The Ventilatory and Diffusion Dysfunctions in Obese Patients with and without Obstructive Sleep Apnea-Hypopnea Syndrome

Abstract

Objective. To analyze the ventilatory and alveolar-capillary diffusion dysfunctions in case of obesity with or without an OSAS. Methods. It is a cross-sectional study of 48 obese adults (23 OSAS and 25 controls). Anthropometric data (height, weight, and body mass index (BMI)) were collected. All adults responded to a medical questionnaire and underwent polysomnography or sleep polygraphy for apnea-hypopnea index (AHI) and percentage of desaturation measurements. The following lung function data were collected: pulmonary flows and volumes, lung transfer factor for carbon monoxide (DLCO), and fraction of exhaled nitric oxide (FeNO). Results. Obesity was confirmed for the two groups with a total sample mean value of BMI = 35.06 ± 4.68 kg/m2. A significant decrease in lung function was noted in patients with OSAS compared with controls. Indeed, when compared with the control group, the OSAS one had a severe restrictive ventilatory defect (total lung capacity: 93 ± 14 vs. 79 ± 12%), an abnormal DLCO (112 ± 20 vs. 93 ± 22%), and higher bronchial inflammation (18.40 ± 9.20 vs. 31.30 ± 13.60 ppb) (p<0.05). Conclusion. Obesity when associated with OSAS increases the severity of pulmonary function and alveolar-capillary diffusion alteration. This can be explained in part by the alveolar inflammation.

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“…Obesity is known to be highly correlated with the presence of OSA, and it was undiagnosed in the vast majority [ 20 , 21 ]. This is because OSA causes decreased lung function, and importantly, increased lung inflammation [ 22 ]. In addition, angiotensin-converting enzyme (ACE) plasma activity is known to be increased in untreated patients with OSA [ 23 ].…”

“…Obesity is known to be highly correlated with the presence of OSA, and it was undiagnosed in the vast majority [20,21]. This is because OSA causes decreased lung function, and importantly, increased lung inflammation [22]. In addition, Fig.…”

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“…Similar to our study, in many studies, FEV1 was considered to be an unsuitable tool for assessing the functional impact of OSAS as these data did not show a significant difference between participants with and without OSAS during their studies. [ 4 ]…”

“…Rouatbi et al . [ 4 ] found in her study that obesity when associated with OSAS increases the severity of pulmonary function abnormalities.…”

“…Obese patients have reduced functional residual capacity which leads to significant intrathoracic depression at the beginning of inspiration caused by the contraction of the diaphragm and the result is pharyngeal collapse in these patients. [ 4 ] A 10% gain in bodyweight could predict a 32% increase in apnea–hypopnea index (AHI). [ 4 ]…”