Health Sciences Department, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
Surgery Department, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Bazil.
PLoS One. 2022 Jun 7;17(6):e0267546. doi: 10.1371/journal.pone.0267546. eCollection 2022.
Obesity can increase the airways resistance, mainly in the periphery, leading to dyspnea perception that can impair the functional capacity. This study aimed to analyze if airways resistance could be related to the walking capacity of women with morbid obesity.
Thirty-seven women with grade III obesity in preoperative bariatric surgery were evaluated using the spirometry test, impulse oscillometry system (IOS), and six-minute walk test (6MWT). Additionally, data about their daily dyspnea perception and physical activity level were collected.
Variables of the spirometry test did not detect ventilator disorders. Compared to the predicted values, the IOS identified significant increase in airways resistance (kPa/L/s) (R5: 0.36 (0.34; 0.36) and 0.53 (0.47; 0.61); R20: 0.30 (0.28; 0.30) and 0.41 (0.35; 0.45); R5-20: 0.06 (0.06; 0.06) and 0.14 (0.10; 0.15); X5: -0.03 (-0.04; -0.01) and -0.20 (-0.27; -0.18), respectively). The distance walked in the 6MWT, 491.4±60.4m was significantly correlated to R5 (rho = -0.41, p = 0.01), R5-20 (rho = -0.52, p = 0.001), and X5 (rho = 0.54, p = 0.0006).
The IOS is able to identify changes in airway resistance even before the onset of symptoms. When evaluated by IOS women with severe obesity and normal spirometry exhibited central and peripheral airways obstruction. The correlations between the IOS and six-minute walk distance suggest that increased peripheral airways resistance could be related to worsening functional capacity.
肥胖可增加气道阻力,主要在外周,导致呼吸困难感知,从而损害功能能力。本研究旨在分析气道阻力是否与病态肥胖女性的步行能力相关。
对 37 例术前减重手术的 III 级肥胖女性进行了肺量计测试、脉冲震荡系统(IOS)和 6 分钟步行测试(6MWT)评估。此外,还收集了关于日常呼吸困难感知和身体活动水平的数据。
肺量计测试的变量未发现通气障碍。与预测值相比,IOS 检测到气道阻力显著增加(kPa/L/s)(R5:0.36(0.34;0.36)和 0.53(0.47;0.61);R20:0.30(0.28;0.30)和 0.41(0.35;0.45);R5-20:0.06(0.06;0.06)和 0.14(0.10;0.15);X5:-0.03(-0.04;-0.01)和-0.20(-0.27;-0.18))。6MWT 中行走的距离,491.4±60.4m,与 R5(rho=-0.41,p=0.01)、R5-20(rho=-0.52,p=0.001)和 X5(rho=0.54,p=0.0006)显著相关。
IOS 能够在症状出现之前识别气道阻力的变化。通过 IOS 评估,严重肥胖且肺量计正常的女性表现出中央和外周气道阻塞。IOS 和 6 分钟步行距离之间的相关性表明,外周气道阻力的增加可能与功能能力的恶化有关。