Sikarin Upala1, Subhanudh Thavaraputta2, Anawin Sanguankeo3. 1. Department of Preventive and Social Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand. 2. Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas. 3. Department of Preventive and Social Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand; Division of Nephrology, Johns Hopkins University School of Medicine, Baltimore, Maryland. Electronic address: asangua1@jhmi.edu.
Abstract
BACKGROUND: The association between obesity and asthma is well-established. Some evidence suggests that weight loss may improve asthma outcomes; however, the effect of bariatric surgery on pulmonary function in asthmatic patients remains inconclusive. This systematic review and meta-analysis of observational studies assessed the impact of bariatric surgery on patients with asthma. OBJECTIVES: To investigate the effect of bariatric surgery on pulmonary function in patients with asthma. SETTING: Systematic review and meta-analysis of published studies. METHODS: A comprehensive search of the MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials (CENTRAL) databases was conducted. The sole inclusion criterion was published studies that evaluated the effects of bariatric surgery on pulmonary function in asthmatic patients. The outcomes of interest were forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), and FEV1/FVC. A meta-analysis of studies comparing pre- and postsurgery spirometric measures, and of studies comparing surgery and control groups was performed. RESULTS: From 25 full-text articles, 6 observational studies met the inclusion criteria and were included in this meta-analysis based on the random-effects model. A significant increase in FEV1 and FVC was observed after bariatric surgery among studies without a control group (mean difference: .21 L, 95% confidence interval: .07-.35 for FEV1, and mean difference: .34 L, 95% confidence interval: .14-.53 for FVC). There was no significant change in FEV1/FVC after bariatric surgery compared with control. CONCLUSIONS: FEV1 and FVC were both found to be significantly improved after bariatric surgery; however, no significant postsurgical improvement was observed for FEV1/FVC.
BACKGROUND: The association between obesity and asthma is well-established. Some evidence suggests that weight loss may improve asthma outcomes; however, the effect of bariatric surgery on pulmonary function in asthmatic patients remains inconclusive. This systematic review and meta-analysis of observational studies assessed the impact of bariatric surgery on patients with asthma. OBJECTIVES: To investigate the effect of bariatric surgery on pulmonary function in patients with asthma. SETTING: Systematic review and meta-analysis of published studies. METHODS: A comprehensive search of the MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials (CENTRAL) databases was conducted. The sole inclusion criterion was published studies that evaluated the effects of bariatric surgery on pulmonary function in asthmatic patients. The outcomes of interest were forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), and FEV1/FVC. A meta-analysis of studies comparing pre- and postsurgery spirometric measures, and of studies comparing surgery and control groups was performed. RESULTS: From 25 full-text articles, 6 observational studies met the inclusion criteria and were included in this meta-analysis based on the random-effects model. A significant increase in FEV1 and FVC was observed after bariatric surgery among studies without a control group (mean difference: .21 L, 95% confidence interval: .07-.35 for FEV1, and mean difference: .34 L, 95% confidence interval: .14-.53 for FVC). There was no significant change in FEV1/FVC after bariatric surgery compared with control. CONCLUSIONS: FEV1 and FVC were both found to be significantly improved after bariatric surgery; however, no significant postsurgical improvement was observed for FEV1/FVC.
Authors: Regina Maria de Carvalho-Pinto; José Eduardo Delfini Cançado; Marcia Margaret Menezes Pizzichini; Jussara Fiterman; Adalberto Sperb Rubin; Alcindo Cerci Neto; Álvaro Augusto Cruz; Ana Luisa Godoy Fernandes; Ana Maria Silva Araujo; Daniela Cavalet Blanco; Gediel Cordeiro Junior; Lilian Serrasqueiro Ballini Caetano; Marcelo Fouad Rabahi; Marcelo Bezerra de Menezes; Maria Alenita de Oliveira; Marina Andrade Lima; Paulo Márcio Pitrez Journal: J Bras Pneumol Date: 2021-12-15 Impact factor: 2.624