van de Kant Kim D G, Paredi Paolo, Meah Sally, Kalsi Harpal S, Barnes Peter J, Usmani Omar S
National Heart and Lung Institute, Imperial College, Dovehouse Street, London SW3 6LY, United Kingdom.
Obes Res Clin Pract. 2016 Sep-Oct;10(5):564-573. doi: 10.1016/j.orcp.2015.10.005. Epub 2015 Nov 24.
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.
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 (R) 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; R: 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).
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.
背景/目的：肥胖是一个全球性的健康问题，对呼吸系统有不利影响。我们评估了体重指数（BMI）对远端气道功能和气道炎症的影响。
受试者/方法：在不同BMI的成年人中，评估了脉冲振荡法（IOS）作为远端气道功能的一种测量方法，以及肺量计。通过呼出一氧化氮分数（FeNO）评估气道炎症，参与者以不同的呼气流量呼气以测定肺泡和支气管一氧化氮。
共有34名受试者参与了该研究；19名受试者BMI正常（18.50 - 24.99），而15名受试者超重（BMI 25.00 - 29.99）或肥胖（BMI≥30）。所有受试者肺量计检查结果均正常。然而，与BMI正常的受试者相比，超重/肥胖个体在5Hz、20Hz时的气道阻力（R）测量值以及频率依赖性（R）升高（中位数（四分位间距））；5Hz：0.41（0.37，0.45）对0.32（0.30，0.37）kPa/l/s；20Hz：0.34（0.30，0.37）对0.30（0.26，0.33）kPa/l/s；R：0.06（0.04，0.11）对0.03（0.01，0.05）kPa/l/s；p<0.05），而超重/肥胖个体在20Hz时的气道电抗降低（20Hz：0.07（0.03，0.09）对0.10（0.07，0.13）kPa/l/s，p = 0.009；5Hz：-0.12（-0.15，-0.10）对-0.10（-0.13，-0.09）kPa/l/s，p = 0.07）。相比之下，组内呼吸IOS测量值（呼气流量受限的一个标志）和FeNO炎症测量值在组间无差异（p>0.05）。
超重对IOS测定的远端和中央气道功能有显著影响，而肺量计未检测到这种影响。肥胖对FeNO测量的气道炎症无影响。IOS是一种在超重人群肺量计检查正常时识别气道异常的可靠技术。
