Kim D G van de Kant1, Paolo Paredi2, Sally Meah3, Harpal S Kalsi4, Peter J Barnes5, Omar S Usmani6. 1. National Heart and Lung Institute, Imperial College, Dovehouse Street, London SW3 6LY, United Kingdom. Electronic address: kim.vande.kant@mumc.nl. 2. National Heart and Lung Institute, Imperial College, Dovehouse Street, London SW3 6LY, United Kingdom. Electronic address: p.paredi@imperial.ac.uk. 3. National Heart and Lung Institute, Imperial College, Dovehouse Street, London SW3 6LY, United Kingdom. Electronic address: sally.meah@imperial.ac.uk. 4. National Heart and Lung Institute, Imperial College, Dovehouse Street, London SW3 6LY, United Kingdom. Electronic address: h.kalsi09@imperial.ac.uk. 5. National Heart and Lung Institute, Imperial College, Dovehouse Street, London SW3 6LY, United Kingdom. Electronic address: p.j.barnes@imperial.ac.uk. 6. National Heart and Lung Institute, Imperial College, Dovehouse Street, London SW3 6LY, United Kingdom. Electronic address: o.usmani@imperial.ac.uk.
Abstract
BACKGROUND/ OBJECTIVES: Obesity is a global health problem that adversely influences the respiratory system. We assessed the effects of body mass index (BMI) on distal airway function and airway inflammation. SUBJECTS/ METHODS: Impulse oscillometry (IOS) as a measure of distal airway function, together with spirometry, were assessed in adults with a range of different BMIs. Airway inflammation was assessed with the fraction of exhaled nitric oxide (FeNO) and participants exhaled at various exhalation flows to determine alveolar and bronchial NO. RESULTS: In total 34 subjects were enrolled in the study; 19 subjects had a normal BMI (18.50-24.99), whilst 15 subjects were overweight (BMI 25.00-29.99), or obese (BMI ≥30). All subjects had normal spirometry. However, IOS measures of airway resistance (R) at 5Hz, 20Hz and frequency dependence (R5-20) were elevated in overweight/obese individuals, compared to subjects with a normal BMI (median (interquartile range)); 5Hz: 0.41 (0.37, 0.45) vs. 0.32 (0.30, 0.37)kPa/l/s; 20Hz: 0.34 (0.30, 0.37) vs. 0.30 (0.26, 0.33)kPa/l/s; R5-20: 0.06 (0.04, 0.11) vs. 0.03 (0.01, 0.05)kPa/l/s; p<0.05), whereas airway reactance at 20Hz was decreased in overweight/obese individuals (20Hz: 0.07 (0.03, 0.09) vs. 0.10 (0.07, 0.13)kPa/l/s, p=0.009; 5Hz: -0.12 (-0.15, -0.10) vs. -0.10 (-0.13, -0.09)kPa/l/s, p=0.07). In contrast, within-breath IOS measures (a sign of expiratory flow limitation) and FeNO inflammatory measures, did not differ between groups (p>0.05). CONCLUSIONS: Being overweight has significant effects on distal and central airway function as determined by IOS, which is not detected by spirometry. Obesity does not influence airway inflammation as measured by FeNO. IOS is a reliable technique to identify airway abnormalities in the presence of normal spirometry in overweight people.
BACKGROUND/ OBJECTIVES: Obesity is a global health problem that adversely influences the respiratory system. We assessed the effects of body mass index (BMI) on distal airway function and airway inflammation. SUBJECTS/ METHODS: Impulse oscillometry (IOS) as a measure of distal airway function, together with spirometry, were assessed in adults with a range of different BMIs. Airway inflammation was assessed with the fraction of exhaled nitric oxide (FeNO) and participants exhaled at various exhalation flows to determine alveolar and bronchial NO. RESULTS: In total 34 subjects were enrolled in the study; 19 subjects had a normal BMI (18.50-24.99), whilst 15 subjects were overweight (BMI 25.00-29.99), or obese (BMI ≥30). All subjects had normal spirometry. However, IOS measures of airway resistance (R) at 5Hz, 20Hz and frequency dependence (R5-20) were elevated in overweight/obese individuals, compared to subjects with a normal BMI (median (interquartile range)); 5Hz: 0.41 (0.37, 0.45) vs. 0.32 (0.30, 0.37)kPa/l/s; 20Hz: 0.34 (0.30, 0.37) vs. 0.30 (0.26, 0.33)kPa/l/s; R5-20: 0.06 (0.04, 0.11) vs. 0.03 (0.01, 0.05)kPa/l/s; p<0.05), whereas airway reactance at 20Hz was decreased in overweight/obese individuals (20Hz: 0.07 (0.03, 0.09) vs. 0.10 (0.07, 0.13)kPa/l/s, p=0.009; 5Hz: -0.12 (-0.15, -0.10) vs. -0.10 (-0.13, -0.09)kPa/l/s, p=0.07). In contrast, within-breath IOS measures (a sign of expiratory flow limitation) and FeNO inflammatory measures, did not differ between groups (p>0.05). CONCLUSIONS: Being overweight has significant effects on distal and central airway function as determined by IOS, which is not detected by spirometry. Obesity does not influence airway inflammation as measured by FeNO. IOS is a reliable technique to identify airway abnormalities in the presence of normal spirometry in overweight people.
Authors: Abigail Gaylord; Kenneth I Berger; Mrudula Naidu; Teresa M Attina; Joseph Gilbert; Tony T Koshy; Xiaoxia Han; Michael Marmor; Yongzhao Shao; Robert Giusti; Roberta M Goldring; Kurunthachalam Kannan; Leonardo Trasande Journal: Environ Res Date: 2019-02-16 Impact factor: 6.498
Authors: Alice Trye; Kenneth I Berger; Mrudula Naidu; Teresa M Attina; Joseph Gilbert; Tony T Koshy; Xiaoxia Han; Michael Marmor; Yongzhao Shao; Robert Giusti; Roberta M Goldring; Leonardo Trasande Journal: J Pediatr Date: 2018-07-18 Impact factor: 4.406
Authors: Marcus H Jones; Cristian Roncada; Morgana Thais Carollo Fernandes; João Paulo Heinzmann-Filho; Edgar Enrique Sarria Icaza; Rita Mattiello; Paulo Marcio C Pitrez; Leonardo A Pinto; Renato T Stein Journal: Front Pediatr Date: 2017-12-18 Impact factor: 3.418
Authors: Daniele Oliveira Dos Santos; Hugo Celso Dutra de Souza; José Antônio Baddini-Martinez; Ercy Mara Cipulo Ramos; Ada Clarice Gastaldi Journal: Medicine (Baltimore) Date: 2018-02 Impact factor: 1.817
Authors: Ju Hee Kim; Jin Ah Kim; Eun Kyo Ha; Hye Mi Jee; Seung Won Lee; Mo Kyung Jung; Sanghoo Lee; Yoon Ho Shin; Eun-Gyong Yoo; Man Yong Han Journal: BMC Pediatr Date: 2022-03-17 Impact factor: 2.125
Authors: Nicole Probst-Hensch; Ayoung Jeong; Daiana Stolz; Marco Pons; Paola M Soccal; Robert Bettschart; Deborah Jarvis; John W Holloway; Florian Kronenberg; Medea Imboden; Christian Schindler; Gianfranco F Lovison Journal: Front Public Health Date: 2021-05-11