Waist-to-Hip Ratio Is Associated With Pulmonary Gas Exchange in the Morbidly Obese

Zavorsky, Gerald S.; Murias, Juan M.; Kim, Do Jun; Gow, Jennifer; Sylvestre, Jean-Loup; Christou, Nicolas V.

doi:10.1378/chest.06-1513

Cited by 66 publications

(69 citation statements)

References 11 publications

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“…The waist-to-hip ratio has been suggested to explain a large part of the variance in pulmonary functions rather than the BMI (33,34); in order to decrease the lung volume in obese patients, fat distribution and tissue composition are needed (35). However, body proportions normally change during pubertal development and can vary according to the individual, therefore, measuring waist circumference and fat distribution makes it difficult to interpret in children.…”

Section: Discussionmentioning

confidence: 99%

The Effect of Obesity Degree on Childhood Pulmonary Function Tests

Torun¹,

Çakır²,

Özgüç³

et al. 2014

Balkan Med J

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Background:Childhood obesity has become a global epidemic. It is related to several chronic diseases such as essential hypertension, type 2 diabetes mellitus, and renal disease. The relationship between the degree of obesity and lung functions is well defined in adults, but limited information is available about the childhood period. Aims: This study aims to determine the impact of the degree of obesity on the pulmonary functions of school children and adolescents. Study Design: Cross sectional study. Methods: Included in the study were a total of 170 school children and adolescents (9-17 years old) referred to our paediatric outpatient clinic. Of these subjects, 42 were lean and non-obese (BMI % <85), 30 subjects were overweight (BMI % ˃85, <95), 34 subjects were obese (BMI % ˃95, <97), and 64 subjects were morbidly obese (BMI % ˃97). Anthropometric measurements were taken and spirometry was performed on all subjects. Forced vital capacity (FVC), forced expiratory volume in 1 second (FEV 1 ), forced vital capacity ) and peak expiratory flow (PEF) were used to measure the ventilatory functions for all the subjects. Results: The groups showed no significant differences in age or gender. Despite no statistically significant differences in FEV 1 , FVC, or FEV 1 /FVC, there were significant reductions in PEF (p<0.001) and FEV 25-75 (p<0.001) in the overweight, obese and morbidly obese subjects, when compared with those who were non-obese. Conclusion: Overweight, obese and morbidly obese children have no obstructive abnormalities compared with healthy lean subjects. (Balkan Med J 2014;31:235-8).

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Section: Discussionmentioning

confidence: 99%

The Effect of Obesity Degree on Childhood Pulmonary Function Tests

Torun¹,

Çakır²,

Özgüç³

et al. 2014

Balkan Med J

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“…Studies have shown that morbid obesity can affect pulmonary exchange at rest [1][2][3][4][5][6] and that it has been associated with the waist-to-hip ratio [7]. This is likely because obesity results in increased ventilatory constraints due to large abdominal fat mass surrounding the chest [14,15], which can promote ventilation-perfusion inequality (low V/Q ratios) [16].…”

Section: Discussionmentioning

confidence: 99%

“…Specifically, the impairment in pulmonary gas exchange, otherwise known as the alveolar-arterial PO 2 difference (AaDO 2 ), has been associated with the waist-to-hip ratio in the morbidly obese [7]. If an impairment in pulmonary gas exchange, as well as a reduction in arterial PO 2 (PaO 2 ) and an increase in arterial PCO 2 (PaCO 2 ) is related to the waist circumference and waist-to-hip ratio in the morbidly obese at rest [7], then these variables may also be affected during exercise.…”

Section: Introductionmentioning

confidence: 99%

Compensatory Exercise Hyperventilation is Restored in the Morbidly Obese After Bariatric Surgery

2008

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“…6 However, a review of the literature found better P aO 2 (by 10 mm Hg, range 1-23 mm Hg) as well as reduced P (A-a)O 2 (by Ϫ8 mm Hg, range Ϫ3 to Ϫ16 mm Hg) and P aCO 2 values (by Ϫ3 mm Hg, range 3 to Ϫ14 mm Hg) for a mean ⌬BMI of Ϫ13 kg/m 2 . 29 The better gas exchange at rest described in morbidly obese women compared with men, attributed to lower waist-tohip ratios in women, 30 may explain the minor difference in P aO 2 and P aCO 2 values recorded before and after weight loss in our cohort (sex ratio [M/F]: 2/8). 29 …”

Section: Discussionmentioning

confidence: 73%

Effect of Weight Loss on Postural Changes in Pulmonary Function in Obese Subjects: A Longitudinal Study

et al. 2015

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BACKGROUND: Postural changes are known to affect normal lung volumes. A reduction in sitting to supine functional residual capacity (FRC) is well-described in non-obese subjects adopting a supine position. However, postural changes in lung volumes in the obese require further exploration. We aimed to longitudinally address the effects of weight loss on postural changes in lung volumes and pulmonary function in obese subjects. We tested the hypothesis that supine reduction in FRC would be absent in morbid obesity and recovered upon weight loss. METHODS: This was a prospective, observational, longitudinal study. Consecutive morbidly obese adults (N ‫؍‬ 12, age: 44 ؎ 14 y, body mass index: 45 ؎ 5 kg/m 2 ) enrolled in a bariatric surgery program were included. Standard pulmonary function tests and blood gas analysis were performed both before and 1 y after surgery. Pulmonary function was assessed in both the sitting and supine position using spirometry and multi-breath helium dilution. Parameters recorded before and after weight loss were compared. The main outcome measure was FRC. RESULTS: Ten subjects were retested 1 y after surgery (body mass index: 31 ؎ 5 kg/m 2 ). FRC was not affected by change in posture before surgery. Supine reduction in FRC was observed after weight loss (⌬FRC: ؊0.6 ؎ 0.4 L, sitting vs supine, P ‫؍‬ .002). Pulmonary gas exchange improved (alveolar-to-arterial oxygen partial pressure difference: ؊8 ؎ 11 mm Hg, P ‫؍‬ .035). CONCLUSIONS: Although postural change in FRC is absent when the morbidly obese adopt a supine position, supine reduction in FRC can be recovered following gastroplasty-induced weight loss, despite residual mild to moderate obesity. This also shows that mild to moderate obesity may affect supine FRC more than morbid obesity. (ClinicalTrials.gov registration NCT02207192.) Key words: lung function; obesity; weight loss; postural change; pulmonary function test; functional residual capacity; bariatric surgery. [Respir Care 2015;60(7):992-999.

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Waist-to-Hip Ratio Is Associated With Pulmonary Gas Exchange in the Morbidly Obese

Cited by 66 publications

References 11 publications

The Effect of Obesity Degree on Childhood Pulmonary Function Tests

The Effect of Obesity Degree on Childhood Pulmonary Function Tests

Compensatory Exercise Hyperventilation is Restored in the Morbidly Obese After Bariatric Surgery

Effect of Weight Loss on Postural Changes in Pulmonary Function in Obese Subjects: A Longitudinal Study

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