Correlation between peak flow and body mass index in obese and non-obese children in Kocaeli, Turkey

Association between the Risk of Obstructive Sleep Apnea and Lung Function: Korea National Health and Nutrition Examination Survey

BACKGROUND

Obstructive sleep apnea (OSA) is a prevalent sleep disorder associated with various health issues. Although some studies have suggested an association between reduced lung function and OSA, this association remains unclear. Our study aimed to explore this relationship using data from a nationally representative population- based survey.

METHODS

We performed an analysis of data from the 2019 Korea National Health and Nutrition Examination Survey. Our study encompassed 3,675 participants aged 40 years and older. Risk of OSA was assessed using the STOP-Bang (Snoring, Tiredness during daytime, Observed apnea, and high blood Pressure-Body mass index, Age, Neck circumference, Gender) questionnaire and lung function tests were performed using a portable spirometer. Logistic regression analysis was applied to identify the risk factors associated with a high-risk of OSA, defined as a STOP-Bang score of ≥3.

RESULTS

Of 3,675 participants, 600 (16.3%) were classified into high-risk OSA group. Participants in the high-risk OSA group were older, had a higher body mass index, and a higher proportion of males and ever-smokers. They also reported lower lung function and quality of life index in various domains along with increased respiratory symptoms. Univariate logistic regression analysis indicated a significant association between impaired lung function and a high-risk of OSA. However, in the multivariable analysis, only chronic cough (odds ratio [OR], 2.413; 95% confidence interval [CI], 1.383 to 4.213) and sputum production (OR, 1.868; 95% CI, 1.166 to 2.992) remained significantly associated with a high OSA risk.

CONCLUSION

Our study suggested that, rather than baseline lung function, chronic cough, and sputum production are more significantly associated with OSA risk.

Factors Responsible for Nonselection of Donors in Living Related Kidney Transplantation

OBJECTIVES

Living donor kidney transplant is the preferred method of renal transplant in Pakistan as deceased donor transplant has not yet been estab-lished. However, many patients who are dialysis-dependent, particularly younger patients, lack suitable living related donors. We aimed to determine factors contributing to nonselection of donors for living related renal transplant in Pakistan.

MATERIALS AND METHODS

For this cross-sectional study, we included patients seen at the Sindh Institute of Urology & Transplantation Karachi, Pakistan) from March to November 2019. Potential donors were adult family members who accompanied patients with end-stage kidney disease to the clinic. Demographic and clinical information were recorded on predesigned proforma. After workup and baseline investigations had been completed, potential living related donors were selected. Factors leading to nonselection of donors were noted for those who did not qualify for donation. We used SPSS version 20 for analysis.

RESULTS

During the study period, 253 potential donors (151 males, 102 females) with mean age of 35.68 ± 6.14 years were found to be ineligible for kidney donation. ABO incompatibility was the most common factor leading to nonselection (n = 101; 39.92%), followed by diabetes mellitus (n = 71; 28.06%), hypertension (n= 50; 19.76%), renal disease (n = 15; 5.92%), liver disease (n = 8; 3.16%), crossmatch positive (n = 5; 1.97%), and ischemic heart disease (n = 3; 1.18%). No differences were shown between potential male and female donors regarding factors leading to nonselection; diabetes was significantly more prevalent among those <40 years of age (P = .025).

CONCLUSIONS

ABO incompatibility, diabetes mellitus, and hypertension were the most common factors leading to nonselection of potential donors in living related kidney transplant. More efforts are needed to expand the donor pool by considering second- or third-degree relatives to tackle the scarcity of organs for transplantation.

Peak expiratory flow, core performance and physical activity in normal-weight, overweight, and obese adolescents

The objectives of this study were to (1) compare peak expiratory flow (PEF), physical activity (PA), and core performance among normal-weight, overweight, and obese adolescents and (2) explore the relationships between PEF, physical activity, core performance, and anthropometric measurements across these groups. Ninety adolescents aged 10-13 yr were categorized based on BMI: normal weight (n = 30, 5th to < 85th percentile, BMI-Z score -2 to < 1), overweight (n = 30, 85th to < 95th percentile, BMI-Z score 1 to < 2), and obese (n = 30, > 95th percentile, BMI-Z score > 2). PEF and percent-predicted values of PEF (PEF% pred) values were calculated. Waist and neck circumferences were measured. Physical activity levels were assessed using the Physical Activity Questionnaire for Older Children (PAQ-C), from which total and subscores were derived. Core performance was evaluated through modified push-up (MPU) and sit-up tests. The PEF% pred and PAQ-C scores showed no significant differences between groups (p > 0.05). However, MPU repetition rates were significantly lower in obese adolescents compared to overweight (p = 0.019) and normal-weight peers (p < 0.001). There was a significant correlation between PEF% pred and PAQ-C total scores (p = 0.014), as well as out-of-school subscores (p = 0.039) in overweight adolescents. Similarly, PEF% pred was linked to MPU repetitions in obese adolescents (p = 0.029). Obese adolescents exhibited decreased core performance relative to their overweight and normal-weight counterparts, which correlated with the PEF% pred. Physical activity was associated with PEF% pred exclusively in overweight adolescents.

Relationship between peak expiratory flow and impaired functional capacity in obese individuals

Abstract Introduction: Obesity, characterized by the accumulation of excess body fat, can alter respiratory mechanics and compromise functional capacity. Given its increasing prevalence and the significant morbidity associated with the condition, it is important to investigate techniques that enable rapid, easy measurement of lung function and the possible correlation between obesity and functional capacity. Objective: To assess lung function and functional capacity in obese adults and determine whether there is a correlation between reduced peak expiratory flow and impaired functional capacity. Methods: 30 participants, distributed into two groups: obese (36 ± 13 years) and normal weight (31 ± 9 years) were evaluated based on anthropometric measurements, the six-minute walk test (6MWT) and peak expiratory flow (PEF). Results: The obese individuals showed reduced PEF (382 ± 99 vs. 497 ± 104 L/min, p < 0.01), walked shorter distances in the 6MWT (453 ± 37 vs. 617 ± 50 m, p < 0.01), had higher blood pressure and perceived exertion (p < 0.05) when compared to normal weight participants. Additionally, there was a positive significant association between expiratory flow and distance walked in the 6MWT (r = 0.635 and p < 0.001). Conclusion: Obese individuals exhibited lower PEF and walked shorter distances in the 6MWT, indicating a positive correlation between these two variables. In light of this outcome, the assessment methods used could contribute to improving analysis of respiratory and functional status in this population and aid in exercise prescription.

Lung function in obese children and adolescents without respiratory disease: a systematic review

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.

New Risk Factors for Transient Tachypnea of the Newborn and Childhood Asthma: A Study of Clinical Data and a Survey of Parents

Objectives: It is established that transient tachypnea of the newborn (TTN) is associated with an increased risk of early childhood asthma. However, the question remains whether both asthma and TTN have common risk factors as well as the same underlying etiology. This study aims to determine possible risk factors for TTN as well as early childhood asthma.

Methods: This study was carried out in two phases. While the first phase included medical records of 1318 newborns, the second phase consisted of a phone survey.

Results: Elective cesarean section (ECS), maternal asthma, gestational age (GA), babies with large and small birth weight, number of pregnancies, and number of children were found to be significantly associated with TTN. ECS, maternal asthma, length of the hospital stay due to TTN, and O₂ treatment were statistically significant for asthma. TTN was found to be associated with a subsequent diagnosis of childhood asthma after adjusting for ECS and maternal asthma.

Conclusions: Both ECS and maternal asthma are the common risk factors for the development of both TTN and childhood asthma as previously reported. In order to uncover this association, when ECS is taken out, it is seen that the association between TTN and asthma is stronger. Furthermore, O₂ treatment and duration of hospital stay due to TTN were also found to be associated with childhood asthma. Association of maternal allergic rhinitis and eczema with TTN was investigated and there was no relationship between maternal allergic rhinitis or maternal eczema and the subsequent diagnosis of TTN.

Relationship between ultrasound bone parameters, lung function, and body mass index in healthy student population

Low bone mineral density has been reported in paediatric and adult patients with different lung diseases, but limited data are available on the association between lung function and bone density in a healthy young population. We explored the predictors of association between bone mass and pulmonary function in healthy first-year university students, focusing on body mass index (BMI). In this cross-sectional study we measured bone density with ultrasound and lung function with spirometry in 370 university students (271 girls and 99 boys). Information on lifestyle habits, such as physical activity, smoking, and alcohol consumption were obtained with a questionnaire. All lung function and bone parameters were significantly higher in boys than in girls (P<0.001). Underweight students had a significantly lower forced vital capacity (FVC%) (P=0.001 girls; P=0.012 boys), while overweight students had a significantly higher FVC% than normal weight students (P=0.024 girls; P=0.001 boys). BMI significantly correlated with FVC% (P=0.001) and forced expiratory volume in 1 second (FEV1 %) in both genders (P=0.001 girls; P=0.018 boys) and with broadband ultrasound attenuation (BUA) in boys. There were no significant associations between any of the bone and lung function parameters either in boys or girls. The most important determinant of lung function and ultrasound bone parameters in our study population was body mass index, with no direct association between bone density and lung function.

Maximal Oxygen Consumption, Respiratory Volume and Some Related Factors in Fire-fighting Personnel

Background:

Firefighters for difficult activities and rescue of damaged people must be in appropriate physical ability. Maximal oxygen capacity is an indicator for diagnosis of physical ability of workers. This study aimed to assess the cardiorespiratory system and its related factors in firefighters.

Methods:

This study was conducted on 110 firefighters from various stations. An self-administered questionnaire (respiratory disorders questionnaire, Tuxworth-Shahnavaz step test, and pulmonary function test) was used to collection of required data. Average of humidity and temperature was 52% and 17°C, respectively. Background average noise levels were between 55 and 65 dB. Data were analyzed using SPSS software (version 19).

Results:

The mean age of the study participants was 32 ± 6.2 years. The means of forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), and FEV1/FVC were 92% ±9.4%, 87% ±9.2%, and 80% ±6.1%, respectively. The participants’ mean VO₂-max was 2.79 ± 0.29 L/min or 37.34 ± 4.27 ml/kg body weight per minute. The results revealed that weight has a direct association with vital capacity (VC), FVC, and peak expiratory flow. In addition, height was directly associated with VC, FVC, and VO₂-max (P < 0.05). However, there was an inverse and significant association between height and FEV1/FVC (r = −0.23, P < 0.05). Height, weight, body mass index, and waist circumference were directly associated with VO₂-max.

Conclusions:

The findings of this study showed that the amount of maximum oxygen consumption is close with the proposed range of this parameter among firefighters in other studies. Furthermore, the results of the study revealed that individuals had normal amounts of lung volume index. This issue can be attributed to the appropriate usage of respiratory masks.

Lung function and functional capacity in school age children

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.

Pulmonary function of adolescents from Tripura, a North-eastern state of India

Objective:

Spirometric evaluation of pulmonary function has been evolved as clinical tool in diagnosis, management, and follow-up of respiratory disorders. There are very few studies on normative reference values of pulmonary function parameters for adolescents from Tripura, a North-eastern state of India. The present study was aimed to evaluate pulmonary function and their predictors in male and female adolescents of Tripura.

Materials and Methods:

A total of 640 (320 from tribal and 320 non-tribal) healthy, non-smoking male and female school children (age 10-14 years) from four different districts of Tripura were randomly sampled for the study. The pulmonary function parameters analysed included forced vital capacity (FVC), forced expiratory volume in 1 second (FEV₁), peak expiratory flow rate (PEFR), forced expiratory flow between 25% and 75% expired volume (FEF_25-75%), ratio of FEV₁/FVC and maximum voluntary ventilation (MVV).

Results:

The results revealed that body weight, body mass index (BMI), PEFR, FEF_25-75% and MVV are significantly high among male tribal children in comparison to non-tribal children. Height, weight, waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), PEFR and MVV were found to be significantly more in tribal girls. In case of adolescents from Tripura, most of the pulmonary function parameters correlated with anthropometric parameters of the subject like height, weight, BMI, WHR, and WHtR.

Conclusion:

From the present study, it can be concluded that both anthropometric and pulmonary function status of tribal and non-tribal adolescents from Tripura are comparable. The computed regression norms may be used to predict pulmonary function of adolescents from Tripura by using anthropometric indices.

Effects of ionizing radiation on respiratory function tests and blood parameters in radiology staff

AIM

To evaluate pulmonary function tests and blood parameters and their relationship with sociodemographic data for radiology staff continuously exposed to ionizing radiation.

SUBJECTS AND METHODS

Thirty-eight personnel from Suleyman Demirel University Training and Research Hospital, Radiology Unit, were included in this study. Sociodemographic data were evaluated by a questionnare that was developed by the researchers. Height and weight measurements were performed with a standard scale and meter. Routine blood parameters and spirometric lung function measurements of the cases were recorded. Statistical significances were determined by independent t-test, analysis of variance (ANOVA), bivariate correlation and Kruskal-Wallis tests using SPSS 18.0.

RESULTS

The mean age was 32.42 ± 5.5 years; 19 patients (50%) were male and 19 patients (50%) were female. Body mass index (BMI) was calculated as 25.68 ± 0.47 for men and 24.58 ± 1.13 for women. Forced vital capacity (FVC), forced expiratory volume in the 1st second (FEV1), peak expiratory flow (PEF) and maximum mid-expiratory flow (FEF25-75) showed negatively statistically significant differences between gender (p < 0.01). In addition, FEV1 and FEF25-75 also demonstrated statistically negatively significant difference with the type of task (p < 0.05). A statistically significant negative difference was found between FEF25-75 value and time to start smoking (p < 0.05). Among FVC, FEV1, PEF and FEF25-75 values and alcohol usage, statistically significant positive difference was detected (p < 0.05). Statistically significant positive difference was found among FVC, PEF and FEF25-75 values and sports activity (p < 0.05). According to BMI groups, statistically significant positive difference with FVC, FEV1 and PEF values were found (p < 0.05). Statistically significant correlations were found among FVC value and haemoglobin level (Hgb), haematocrit level (Hct) and mean corpuscular volume (MCV), among FEV1 value and Hgb, MCV, among PEF value and red blood cell count (RBC), Hgb, Hct, MCV, red cell distribution width (RDW), and between FEF25-75 value and MCV.

CONCLUSION

Although respiratory functions of radiology staff are affected by many factors, continuous exposure to ionizing radiation is one of the important parameters. Radiology staff should be informed about factors that negatively affect the respiratory functions.

Peak expiratory flow rate of healthy school children living at high altitude

Background:

Anthropometric and socioeconomic factors are known to influence peak expiratory flow rate, but the effect of altitude has not been established decisively, due to conflicting results of various studies.

Aim:

This study was conducted to evaluate the effect of altitude on peak expiratory flow rate of healthy school children.

Materials and Methods:

A cross-sectional study was conducted in which the peak expiratory flow rate of a group of 290 school children (140 male and 150 female), aged 7-14 years, residing in Shimla (altitude 2150 meters), were compared with the results obtained in an age- and sex-matched control group, consisting of 280 school children (138 male and 142 female), residing in Patiala (altitude 278 meters). Mini Wright Peak Flow Meter was used for the study.

Results:

The mean peak expiratory flow rate value of boys at high altitude (265 ± 92.6 L/min) was significantly higher than those in plain areas (245 ± 82.1 L/min). Similarly, the mean peak expiratory flow rate of highlander girls (250.4 ± 70.2 L/min) was significantly higher than girls of plains (232.6 ± 65 L/min).

Conclusion:

The study suggests that besides anthropometric and socioeconomic factors, altitude is an important determinant of lung function.

Assessment of airway resistance in normal trained and fat untrained adolescent boys influenced by exercise experiences

BACKGROUND

Overweight and obese children are at increased risk of a wide range of health conditions including respiratory diseases. In addition, inactivity can decrease pulmonary function. This study assessed the effect of obesity and inactivity on pulmonary function impairment in adolescents.

MATERIALS AND METHODS

This study was conducted on 80 adolescents. Subjects were divided into two groups. Group I included 40 untrained (VO2max= 29.30±4.20) fat adolescents (UO). Group II included 40 healthy trained (VO2max= 58.11±2.23) normal weight adolescents (TN). Body mass index (BMI), body fat percentage and waist to hip ratio (WHR) were calculated and pulmonary function tests were carried out according to the standard protocols. Data were analyzed using student's "t" test and Pearson's correlation coefficient.

RESULTS

UO had significantly lower pulmonary function values than the TN group. They also showed lower FEV1/FVC ratio when compared to TN group (P < 0.05). In UO group, BMI, body fat percentage and WHR had a significant negative correlation with pulmonary function whereas in TN group only BMI had significant negative correlation with pulmonary function. A significant decrease in FEV1 was observed in the two groups, which led to a decrease in FEV1/FVC% after the exercise compared to before. Thus, exercise test induced airway resistance in both groups.

CONCLUSION

untrained obese adolescents have more respiratory symptoms than their normal weight trained peers, and these factors are recommended to be used as a predictor of pulmonary function in assessment of obese children in epidemiological studies. In addition, obesity and inactivity can surcharge pulmonary function abnormalities in adolescents.