Effects of Obesity and Asthma on Lung Function and Airway Dysanapsis in Adults and Children.
Ebymar ArismendiMarina BantulàMiguel PerpiñáCésar PicadoPublished in: Journal of clinical medicine (2020)
Obesity increases the risk of developing asthma in children and adults. Obesity is associated with different effects on lung function in children and adults. In adults, obesity has been associated with reduced lung function resulting from a relatively small effect on forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC), with the FEV1/FVC ratio remaining unchanged or mildly increased (restrictive pattern). In contrast, in children, obesity is associated with normal or higher FEV1 and FVC but a lower FEV1/FVC ratio (obstructive pattern). This anomaly has recently been associated with a phenomenon known as dysanapsis which results from a disproportionate growth between lung parenchyma size and airway calibre. The mechanisms that promote disproportionate lung parenchyma growth compared with airways in obese children remain to be elucidated. Obesity and dysanapsis in asthma patients might contribute to asthma morbidity by increasing airway obstruction, airway hyper-reactivity and airway inflammation. Obesity and dysanapsis in asthma patients are associated with increased medication use, more emergency department visits, hospitalizations and systemic corticosteroid burst than patients with normal weight. Dysanapsis may explain the reduced response to asthma medications in obese children. Weight loss results in a significant improvement in lung function, airway reactivity and asthma control. Whether these improvements are associated with the changes in the dysanaptic alteration is as yet unclear.
Keyphrases
- lung function
- weight loss
- chronic obstructive pulmonary disease
- cystic fibrosis
- metabolic syndrome
- air pollution
- insulin resistance
- bariatric surgery
- type diabetes
- weight gain
- emergency department
- roux en y gastric bypass
- young adults
- high fat diet induced
- gastric bypass
- adipose tissue
- end stage renal disease
- body mass index
- magnetic resonance imaging
- chronic kidney disease
- physical activity
- patient reported outcomes
- obese patients
- high frequency
- peritoneal dialysis
- intensive care unit
- mechanical ventilation
- patient reported
- body weight