肥胖的间质性肺疾病患者减肥对呼吸功能的有益影响。

Beneficial impact of weight loss on respiratory function in interstitial lung disease patients with obesity.

机构信息

Department of Respiratory Medicine, Kanagawa Cardiovascular and Respiratory Center, Japan.

出版信息

Respir Investig. 2021 Mar;59(2):247-251. doi: 10.1016/j.resinv.2020.10.002. Epub 2020 Nov 12.

DOI:10.1016/j.resinv.2020.10.002

PMID:33189601

Abstract

BACKGROUND

Interstitial lung disease (ILD) patients commonly become obese or overweight due to deteriorated daily living activities and the adverse effects of prednisolone. This study aimed to clarify the effect of weight loss on pulmonary function test (PFT) in ILD patients with obesity.

METHODS

Among all consecutive ILD patients with a body mass index (BMI) ≥ 27 kg/m who received nutrition education for improving obesity between June 2014 and December 2018, we retrospectively included patients who successfully decreased their body weight by over 2 kg and underwent follow-up PFT within 6 months. The results of PFT at baseline and follow-up and the level of Krebs von den Lungen-6 (KL-6) were compared.

RESULTS

Eleven patients (5 men and 6 women; median BMI of 34.1 kg/m), were enrolled. For PFT at baseline, the percentages of forced vital capacity (%FVC), functional residual capacity (%FRC), and diffusing capacity of the lung for carbon monoxide (%DLCO) were 69.3%, 59.9%, and 54%, respectively. The median KL-6 was 1035 U/mL. The median interval from baseline to the follow-up PFTs was 41 days. Compared to the baseline results of PFT, %FVC, %FRC, and %DLCO significantly increased (p = 0.018, 0.0006, and 0.024, respectively), and the changes in body weight and FVC were strongly correlated (p = 0.0004). In addition, the median serum level of KL-6 at follow-up tended to decrease by 206.5 U/mL (p = 0.083).

CONCLUSION

In ILD patients with obesity, weight loss is important and potentially improves their disease course.

摘要

背景

间质性肺疾病（ILD）患者由于日常生活活动恶化和泼尼松龙的不良反应，常变得肥胖或超重。本研究旨在阐明减肥对肥胖ILD 患者肺功能测试（PFT）的影响。

方法

在 2014 年 6 月至 2018 年 12 月期间接受改善肥胖营养教育的所有连续 BMI≥27kg/m²的ILD 患者中，我们回顾性纳入成功减轻体重超过 2kg 并在 6 个月内进行随访 PFT 的患者。比较了基线和随访时的 PFT 结果和 Krebs von den Lungen-6（KL-6）水平。

结果

共纳入 11 名患者（5 名男性和 6 名女性；中位 BMI 为 34.1kg/m²）。对于基线时的 PFT，用力肺活量（%FVC）、功能残气量（%FRC）和一氧化碳弥散量（%DLCO）分别为 69.3%、59.9%和 54%。KL-6 的中位数为 1035U/mL。从基线到随访 PFT 的中位间隔时间为 41 天。与 PFT 的基线结果相比，%FVC、%FRC 和 %DLCO 显著增加（p=0.018、0.0006 和 0.024），体重变化与 FVC 变化呈强相关性（p=0.0004）。此外，随访时 KL-6 的中位血清水平下降 206.5U/mL，有下降趋势（p=0.083）。