed at the age of 16 years in boys and 20 years in girls. The effects attenuated at approximately 30 years and then shifted to the restrictive pattern after 35 years of age in men and 40 years in women. The effects of obesity on pulmonary function change from the obstructive pattern in childhood to the restrictive pattern in adulthood.
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Affiliation(s)
- Li Huang
- Department of Family Medicine, Taipei Medical University Hospital, Taipei, Taiwan
| | - Sen-Te Wang
- Department of Family Medicine, Taipei Medical University Hospital, Taipei, Taiwan.,Department of Family Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Han-Pin Kuo
- Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Christophe Delclaux
- Department of Pediatric Physiology and Sleep Center, AP-HP, Robert Debré Hospital, Paris, France
| | - Megan E Jensen
- Priority Research Centre Grow Up Well and School of Medicine & Public Health, University of Newcastle, Newcastle, Australia
| | - Lisa G Wood
- Priority Research Centre for Healthy Lungs, School of Biomedical Science and Pharmacy, University of Newcastle, Newcastle, Australia
| | - Dirceu Costa
- Rehabilitation Sciences Postgraduate Program, University Nove de Julho, Sao Paulo, Brazil
| | - Dariusz Nowakowski
- Department of Anthropology, Wroclaw University of Environmental and Life Science, Wroclaw, Poland
| | - Iwona Wronka
- Laboratory of Anthropology, Institute of Zoology and Biomedical Research, Jagiellonian University, Krakow, Poland
| | - Paula D Oliveira
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Yi-Chun Chen
- Department of Health Management, I-Shou University, Kaohsiung, Taiwan
| | - Yang-Ching Chen
- Department of Family Medicine, Taipei Medical University Hospital, Taipei, Taiwan.,Department of Family Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.,School of Nutrition and Health Sciences, College of Nutrition, Taipei Medical University, Taipei, Taiwan.,Graduate Institute of Metabolism and Obesity Sciences, College of Nutrition, Taipei Medical University, Taipei, Taiwan
| | - Yungling L Lee
- Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan.,College of Public Health, China Medical University, Taichung, Taiwan
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4
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Khramova RN, Tush EV, Khramov AA, Ovsyannikov DY, Popov KS, Dolbin IV, Khaletskaya OV, Stroganov AB, Kubysheva NI, Eliseeva TI. Relationship of Nutritional Status and Spirometric Parameters in Children with Bronchial Asthma. Sovrem Tekhnologii Med 2021; 12:12-23. [PMID: 34795975 PMCID: PMC8596246 DOI: 10.17691/stm2020.12.3.02] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Indexed: 12/23/2022] Open
Abstract
The potential mechanisms of bronchial asthma (BA) negative modification under the influence of obesity are currently being actively studied. However, at present, the effect of nutritional status on bronchial obstruction in children with BA cannot be considered established. In this regard, the purpose of this work was to study the relationship of spirometric parameters reflecting bronchial patency with nutritional status in children with asthma.
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Affiliation(s)
- R N Khramova
- Medical Resident, Department of Hospital Pediatrics; Privolzhsky Research Medical University, 10/1 Minin and Pozharsky Square, Nizhny Novgorod, 603005, Russia
| | - E V Tush
- Associate Professor, Department of Hospital Pediatrics; Privolzhsky Research Medical University, 10/1 Minin and Pozharsky Square, Nizhny Novgorod, 603005, Russia
| | - A A Khramov
- Medical Resident, Department of Hospital Pediatrics; Privolzhsky Research Medical University, 10/1 Minin and Pozharsky Square, Nizhny Novgorod, 603005, Russia
| | - D Yu Ovsyannikov
- Professor, Head of the Department of Children's Diseases; Peoples' Friendship University of Russia, 6 Miklukho-Maklaya St., Moscow, 117198, Russia
| | - K S Popov
- Medical Resident, Department of Hospital Pediatrics; Privolzhsky Research Medical University, 10/1 Minin and Pozharsky Square, Nizhny Novgorod, 603005, Russia
| | - I V Dolbin
- Consultant; City Clinical Hospital No.38, 22 Chernyshevskogo St., Nizhny Novgorod, 603000, Russia
| | - O V Khaletskaya
- Professor, Head of the Department of Hospital Pediatrics; Privolzhsky Research Medical University, 10/1 Minin and Pozharsky Square, Nizhny Novgorod, 603005, Russia
| | - A B Stroganov
- Associate Professor, Department of Faculty Surgery and Transplantology; Privolzhsky Research Medical University, 10/1 Minin and Pozharsky Square, Nizhny Novgorod, 603005, Russia
| | - N I Kubysheva
- Senior Researcher, Research Laboratory "Clinical Linguistics"; Kazan Federal University, 18 Kremlyovskaya St., Kazan, Republic of Tatarstan, 420008, Russia
| | - T I Eliseeva
- Professor, Department of Hospital Pediatrics; Privolzhsky Research Medical University, 10/1 Minin and Pozharsky Square, Nizhny Novgorod, 603005, Russia
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5
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Zeng X, Liu D, An Z, Li H, Song J, Wu W. Obesity parameters in relation to lung function levels in a large Chinese rural adult population. Epidemiol Health 2021; 43:e2021047. [PMID: 34353001 PMCID: PMC8602009 DOI: 10.4178/epih.e2021047] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 08/03/2021] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES The association between obesity parameters and lung function indicators in the general Chinese rural adult population remains unclear. METHODS In total, 8,284 Chinese adults aged 20 years to 80 years old from Xinxiang were recruited. Obesity-related parameters, including body mass index (BMI), waist circumference (WC), hip circumference (HC), waist-to-hip ratio (WHR), waistto-height ratio (WHtR), body fat percentage (BFP), basal metabolism, and visceral fat index, and lung function parameters such as forced vital capacity and forced expiratory volume in first second were measured. RESULTS The total prevalence of obesity defined by BMI, WC, WHR, WHtR, and BFP was 23.2%, 58.2%, 66.7%, 69.2%, and 56.5%, respectively. Spearman correlation analyses showed significant correlations between all obesity-related parameters and lung function. Linear regression analyses further demonstrated that BMI, WHtR, BFP, and general obesity defined using those indicators were negatively associated with lung function, while WC, WHR, and central obesity defined accordingly were positively associated with lung function. The relationship between general obesity and lung function was more evident in women than in men, while the link between central obesity and lung function was more obvious in men than in women. CONCLUSIONS Obesity is closely related to lung function in the general Chinese adult population. Weight control and loss are important strategies to improve lung function and respiratory health.
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Affiliation(s)
- Xiang Zeng
- School of Public Health, Xinxiang Medical University, 601 Jinsui Road, Xinxiang 453003, Henan, China.,Laboratory of Environmental Medicine and Developmental Toxicology, Guangdong Key Laboratory of Environmental Pollution and Health, School of Environment, Jinan University, Guangzhou 511443, Guangdong, China
| | - Dongling Liu
- Henan Key Laboratory of Medical Tissue Regeneration, Xinxiang Medical University, 601 Jinsui Road, Xinxiang 453003, China
| | - Zhen An
- School of Public Health, Xinxiang Medical University, 601 Jinsui Road, Xinxiang 453003, Henan, China
| | - Huijun Li
- School of Public Health, Xinxiang Medical University, 601 Jinsui Road, Xinxiang 453003, Henan, China
| | - Jie Song
- School of Public Health, Xinxiang Medical University, 601 Jinsui Road, Xinxiang 453003, Henan, China
| | - Weidong Wu
- School of Public Health, Xinxiang Medical University, 601 Jinsui Road, Xinxiang 453003, Henan, China
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6
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Probst-Hensch N, Jeong A, Stolz D, Pons M, Soccal PM, Bettschart R, Jarvis D, Holloway JW, Kronenberg F, Imboden M, Schindler C, Lovison GF. Causal Effects of Body Mass Index on Airflow Obstruction and Forced Mid-Expiratory Flow: A Mendelian Randomization Study Taking Interactions and Age-Specific Instruments Into Consideration Toward a Life Course Perspective. Front Public Health 2021; 9:584955. [PMID: 34046380 PMCID: PMC8144328 DOI: 10.3389/fpubh.2021.584955] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 04/01/2021] [Indexed: 11/22/2022] Open
Abstract
Obesity has complex links to respiratory health. Mendelian randomization (MR) enables assessment of causality of body mass index (BMI) effects on airflow obstruction and mid-expiratory flow. In the adult SAPALDIA cohort, recruiting 9,651 population-representative samples aged 18–60 years at baseline (female 51%), BMI and the ratio of forced expiratory volume in 1 second (FEV1) to forced vital capacity (FVC) as well as forced mid-expiratory flow (FEF25–75%) were measured three times over 20 follow-up years. The causal effects of BMI in childhood and adulthood on FEV1/FVC and FEF25–75% were assessed in predictive (BMI averaged over 1st and 2nd, lung function (LF) averaged over 2nd and 3rd follow-up; N = 2,850) and long-term cross-sectional models (BMI and LF averaged over all follow-ups; N = 2,728) by Mendelian Randomization analyses with the use of weighted BMI allele score as an instrument variable and two-stage least squares (2SLS) method. Three different BMI allele scores were applied to specifically capture the part of BMI in adulthood that likely reflects tracking of genetically determined BMI in childhood. The main causal effects were derived from models containing BMI (instrumented by BMI genetic score), age, sex, height, and packyears smoked as covariates. BMI interactions were instrumented by the product of the instrument (BMI genetic score) and the relevant concomitant variable. Causal effects of BMI on FEV1/FVC and FEF25–75% were observed in both the predictive and long-term cross-sectional models. The causal BMI- LF effects were negative and attenuated with increasing age, and stronger if instrumented by gene scores associated with childhood BMI. This non-standard MR approach interrogating causal effects of multiplicative interaction suggests that the genetically rooted part of BMI patterns in childhood may be of particular relevance for the level of small airway function and airflow obstruction later in life. The methodological relevance of the results is first to point to the importance of a life course perspective in studies on the etiological role of BMI in respiratory health, and second to point out novel methodological aspects to be considered in future MR studies on the causal effects of obesity related phenotypes.
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Affiliation(s)
- Nicole Probst-Hensch
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland.,Department of Public Health, University of Basel, Basel, Switzerland
| | - Ayoung Jeong
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland.,Department of Public Health, University of Basel, Basel, Switzerland
| | - Daiana Stolz
- Clinic of Pulmonary Medicine and Respiratory Cell Research, University Hospital Basel, Basel, Switzerland
| | - Marco Pons
- Division of Pulmonary Medicine, Regional Hospital of Lugano, Lugano, Switzerland
| | - Paola M Soccal
- Division of Pulmonary Medicine, Geneva University Hospitals, Geneva, Switzerland
| | | | - Deborah Jarvis
- Medical Research Council-Public Health England, Centre for Environment and Health, Imperial College London, London, United Kingdom.,Population Health and Occupational Disease, National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - John W Holloway
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, United Kingdom
| | - Florian Kronenberg
- Division of Genetic Epidemiology, Department of Medical Genetics, Molecular and Clinical Pharmacology, Medical University of Innsbruck, Innsbruck, Austria
| | - Medea Imboden
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland.,Department of Public Health, University of Basel, Basel, Switzerland
| | - Christian Schindler
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland.,Department of Public Health, University of Basel, Basel, Switzerland
| | - Gianfranco F Lovison
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland.,Department of Public Health, University of Basel, Basel, Switzerland.,Department of Economics, Business and Statistics, University of Palermo, Palermo, Italy
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7
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Mishra N, Salvi S, Lyngdoh T, Agrawal A. Low lung function in the developing world is analogous to stunting: a review of the evidence. Wellcome Open Res 2020; 5:147. [PMID: 33381655 PMCID: PMC7745193 DOI: 10.12688/wellcomeopenres.15929.2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/10/2020] [Indexed: 01/06/2023] Open
Abstract
Background: Low vital capacity, one of the consequences of restricted lung growth, is a strong predictor of cardiovascular mortality. Vital capacity is lower in the developing world than the developed world, even after adjusting for height, weight and gender. This difference is typically dismissed as ethnic variation, adjusted for by redefining normal. Whether this is a consequence of stunted lung growth, rather than just genetically smaller lungs, has not been investigated in detail. Therefore, we sought to compare factors implicated in both stunting and lung development, particularly in the developing world. Methods: We conducted a manual screen of articles identified through Google Scholar and assessed risk of bias. No language restrictions were applied, so long as there was an associated English abstract. We queried VizHub (Global Burden of Disease Visualization Tool) and Google Dataset search engines for disease burden and genome wide association studies. The scope of the article and the heterogeneity of the outcome measures reported required a narrative review of available evidence. To the extent possible, the review follows PRISMA reporting guidelines. Results: Early life influences operate in synergism with genetic, environmental and nutritional factors to influence lung growth and development in children. Low lung function and stunting have common anthropometric, environmental and nutritional correlates originating during early development. Similar anthropometric correlates shared chronic inflammatory pathways, indicated that the two conditions were analogous. Conclusion: The analogy between poor lung function and stunting is conspicuous in the developing world, with malnutrition at the center of non -achievement of growth potential, susceptibility to infectious diseases and intrauterine programming for metabolic syndrome. This counter the idea of redefining the normal for lung function measurements, since observed inter-ethnic variations are likely a mix of natural genetic differences as well as differences in nurture such that reduced lung function reflects early life adversities.
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Affiliation(s)
- Navya Mishra
- Public Health Foundation of India, Delhi, India.,Academy of Scientific and Innovative Research, Ghaziabad, India
| | | | | | - Anurag Agrawal
- Academy of Scientific and Innovative Research, Ghaziabad, India.,CSIR Institute of Genomics and Integrative Biology, Delhi, Delhi, India
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8
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Ferreira MS, Marson FAL, Wolf VLW, Ribeiro JD, Mendes RT. Lung function in obese children and adolescents without respiratory disease: a systematic review. BMC Pulm Med 2020; 20:281. [PMID: 33115462 PMCID: PMC7594270 DOI: 10.1186/s12890-020-01306-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 10/01/2020] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Obesity in children and adolescents is associated with increased morbidity and mortality due to multisystemic impairment, including deleterious changes in lung function, which are poorly understood. OBJECTIVES To perform a systematic review to assess lung function in children and adolescents affected by obesity and to verify the presence of pulmonary changes due to obesity in individuals without previous or current respiratory diseases. METHODS A systematic search was performed in the MEDLINE-PubMed (Medical Literature Analysis and Retrieval System Online), Embase (Excerpta Medica Database) and VHL (Virtual Health Library/Brazil) databases using the terms "Lung Function" and "Pediatric Obesity" and their corresponding synonyms in each database. A period of 10 years was considered, starting in February/2008. After the application of the filters, 33 articles were selected. Using the PICOS strategy, the following information was achieved: (Patient) children and adolescents; (Intervention/exposure) obesity; (Control) healthy children and adolescents; (Outcome) pulmonary function alterations; (Studies) randomized controlled trial, longitudinal studies (prospective and retrospective studies), cross-over studies and cross-sectional studies. RESULTS Articles from 18 countries were included. Spirometry was the most widely used tool to assess lung function. There was high variability in lung function values, with a trend towards reduced lung function markers (FEV1/FVC, FRC, ERV and RV) in obese children and adolescents. CONCLUSION Lung function, measured by several tools, shows numerous markers with contradictory alterations. Differences concerning the reported results of lung function do not allow us to reach a consensus on lung function changes in children and adolescents with obesity, highlighting the need for more publications on this topic with a standardized methodology.
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Affiliation(s)
- Mariana Simões Ferreira
- Department of Pediatrics, School of Medical Sciences, Unicamp, Rua Tessália Vieira de Camargo, Cidade Universitária Zeferino Vaz - Barão Geraldo, 126, Campinas, 13083-887 São Paulo Brazil
| | - Fernando Augusto Lima Marson
- Department of Pediatrics and Center of Investigation in Pediatrics, Laboratory of Lung Function, School of Medical Sciences, Unicamp, Rua Tessália Vieira de Camargo, Cidade Universitária Zeferino Vaz - Barão Geraldo, 126, Campinas, 13083-887 São Paulo Brazil
- Department of Medical Genetics and Genomic Medicine, School of Medical Sciences, Unicamp, Rua Tessália Vieira de Camargo, Cidade Universitária Zeferino Vaz - Barão Geraldo, 126, Campinas, 13083-887 São Paulo Brazil
- Postgraduate Program in Health Science, Laboratory of Human and Medical Genetics and Laboratory of Cellular and Molecular Biology and Bioactive Compounds, São Francisco University, Avenida São Francisco de Assis, Jardim São José, 218, Bragança Paulista, 12916-900 São Paulo Brazil
| | - Vaneza Lira Waldow Wolf
- Department of Pediatrics, School of Medical Sciences, Unicamp, Rua Tessália Vieira de Camargo, Cidade Universitária Zeferino Vaz - Barão Geraldo, 126, Campinas, 13083-887 São Paulo Brazil
| | - José Dirceu Ribeiro
- Department of Medical Genetics and Genomic Medicine, School of Medical Sciences, Unicamp, Rua Tessália Vieira de Camargo, Cidade Universitária Zeferino Vaz - Barão Geraldo, 126, Campinas, 13083-887 São Paulo Brazil
| | - Roberto Teixeira Mendes
- Department of Pediatrics, School of Medical Sciences, Unicamp, Rua Tessália Vieira de Camargo, Cidade Universitária Zeferino Vaz - Barão Geraldo, 126, Campinas, 13083-887 São Paulo Brazil
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9
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Mishra N, Salvi S, Lyngdoh T, Agrawal A. Low lung function in the developing world is analogous to stunting: a review of the evidence. Wellcome Open Res 2020; 5:147. [DOI: 10.12688/wellcomeopenres.15929.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/11/2020] [Indexed: 11/20/2022] Open
Abstract
Background: Low vital capacity, one of the consequences of restricted lung growth, is a strong predictor of cardiovascular mortality. Vital capacity is lower in the developing world than the developed world, even after adjusting for height, weight and gender. This difference is typically dismissed as ethnic variation, adjusted for by redefining normal. Whether this is a consequence of stunted lung growth, rather than genetically smaller lungs, has not been investigated in detail. Therefore, we sought to compare factors implicated in both stunting and lung development, particularly in the developing world. Methods: We conducted a manual screen of articles identified through Google Scholar and assessed risk of bias. No language restrictions were applied, so long as there was an associated English abstract. We queried VizHub (Global Burden of Disease Visualization Tool) and Google Dataset search engines for disease burden and genome wide association studies. The scope of the article and the heterogeneity of the outcome measures reported required a narrative review of available evidence. To the extent possible, the review follows PRISMA reporting guidelines. Results: Early life influences operate in synergism with environmental and nutritional factors to influence lung growth and development in children. Low lung function and stunting have common anthropometric, environmental and nutritional correlates originating during early development. Similar anthropometric correlates and shared chronic inflammatory pathways indicated that the two conditions were analogous. Conclusion: The analogy between poor lung function and stunting is conspicuous in the developing world, where malnutrition lies at the center of non -achievement of growth potential, susceptibility to infectious diseases and intrauterine programming for metabolic syndrome. The common pathological mechanisms governing stunting and lung function deficits counter the idea of redefining the normal for lung function measurements.
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10
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Mikalsen IB, Byberg K, Forman MR, Øymar K. Adipokines in adolescence; the associations with lung function and atopy - A cross-sectional study. Respir Med 2020; 170:106063. [PMID: 32705985 DOI: 10.1016/j.rmed.2020.106063] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 06/07/2020] [Accepted: 06/08/2020] [Indexed: 12/31/2022]
Abstract
Both inflammatory and mechanical effects have been proposed to explain the increased risk of asthma and reduced lung function observed in obese children and adults. The evidence regarding the potential role of obesity in the aetiology of atopy and allergy is more conflicting. The adipokines leptin and adiponectin are inflammatory markers of fat metabolism which may be involved in explaining the increased risk of asthma and reduced lung function in obese children and adults. In this cross-sectional study, we aimed to study how adiponectin and leptin were associated with lung function and atopic sensitisation in adolescents. The study included 384 children at mean age 12.9 years with measurements of adiponectin, leptin, lung function and atopic sensitisation. Adiponectin and leptin levels were measured in serum, lung function was measured by spirometry and atopic sensitisation was measured by serum specific Immunoglobulin E. In linear regression models, leptin was negatively associated with forced vital capacity (FVC) (Beta: -4.13; 95% Confidence Interval: -5.83, -2.44, P < 0.001) and forced expiratory volume in the first second (FEV1) (-3.74; -5.39, -2.09, P < 0.001) after adjusting for body mass index (BMI) and other covariates. No associations were observed between adiponectin and lung function or between leptin or adiponectin and atopic sensitisation. In this cross-sectional analysis of adolescents in all weight classes, leptin was negatively associated with FEV1 and FVC independent of BMI, but no associations were found between adiponectin and lung function. The results suggest that leptin may have a functional role in the airways of healthy children.
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Affiliation(s)
- Ingvild Bruun Mikalsen
- Department of Pediatrics, Stavanger University Hospital, Stavanger, Norway; Department of Clinical Science, University of Bergen, Norway.
| | - Kristine Byberg
- Department of Pediatrics, Stavanger University Hospital, Stavanger, Norway
| | - Michele R Forman
- Department of Nutritional Sciences, Purdue University, West Lafayette, IN, USA
| | - Knut Øymar
- Department of Pediatrics, Stavanger University Hospital, Stavanger, Norway; Department of Clinical Science, University of Bergen, Norway
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11
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Variants in ADIPOQ gene are linked to adiponectin levels and lung function in young males independent of obesity. PLoS One 2020; 15:e0225662. [PMID: 31978107 PMCID: PMC6980555 DOI: 10.1371/journal.pone.0225662] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Accepted: 11/08/2019] [Indexed: 11/19/2022] Open
Abstract
Background Obesity is a major risk factor for many chronic diseases, including reduced lung function. The role of polymorphisms of the adiponectin gene, though linked with cardiometabolic consequences of obesity, has not been studied in relation to lung function. Objectives The aim of this study is to examine polymorphisms in the ADIPOQ, ADIPOR1, and ADIPOR2 genes in relation to adiponectin serum levels, BMI, and adiposity in 18-year old Cypriot males, as well as determine whether BMI, adipokines levels and polymorphisms in adipokine related genes are associated with lung function levels. Results From the participants, 8% were classified as obese, 22% as overweight, and the remaining 71% as normal. We found that rs266729 and rs1501299 in ADIPOQ and rs10920531 in ADIPOR1 were significantly associated with serum adiponectin levels, after adjusting for ever smoking. In addition, there was an overall significant increase in FEV1% predicted with increasing BMI (β = 0.53, 95% CI: 0.27, 0.78) and in FVC % predicted (β = 1.02, 95% CI: 0.73, 1.30). There was also a decrease in FEV1/FVC with increasing BMI (β = -0.53, 95% CI: -0.71, -0.35). Finally, rs1501299 was associated with lung function measures. Discussion Functional variants in the ADIPOQ gene were linked with lung function in young males. Further studies should concentrate on the role of adipokines on lung function which may direct novel therapeutic approaches.
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12
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Lung function, obesity and physical fitness in young children: The EXAMIN YOUTH study. Respir Med 2019; 159:105813. [PMID: 31731085 DOI: 10.1016/j.rmed.2019.105813] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Accepted: 11/04/2019] [Indexed: 01/10/2023]
Abstract
OBJECTIVE The prevalence of obesity and physical inactivity in children are increasing globally. The study aimed to investigate the association of obesity and cardiorespiratory fitness (CRF) with patterns of lung function in young children. METHODS In this cross-sectional study, lung function, body mass index (BMI), blood pressure (BP) and CRF (shuttle run stages) were measured in an unselected cohort of 1246 children aged 7.2 ± 0.4 years. All parameters and lung function, such as the ratio of forced expiratory volume in 1 s (FEV1) to forced vital capacity (FVC), were assessed by standardized procedures for children. Statistical models were applied for systematic adjustment of potential confounders. RESULTS Obese children had significantly higher FEV1 (Coef. (95% CI) (1.57 (1.50; 1.64) L) and FVC (1.75 (1.67; 1.83) L) compared to normal weight children (1.38 (1.37; 1.40) L; (1.53 (1.51; 1.54) L, respectively). However, with each unit increase of BMI, FEV1/FVC decreased (-0.003 (-0.005; -0.001)) due to a disproportional increase in FVC compared to FEV1. Per stage increase of CRF, FEV1 (0.017 (0.008; 0.025) L) and FVC increased (0.022 (0.012; 0.031) L)). In obese children, higher CRF was independently associated with higher FEV1/FVC (0.03 (0.5E-4; 0.06)) due to a higher increase of FEV1 over FVC with increasing fitness. CONCLUSIONS The decrease of FEV1/FVC with increasing BMI suggests that childhood obesity is associated with an imbalance of ventilation and airway flow. In children with obesity, higher CRF is associated with an improved FEV1/FVC ratio. Physical exercise programs may have the potential to improve patterns of lung function in children with obesity.
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13
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Kim M, Choi S, Choi SH, Shin SH, Kim SK, Shim YS, Jeon YH. Metabolic syndrome and lung function in Korean children and adolescents: A cross-sectional study. Sci Rep 2019; 9:15646. [PMID: 31666559 PMCID: PMC6821710 DOI: 10.1038/s41598-019-51968-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 10/10/2019] [Indexed: 12/20/2022] Open
Abstract
This study aimed to investigate whether obesity and metabolic syndrome (MetS) are associated with pulmonary function in Korean children and adolescents. Data from the 2009–2011 Korea National Health and Nutrition Examination Survey which is cross-sectional, nationwide, and representative survey were used. Adjusted regression analysis was performed to evaluate the association of obesity and MetS with lung function in children and adolescents. A total of 763 children and adolescents aged 10–18 years were evaluated. We found no significant difference in FEV1% predicted, FVC% predicted, and FEV1/FVC ratio among the obesity groups. Subjects with MetS showed a significantly lower FEV1 predicted (91.54 ± 0.74% vs 94.64 ± 0.73%, P = 0.004), lower FVC% predicted (91.86 ± 0.63% vs 95.20 ± 0.63%, P < 0.001), and lower FEV1/FVC ratio (76.76 ± 0.43% vs 80.13 ± 0.43%, P < 0.001) than those without MetS. Elevated waist circumference (WC), systolic blood pressure, fasting glucose, and lower high-density lipoprotein cholesterol (HDL-C) were independently associated with lower FEV1/FVC ratio (all P < 0.05, respectively). Among MetS components, increased WC was the most important factor influencing lower FEV1/FVC ratio. In conclusion, lung function in MetS patients was significantly lower, and the MetS component was independently associated.
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Affiliation(s)
- Minji Kim
- Department of Pediatrics, Hallym University, Dongtan Sacred Heart Hospital, Hwaseong, Gyeonggi-do, Korea.,Allergy and Clinical Immunology Research center, Hallym University College of Medicine, Chuncheon, Korea
| | - Seoheui Choi
- Department of Pediatrics, Hallym University, Dongtan Sacred Heart Hospital, Hwaseong, Gyeonggi-do, Korea
| | - Soo-Han Choi
- Department of Pediatrics, Hallym University, Dongtan Sacred Heart Hospital, Hwaseong, Gyeonggi-do, Korea
| | - Seon-Hee Shin
- Department of Pediatrics, Hallym University, Dongtan Sacred Heart Hospital, Hwaseong, Gyeonggi-do, Korea
| | - Sung Koo Kim
- Department of Pediatrics, Hallym University, Dongtan Sacred Heart Hospital, Hwaseong, Gyeonggi-do, Korea
| | - Young Suk Shim
- Department of Pediatrics, Hallym University, Dongtan Sacred Heart Hospital, Hwaseong, Gyeonggi-do, Korea.
| | - You Hoon Jeon
- Department of Pediatrics, Hallym University, Dongtan Sacred Heart Hospital, Hwaseong, Gyeonggi-do, Korea. .,Allergy and Clinical Immunology Research center, Hallym University College of Medicine, Chuncheon, Korea.
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14
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Taytard J, Dubern B, Aubertin G. [Obesity in childhood: What are the respiratory risks?]. Rev Mal Respir 2019; 36:1139-1147. [PMID: 31558348 DOI: 10.1016/j.rmr.2019.09.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Accepted: 03/06/2019] [Indexed: 11/09/2022]
Abstract
In childhood and adolescence overweight is defined as a body mass index (BMI) above the 97th percentile for age and sex, according to the curves established by the International Obesity Task Force (IOTF). In France, it is estimated that 25 % of children under 18 years old are overweight. Overweight and obesity in this population are multifactorial, with an important influence of genetic factors, modulated by pre and post-natal (maternal smoking), societal and psychological determinants. The impact of obesity on respiratory function in children is mostly characterized by a decreased FEV1/FCV. Moreover, several studies have shown an association between asthma and overweight/obesity, with a pejorative impact of BMI on asthma control. However, asthma is still poorly characterized in this population, and the determinants of bronchial obstruction seem to differ from non-obese children, with less eosinophilic inflammation. Obstructive sleep apnea syndrome (OSAS) is a frequent complication of obesity, affecting up to 80% of obese children and adolescents. It has a specific polysomnographic definition in children. Symptoms are similar to adult OSAS, but with cognitive and neurobehavioral alterations often more important in adolescents. The treatment consists in ENT surgery when indicated (with systematic post-operative polysomnography), and nocturnal continuous positive airway pressure (CPAP). The obesity-hypoventilation syndrome (OHS) has the same definition in children as in adults and affects up to 20% of obese patients. Treatment consists in nocturnal ventilation using bilevel positive airway pressure (BiPAP). Finally, in some extreme cases, bariatric surgery can be performed. The indication should be discussed in a specialised paediatric reference centre.
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Affiliation(s)
- J Taytard
- Service de pneumologie pédiatrique, Sorbonne université, hôpital Trousseau, AP-HP, 26, avenue du Docteur Arnold-Netter, 75012 Paris, France.
| | - B Dubern
- Service de nutrition et gastroentérologie pédiatriques, Sorbonne université, hôpital Trousseau, AP-HP, 75012 Paris, France
| | - G Aubertin
- Service de pneumologie pédiatrique, Sorbonne université, hôpital Trousseau, AP-HP, 26, avenue du Docteur Arnold-Netter, 75012 Paris, France
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15
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Assumpção MSD, Ribeiro JD, Wamosy RMG, Figueiredo FCXSD, Parazzi PLF, Schivinski CIS. Impulse oscillometry and obesity in children. J Pediatr (Rio J) 2018; 94:419-424. [PMID: 28843062 DOI: 10.1016/j.jped.2017.06.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2017] [Revised: 05/11/2017] [Accepted: 05/24/2017] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE To compare impulse oscillometry system parameters of normal-weight children with overweight and obese children. METHOD All participants were submitted to the evaluation of lung function (spirometry and impulse oscillometry) following the American Thoracic Society standards. The evaluation of respiratory mechanics was performed using the Jaeger™ MasterScreen™ Impulse Oscillometry System (Erich Jaeger, Germany), three tests were recorded, with acquisition for at least 20seconds. RESULTS The study included 81 children (30 in the control group, 21 in the overweight group, and 30 the in obesity group), matched for age and sex. Regarding spirometry data, obesity group showed higher numerical values in relation to the control group; however, there were no significant differences among the three groups. For impulse oscillometry parameters, there was a difference between control group and obesity group for respiratory impedance (p=0.036), resistance at 5hertz (p=0.026), resonant frequency (p=0.029), and reactance area (p=0.014). For the parameters expressed in percentage of predicted, there were differences in resistance at 5 hertz, resonant frequency, and reactance area between control group and obesity group. CONCLUSIONS Obese children showed increased oscillometry parameters values representative of airway obstruction, compared to normal-weight children. Changes in some oscillometry parameters can already be observed in overweight school-aged children.
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Affiliation(s)
- Maíra S de Assumpção
- Universidade Estadual de Campinas (Unicamp), Departamento de Pediatria, Campinas, SP, Brazil
| | - José D Ribeiro
- Universidade Estadual de Campinas (Unicamp), Departamento de Pediatria, Campinas, SP, Brazil
| | - Renata M G Wamosy
- Universidade do Estado de Santa Catarina (UDESC), Departamento de Fisioterapia, Florianópolis, SC, Brazil
| | | | - Paloma L F Parazzi
- Universidade Estadual de Campinas (Unicamp), Departamento de Pediatria, Campinas, SP, Brazil
| | - Camila I S Schivinski
- Universidade Estadual de Campinas (Unicamp), Departamento de Pediatria, Campinas, SP, Brazil; Universidade do Estado de Santa Catarina (UDESC), Departamento de Fisioterapia, Florianópolis, SC, Brazil.
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16
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Impulse oscillometry and obesity in children. JORNAL DE PEDIATRIA (VERSÃO EM PORTUGUÊS) 2018. [DOI: 10.1016/j.jpedp.2017.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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17
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Krishnan S, Dozor AJ, Bacharier L, Lang JE, Irvin CG, Kaminsky D, Farber HJ, Gerald L, Brown M, Holbrook JT, Wise RA, Ryu J, Bose S, Yasin R, Saams J, Henderson RJ, Teague WG. Clinical characterization of children with resistant airflow obstruction, a multicenter study. J Asthma 2018; 56:611-617. [PMID: 29771599 DOI: 10.1080/02770903.2018.1477956] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
OBJECTIVE To characterize a cohort of children with airflow limitation resistant to bronchodilator (BD) therapy. METHODS Pulmonary function tests performed in children 6-17 years of age at 15 centers in a clinical research consortium were screened for resistant airflow limitation, defined as a post-BD FEV1 and/or an FEV1/FVC less than the lower limits of normal. Demographic and clinical data were analyzed for associations with pulmonary function. RESULTS 582 children were identified. Median age was 13 years (IQR: 11, 16), 60% were males; 62% were Caucasian, 28% were African-American; 19% were obese; 32% were born prematurely and 21% exposed to second hand smoke. Pulmonary diagnoses included asthma (93%), prior significant pneumonia (28%), and bronchiectasis (5%). 65% reported allergic rhinitis, and 11% chronic sinusitis. Subjects without a history of asthma had significantly lower post-BD FEV1% predicted (p = 0.008). Subjects without allergic rhinitis had lower post-BD FEV1% predicted (p = 0.003). Children with allergic rhinitis, male sex, obesity and Black race had better pulmonary function post-BD. There was lower pulmonary function in children after age 11 years without a history of allergic rhinitis, as compared to those with a history of allergic rhinitis. CONCLUSIONS The most prevalent diagnosis in children with BD-resistant airflow limitation is asthma. Allergic rhinitis and premature birth are common co-morbidities. Children without a history of asthma, as well as those with asthma but no allergic rhinitis, had lower pulmonary function. Children with BD-resistant airflow limitation may represent a sub-group of children with persistent obstruction and high risk for life-long airway disease.
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Affiliation(s)
- Sankaran Krishnan
- a Division of Pediatric Pulmonology, Allergy and Sleep Medicine , New York Medical College and Maria Fareri Children's Hospital at Westchester Medical Center , Valhalla , NY
| | - Allen J Dozor
- a Division of Pediatric Pulmonology, Allergy and Sleep Medicine , New York Medical College and Maria Fareri Children's Hospital at Westchester Medical Center , Valhalla , NY
| | - Leonard Bacharier
- b Division of Allergy, Immunology and Pulmonary Medicine , Washington University School of Medicine at St Louis , Seattle , WA
| | - Jason E Lang
- c Division of Pulmonary and Sleep Medicine, Dept. Of Pediatrics , Duke Univ. School of medicine , Durham , NC
| | - Charles G Irvin
- d Department of Medicine , University of Vermont , Burlington , VT
| | - David Kaminsky
- d Department of Medicine , University of Vermont , Burlington , VT
| | - Harold J Farber
- e Pediatric Pulmonology , Baylor College of Medicine and Texas Children's Hospital , Houston , TX
| | - Lynn Gerald
- f College of Public Health , University of Arizona , Tucson , AZ
| | - Mark Brown
- f College of Public Health , University of Arizona , Tucson , AZ
| | - Janet T Holbrook
- g Bloomberg School of Public Health , Johns Hopkins University , Baltimore , MD
| | - Robert A Wise
- h Pulmonary Medicine , Johns Hopkins University , Baltimore , MD
| | - Julie Ryu
- i Pulmonary Medicine, Rady Children's Hospital , University of California at San Diego , San Diego , CA
| | - Sonali Bose
- h Pulmonary Medicine , Johns Hopkins University , Baltimore , MD
| | - Razan Yasin
- g Bloomberg School of Public Health , Johns Hopkins University , Baltimore , MD
| | - Joy Saams
- g Bloomberg School of Public Health , Johns Hopkins University , Baltimore , MD
| | - Robert J Henderson
- g Bloomberg School of Public Health , Johns Hopkins University , Baltimore , MD
| | - William G Teague
- j Pediatric Pulmonology , University of Virginia , Charlottesville , VA
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18
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Fretzayas A, Moustaki M, Loukou I, Douros K. Is obesity related to the lung function of non-asthmatic children? World J Clin Pediatr 2018; 7:67-74. [PMID: 29881704 PMCID: PMC5988558 DOI: 10.5409/wjcp.v7.i2.67] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Revised: 04/12/2018] [Accepted: 05/13/2018] [Indexed: 02/06/2023] Open
Abstract
Overweight and obesity are highly prevalent in developed and developing countries among children and adolescents. During the last two decades, it became evident that excess weight is adversely related to respiratory health in childhood and adolescence mainly in terms of asthma occurrence. Additionally, there is a mounting body of evidence that overweight/obesity may also affect lung function in non-asthmatic subjects. The aim of this review was to present and discuss the studies that investigated this issue in non-asthmatic children and adolescents. Only a few studies have evaluated the impact of excess weight on static volumes and their results point towards an inverse relationship between overweight/obesity and functional residual capacity. More studies have been conducted on the impact of excess weight on dynamic lung volumes with inconsistent, however, results. Nevertheless, a relatively consistent finding was that the ratio of forced expiratory volume in 1 s/forced vital capacity was significantly lower among overweight/obese children compared to their counterparts with normal weight. The underlying mechanisms of these observations have not been adequately elucidated but it is believed to result from complex interaction of mechanical, developmental, and metabolic causes. There is a need for more well-designed studies in order to clarify the impact of excess weight on lung function in non-asthmatic subjects, as well as to explore the contribution of factors such as duration and degree of obesity, and fat distribution. Despite the absence of conclusive data, there are still convincing evidence to be communicated to the children and their families as part of the arguments to encourage them to adopt a healthier lifestyle.
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Affiliation(s)
- Andrew Fretzayas
- School of Medicine, University of Athens, Athens 11527, Greece
- Department of Pediatrics, Athens Medical Center, Athens University Medical School, Maroussi 15125, Greece
| | - Maria Moustaki
- Department of Cystic Fibrosis, “Agia Sofia”, Children’s Hospital, Athens 11527, Greece
| | - Ioanna Loukou
- Department of Cystic Fibrosis, “Agia Sofia”, Children’s Hospital, Athens 11527, Greece
| | - Konstantinos Douros
- Respiratory Unit, Third Department of Pediatrics, Athens University Medical School, “Attikon” University Hospital, Haidari 15125, Greece
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19
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Ekström S, Hallberg J, Kull I, Protudjer JLP, Thunqvist P, Bottai M, Gustafsson PM, Bergström A, Melén E. Body mass index status and peripheral airway obstruction in school-age children: a population-based cohort study. Thorax 2018; 73:538-545. [PMID: 29382799 PMCID: PMC5969335 DOI: 10.1136/thoraxjnl-2017-210716] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2017] [Revised: 12/18/2017] [Accepted: 01/08/2018] [Indexed: 11/04/2022]
Abstract
BACKGROUND Few large prospective studies have investigated the impact of body mass index (BMI) on lung function during childhood. METHODS Using data collected between 2002 and 2013, we analysed associations between BMI status and lung function (assessed by spirometry) from 8 to 16 years, as well as cross-sectional associations with small airway function (impulse oscillometry) at 16 years in the BAMSE cohort (n=2889). At 16 years, cross-sectional associations with local and systemic inflammation were investigated by analysing FENO, blood eosinophils and neutrophils. RESULTS Overweight and obesity at 8 years were associated with higher FVC, but lower FEV1/FVC ratio at 8 and 16 years. In boys, but not girls, obesity at 8 years was associated with a further reduction in FEV1/FVC between 8 and 16 years. In cross-sectional analyses, overweight and obesity were associated with higher frequency dependence of resistance (R5-20) and larger area under the reactance curve (AX0.5) at 16 years. Increased blood neutrophil counts were seen in overweight and obese girls, but not in boys. No association was found between BMI status and FENO. Persistent, but not transient, overweight/obesity between 8 and 16 years was associated with higher R5-20 and AX0.5 and lower FEV1/FVC (-2.8% (95% CI -4.1 to -1.2) in girls and -2.7% (95% CI -4.4 to -1.1) in boys) at 16 years, compared with persistent normal weight. CONCLUSION In childhood and adolescence, overweight and obesity, particularly persistent overweight, were associated with evidence of airway obstruction, including the small airways.
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Affiliation(s)
- Sandra Ekström
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Jenny Hallberg
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.,Department of Pediatrics, Sachs' Children and Youth Hospital, South General Hospital, Stockholm, Sweden.,Department of Clinical Science and Education, Karolinska Institutet, Stockholm, Sweden
| | - Inger Kull
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.,Department of Pediatrics, Sachs' Children and Youth Hospital, South General Hospital, Stockholm, Sweden.,Department of Clinical Science and Education, Karolinska Institutet, Stockholm, Sweden
| | - Jennifer L P Protudjer
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.,The Centre for Allergy Research, Karolinska Institutet, Stockholm, Sweden
| | - Per Thunqvist
- Department of Pediatrics, Sachs' Children and Youth Hospital, South General Hospital, Stockholm, Sweden.,Department of Clinical Science and Education, Karolinska Institutet, Stockholm, Sweden
| | - Matteo Bottai
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Per Magnus Gustafsson
- Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Paediatrics, Central Hospital, Skövde, Sweden
| | - Anna Bergström
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.,Centre for Occupational and Environmental Medicine, Stockholm County Council, Stockholm, Sweden
| | - Erik Melén
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.,Department of Pediatrics, Sachs' Children and Youth Hospital, South General Hospital, Stockholm, Sweden.,Centre for Occupational and Environmental Medicine, Stockholm County Council, Stockholm, Sweden
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20
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Byberg KK, Mikalsen IB, Eide GE, Forman MR, Júlíusson PB, Øymar K. The associations between weight-related anthropometrics during childhood and lung function in late childhood: a retrospective cohort study. BMC Pulm Med 2018; 18:10. [PMID: 29351745 PMCID: PMC5775530 DOI: 10.1186/s12890-017-0567-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2017] [Accepted: 12/21/2017] [Indexed: 02/08/2023] Open
Abstract
Background An association between body weight in childhood and subsequent lung function and asthma has been suggested, but few longitudinal studies exist. Our aim was to explore whether weight-related anthropometric measurements through childhood were associated with lung function in late childhood. Methods From an original nested case-control study, a cohort study was conducted, where lung function was measured in 463 children aged 12.8 years, and anthropometry was measured at several ages from birth through 12.8 years of age. Associations between anthropometrics and lung function were analysed using multiple linear and fractional polynomial regression analysis. Results Birthweight and body mass index (BMI; kg/m2) at different ages through childhood were positively associated with forced vital capacity in percent of predicted (FVC %) and forced expiratory volume in the first second in percent of predicted (FEV1%) at 12.8 years of age. BMI, waist circumference, waist-to-height ratio and skinfolds at 12.8 years of age and the change in BMI from early to late childhood were positively associated with FVC % and FEV1% and negatively associated with FEV1/FVC and forced expiratory flow at 25–75% of FVC/FVC. Interaction analyses showed that positive associations between anthropometrics other than BMI and lung function were mainly found in girls. Inverse U-shaped associations were found between BMI at the ages of 10.8/11.8 (girls/boys) and 12.8 years (both genders) and FVC % and FEV1% at 12.8 years of age. Conclusions Weight-related anthropometrics through childhood may influence lung function in late childhood. These findings may be physiological or associated with air flow limitation. Inverse U-shaped associations suggest a differential impact on lung function in normal-weight and overweight children. Trial registration This study was observational without any health care intervention for the participants. Therefore, no trial registration number is available. Electronic supplementary material The online version of this article (doi: 10.1186/s12890-017-0567-3) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Kristine Kjer Byberg
- Department of Paediatrics, Stavanger University Hospital, POB 8100, N-4068, Stavanger, Norway.
| | - Ingvild Bruun Mikalsen
- Department of Paediatrics, Stavanger University Hospital, POB 8100, N-4068, Stavanger, Norway.,Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Geir Egil Eide
- Centre for Clinical Research, Haukeland University Hospital, Bergen, Norway.,Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Michele R Forman
- Department of Nutrition Science, Purdue University, West Lafayette, IN, USA
| | - Pétur Benedikt Júlíusson
- Department of Clinical Science, University of Bergen, Bergen, Norway.,Department of Paediatrics, Haukeland University Hospital, Bergen, Norway
| | - Knut Øymar
- Department of Paediatrics, Stavanger University Hospital, POB 8100, N-4068, Stavanger, Norway.,Department of Clinical Science, University of Bergen, Bergen, Norway
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21
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The effect of obesity, weight gain, and weight loss on asthma inception and control. Curr Opin Allergy Clin Immunol 2017; 17:123-130. [PMID: 28030376 DOI: 10.1097/aci.0000000000000339] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
PURPOSE OF REVIEW There is ample and growing evidence that obesity increases the risk of asthma and morbidity from asthma. Here, we review recent clinical evidence supporting a causal link between obesity and asthma, and the mechanisms that may lead to 'obese asthma'. RECENT FINDINGS Although in some children obesity and asthma simply co-occur, those with 'obese asthma' have increased asthma severity, lower quality of life, and reduced medication response. Underlying mechanistic pathways may include anatomical changes of the airways such as obstruction and dysanapsis, systemic inflammation, production of adipokines, impaired glucose-insulin metabolism, altered nutrient levels, genetic and epigenetic changes, and alterations in the airway and/or gut microbiome. A few small studies have shown that weight loss interventions may lead to improvements in asthma outcomes, but thus far research on therapeutic interventions for these children has been limited. SUMMARY Obesity increases the risk of asthma - and worsens asthma severity or control - via multiple mechanisms. 'Obese asthma' is a complex, multifactorial phenotype in children. Obesity and its complications must be managed as part of the treatment of asthma in obese children.
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Abstract
Obesity is an important risk factor for both community-acquired pneumonia (CAP) and healthcare-associated pneumonia. In striking contrast, emerging data suggest that obesity is associated with more favorable outcome of pneumonia, a protective effect coined 'the obesity paradox'. Areas covered: The aim of the present review is to summarize the existing evidence on the outcome of pneumonia in obese patients and to discuss the mechanisms underpinning the association between obesity and pneumonia outcome. Several observational studies showed that obesity is associated with better outcome of CAP. In contrast, obesity represents a risk factor for adverse outcome in patients infected with pandemic influenza. Very limited data exist on the association between obesity and the outcome of healthcare-associated pneumonia. The pathophysiological mechanisms contributing to these paradoxical findings are unclear. Expert commentary: It is possible that residual confounding might partly explain the better outcome of pneumonia in obese patients. On the other hand, obesity might indeed offer a survival advantage in patients with acute diseases, including pneumonia. Clearly, larger and well-designed studies are needed to clarify the pathogenetic links between obesity and pneumonia outcome, which might represent novel therapeutic targets in the management of infectious diseases.
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Affiliation(s)
- Marianthi Papagianni
- a First Propedeutic Department of Internal Medicine, Medical School , Aristotle University of Thessaloniki, AHEPA Hospital , Thessaloniki , Greece
| | - Konstantinos Tziomalos
- a First Propedeutic Department of Internal Medicine, Medical School , Aristotle University of Thessaloniki, AHEPA Hospital , Thessaloniki , Greece
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Luzak A, Fuertes E, Flexeder C, Standl M, von Berg A, Berdel D, Koletzko S, Heinrich J, Nowak D, Schulz H. Which early life events or current environmental and lifestyle factors influence lung function in adolescents? - results from the GINIplus & LISAplus studies. Respir Res 2017; 18:138. [PMID: 28701166 PMCID: PMC5508705 DOI: 10.1186/s12931-017-0619-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Accepted: 07/03/2017] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Various factors may affect lung function at different stages in life. Since investigations that simultaneously consider several factors are rare, we examined the relative importance of early life, current environmental/lifestyle factors and allergic diseases on lung function in 15-year-olds. METHODS Best subset selection was performed for linear regression models to investigate associations between 21 diverse early life events and current factors with spirometric parameters (forced vital capacity, forced expiratory volume in 1 s and maximal mid-expiratory flow (FEF25-75)) in 1326 participants of the German GINIplus and LISAplus birth cohorts. To reduce model complexity, one model for each spirometric parameter was replicated 1000 times in random subpopulations (N = 884). Only those factors that were included in >70% of the replication models were retained in the final analysis. RESULTS A higher peak weight velocity and early lung infections were the early life events prevalently associated with airflow limitation and FEF25-75. Current environmental/lifestyle factors at age 15 years and allergic diseases that were associated with lung function were: indoor second-hand smoke exposure, vitamin D concentration, body mass index (BMI) and asthma status. Sex and height captured the majority of the explained variance (>75%), followed by BMI (≤23.7%). The variance explained by early life events was comparatively low (median: 4.8%; range: 0.2-22.4%), but these events were consistently negatively associated with airway function. CONCLUSIONS Although the explained variance was mainly captured by well-known factors included in lung function prediction equations, our findings indicate early life and current factors that should be considered in studies on lung health among adolescents.
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Affiliation(s)
- Agnes Luzak
- Helmholtz Zentrum München - German Research Center for Environmental Health, Institute of Epidemiology I, Ingolstädter Landstr. 1, 85764, Neuherberg, Germany
| | - Elaine Fuertes
- Helmholtz Zentrum München - German Research Center for Environmental Health, Institute of Epidemiology I, Ingolstädter Landstr. 1, 85764, Neuherberg, Germany.,ISGlobal, Centre for Research in Environmental Epidemiology (CREAL), Doctor Aiguader 88, 08003, Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Plaça de la Mercè 10, 08002, Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Av. Monforte de Lemos, 3-5. Pabellón 11, 28029, Madrid, Spain
| | - Claudia Flexeder
- Helmholtz Zentrum München - German Research Center for Environmental Health, Institute of Epidemiology I, Ingolstädter Landstr. 1, 85764, Neuherberg, Germany
| | - Marie Standl
- Helmholtz Zentrum München - German Research Center for Environmental Health, Institute of Epidemiology I, Ingolstädter Landstr. 1, 85764, Neuherberg, Germany
| | - Andrea von Berg
- Department of Pediatrics, Research Institute, Marien-Hospital Wesel, Pastor-Janßen-Str. 8-38, 46483, Wesel, Germany
| | - Dietrich Berdel
- Department of Pediatrics, Research Institute, Marien-Hospital Wesel, Pastor-Janßen-Str. 8-38, 46483, Wesel, Germany
| | - Sibylle Koletzko
- Dr von Hauner Children's Hospital, Ludwig-Maximilians-University of Munich, Lindwurmstr. 4, 80337, Munich, Germany
| | - Joachim Heinrich
- Helmholtz Zentrum München - German Research Center for Environmental Health, Institute of Epidemiology I, Ingolstädter Landstr. 1, 85764, Neuherberg, Germany.,Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research, Max-Lebsche-Platz 31, 81377, Munich, Germany.,Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, University Hospital of Munich (LMU), Ziemssenstr. 1, 80336, Munich, Germany
| | - Dennis Nowak
- Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research, Max-Lebsche-Platz 31, 81377, Munich, Germany.,Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, University Hospital of Munich (LMU), Ziemssenstr. 1, 80336, Munich, Germany
| | - Holger Schulz
- Helmholtz Zentrum München - German Research Center for Environmental Health, Institute of Epidemiology I, Ingolstädter Landstr. 1, 85764, Neuherberg, Germany. .,Comprehensive Pneumology Center Munich (CPC-M), Member of the German Center for Lung Research, Max-Lebsche-Platz 31, 81377, Munich, Germany.
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Dejima H, Takahashi Y, Hato T, Seto K, Mizuno T, Kuroda H, Sakakura N, Kawamura M, Sakao Y. Mediastinal pulmonary artery is associated with greater artery diameter and lingular division volume. Sci Rep 2017; 7:1273. [PMID: 28455515 PMCID: PMC5430727 DOI: 10.1038/s41598-017-01384-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Accepted: 03/29/2017] [Indexed: 02/08/2023] Open
Abstract
Pulmonary vessels have numerous variation and aberrant branching patterns. Mediastinal lingular artery (MLA), the most common aberrant branch, might contribute to greater blood flow to lingular division. Hence, we investigated a correlation between lingular division volume and MLA using three-dimensional CT volumetry. We included 199 consecutive patients who underwent surveillance chest CT to detect possible malignancies in April 2015. We measured lingular division volume and cross-sectional area of lingular arteries using three-dimensional CT volumetry. MLA was identified in 58 cases (29.1%). The MLA group had significantly greater lingular division volume (median ± quartile deviation: 378.3 ± 75.5 mL vs. 330.0 ± 87.5 mL; p = 0.021) and percentage lingular division to left lung volume (19.0 ± 2.62% vs. 16.6 ± 2.39%; p < 0.001) than the non-MLA group. Total cross-sectional area of lingular arteries of the MLA group was significantly larger than that of the non-MLA group (46.1 ± 9.46 vs. 40.2 ± 5.76 mm2; p = 0.003). The total cross-sectional area of the lingular arteries strongly correlated to the percentage of lingular division to left lung volume (r = 0.689, p < 0.001). This is the first report demonstrating a positive correlation between branching pattern of pulmonary artery and lung volume.
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Affiliation(s)
- Hitoshi Dejima
- Department of Thoracic Surgery, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa, Nagoya, Aichi, Japan.,Department of General Thoracic Surgery, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi, Tokyo, Japan
| | - Yusuke Takahashi
- Department of General Thoracic Surgery, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi, Tokyo, Japan.
| | - Tai Hato
- Department of General Thoracic Surgery, Keio University School of Medicine, 31 Shinanomachi, Shinjuku, Tokyo, Japan
| | - Katsutoshi Seto
- Department of Thoracic Surgery, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa, Nagoya, Aichi, Japan
| | - Tetsuya Mizuno
- Department of Thoracic Surgery, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa, Nagoya, Aichi, Japan
| | - Hiroaki Kuroda
- Department of Thoracic Surgery, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa, Nagoya, Aichi, Japan
| | - Noriaki Sakakura
- Department of Thoracic Surgery, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa, Nagoya, Aichi, Japan
| | - Masafumi Kawamura
- Department of General Thoracic Surgery, Teikyo University School of Medicine, 2-11-1 Kaga, Itabashi, Tokyo, Japan
| | - Yukinori Sakao
- Department of Thoracic Surgery, Aichi Cancer Center Hospital, 1-1 Kanokoden, Chikusa, Nagoya, Aichi, Japan
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Yao TC, Tsai HJ, Chang SW, Chung RH, Hsu JY, Tsai MH, Liao SL, Hua MC, Lai SH, Chen LC, Yeh KW, Tseng YL, Lin WC, Chang SC, Huang JL. Obesity disproportionately impacts lung volumes, airflow and exhaled nitric oxide in children. PLoS One 2017; 12:e0174691. [PMID: 28376119 PMCID: PMC5380337 DOI: 10.1371/journal.pone.0174691] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Accepted: 03/12/2017] [Indexed: 01/14/2023] Open
Abstract
Background The current literature focusing on the effect of obesity and overweight on lung function and fraction of exhaled nitric oxide (FeNO) in children, particularly among healthy children of non-European descent, remains controversial. Furthermore, whether the relationship of obesity and overweight with lung function and FeNO in children is modified by atopy is unclear. The objective of this study was to examine the effect of excess weight on lung function parameters and FeNO among Asian children, with a particular focus on exploring the potential effect modification by atopy. Methods We investigated the effect of excess weight on lung function and FeNO in a population sample of 1,717 children aged 5 to 18 years and explored the potential modifying effect of atopy. Results There were positive associations of body mass index (BMI) z-score with forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), peak expiratory flow (PEF), and forced expiratory flow at 25–75% (FEF25-75) (all P<0.001), after controlling for confounders. The beta coefficient for FEV1 (0.084) was smaller than that for FVC (0.111). In contrast, a negative association was found between BMI z-score and FEV1/FVC ratio (P<0.001) and FeNO (P = 0.03). A consistent pattern of association for lung function variables was observed when stratifying by atopy. There was a negative association of BMI z-score with FeNO in atopic subjects (P = 0.006), but not in non-atopic subjects (P = 0.46). Conclusions Excess weight disproportionately impacts lung volumes and airflow in children from the general population, independent of atopic status. Excess weight inversely affects FeNO in atopic but not in non-atopic children.
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Affiliation(s)
- Tsung-Chieh Yao
- Division of Allergy, Asthma, and Rheumatology, Department of Pediatrics, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taoyuan, Taiwan
- Chang Gung Immunology Consortium, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taoyuan, Taiwan
- Community Medicine Research Center, Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan
- * E-mail: (TCY); (JLH)
| | - Hui-Ju Tsai
- Division of Biostatistics and Bioinformatics, Institutes of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan
- Department of Pediatrics, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, United States of America
- Allergy and Clinical Immunology Research Center, National Cheng Kung University, Tainan, Taiwan
| | - Su-Wei Chang
- Division of Allergy, Asthma, and Rheumatology, Department of Pediatrics, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taoyuan, Taiwan
- Clinical Informatics and Medical Statistics Research Center, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Ren-Hua Chung
- Division of Biostatistics and Bioinformatics, Institutes of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan
| | - Jing-Ya Hsu
- Division of Allergy, Asthma, and Rheumatology, Department of Pediatrics, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taoyuan, Taiwan
- Community Medicine Research Center, Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan
| | - Ming-Han Tsai
- Community Medicine Research Center, Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan
- Department of Pediatrics, Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan
| | - Sui-Ling Liao
- Community Medicine Research Center, Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan
- Department of Pediatrics, Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan
| | - Man-Chin Hua
- Community Medicine Research Center, Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan
- Department of Pediatrics, Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan
| | - Shen-Hao Lai
- Community Medicine Research Center, Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan
- Division of Pediatric Pulmonology, Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Li-Chen Chen
- Division of Allergy, Asthma, and Rheumatology, Department of Pediatrics, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taoyuan, Taiwan
- Community Medicine Research Center, Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan
| | - Kuo-Wei Yeh
- Division of Allergy, Asthma, and Rheumatology, Department of Pediatrics, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taoyuan, Taiwan
- Community Medicine Research Center, Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan
| | - Yu-Lun Tseng
- Division of Allergy, Asthma, and Rheumatology, Department of Pediatrics, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taoyuan, Taiwan
- Community Medicine Research Center, Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan
| | - Wan-Chen Lin
- Division of Allergy, Asthma, and Rheumatology, Department of Pediatrics, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taoyuan, Taiwan
- Community Medicine Research Center, Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan
| | - Su-Ching Chang
- Division of Allergy, Asthma, and Rheumatology, Department of Pediatrics, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taoyuan, Taiwan
- Community Medicine Research Center, Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan
| | - Jing-Long Huang
- Division of Allergy, Asthma, and Rheumatology, Department of Pediatrics, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taoyuan, Taiwan
- Community Medicine Research Center, Chang Gung Memorial Hospital at Keelung, Keelung, Taiwan
- * E-mail: (TCY); (JLH)
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Andrade FSDSDD, Teixeira RDC, Araújo DA, Barbosa TR, Sousa FDJDD, Cruz RV. Lung function and functional capacity in school age children. FISIOTERAPIA EM MOVIMENTO 2017. [DOI: 10.1590/1980-5918.030.001.ao08] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Abstract Introduction: Six-minute walk test (TC6’) and peak expiratory flow (PEF) can be influenced by variables like gender, age and body mass index (BMI). In the school context, these tests can identify losses caused by sedentary habits and/or manifestation of overweight/obesity. Nevertheless, although widely studied in the adult context, they have not been properly clarified in the child public. Objective: To assess the PEF and TC6’ between students in the public and private network and to correlate them with factors like age, gender and BMI. Methods: 39 male and female children between eight and ten years of age were selected for the study. The TC6’ was held at a sports court. The child was instructed to walk at maximum speed for six minutes and the PEF test took place in accordance to the recommendations by Pereira et al (1). Results: No significant correlation was found between the BMI and the PEF and TC6’ scores. No significant correlation was found between sex and PEF, with measures within normal parameters for the entire sample. The EPF measures did not influence the distance walked in the TC6’. A significant correlation was found between sex and distance walked in the TC6’ only among male children attending public schools. Conclusion: Both sex and BMI did not influence the PEF measures which, in turn, does not seem to have influenced the distance the sample walked in the TC6’. Also concerning the TC6’, only the children from public school reached the normal scores proposed in the literature.
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The effect of scoliosis surgery on pulmonary function in spinal muscular atrophy type II patients. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2016; 26:1721-1731. [DOI: 10.1007/s00586-016-4828-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2015] [Revised: 09/24/2016] [Accepted: 10/16/2016] [Indexed: 11/24/2022]
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Chen YC, Huang YL, Ho WC, Wang YC, Yu YH. Gender differences in effects of obesity and asthma on adolescent lung function: Results from a population-based study. J Asthma 2016; 54:279-285. [PMID: 27435689 DOI: 10.1080/02770903.2016.1212367] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To investigate lung function associated with asthma and body mass index (BMI) among adolescents at 96 northern Taiwan junior high schools participating in an asthma screening program. METHODS The questionnaires and lung function test results measured for 3669 boys and 3523 girls were included in this study for data analysis. Measures of forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1) and FEV1/FVC ratio were compared by sex, asthma status and BMI. RESULTS Overall mean FVC levels were similar between students with and without asthma, 3.71 L vs. 3.71 L for boys (p = 0.991) and 2.79 vs. 2.78 for girls (p = 0.517). The overall mean FEV1 levels were also similar between girls with and without asthma. Asthmatic boys had lower FEV1 than non-asthmatic boys. Mean FEV1/FVC was significantly lower in students with asthma than those without asthma. Mean FVC and FEV1 increased with BMI in both sexes. A lower mean FEV1/FVC was observed among students with asthma and high BMI, and was more pronounced in boys than in girls. Multivariable regression analysis also showed that FEV1/FVC ratios were negatively associated with asthma and high BMI, stronger in boys than in girls for asthma (β = -2.176 (standard errors (SE) = 0.268) vs. -1.085 (SE = 0.258) and for BMI (β = -0.309 (SE = 0.025) vs. -0.218 (SE = 0.029)). CONCLUSION This northern Taiwan study suggests that FEV1/FVC is negatively associated with asthma and high BMI in adolescents, stronger for boys than for girls.
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Affiliation(s)
- Yi-Chun Chen
- a Department of Health Management , I-Shou University , Kaohsiung , Taiwan
| | - Yu-Li Huang
- b Department of Safety, Health and Environmental Engineering , National Kaohsiung First University of Science and Technology , Kaohsiung , Taiwan
| | - Wen-Chao Ho
- c Department of Environmental Engineering , College of Engineering, Chung Yuan Christian University , Chung Li , Taiwan
| | - Yu-Chun Wang
- d Department of Public Health , China Medical University , Taichung , Taiwan
| | - Yang-Hao Yu
- e Department of Internal Medicine , Divisions of Pulmonary and Critical Care Medicine, China Medical University Hospital , Taichung , Taiwan.,f School of Medicine, China Medical University , Taichung , Taiwan
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