Institute for Exercise and Environmental Medicine (Primary Research Institution), Texas Health Presbyterian Hospital Dallas & UT Southwestern Medical Center, Dallas, Texas, USA.
Department of Internal Medicine, Center for Tobacco Research, Division of Medical Oncology, The Ohio State University, Columbus, Ohio, USA.
Pediatr Pulmonol. 2022 Dec;57(12):2937-2945. doi: 10.1002/ppul.26111. Epub 2022 Aug 30.
In children, obesity typically reduces functional residual capacity (FRC), which reduces airway caliber and increases airway resistance. Whether these obesity-related changes in respiratory function can alter bronchodilator responsiveness is unknown.
To investigate bronchodilator responsiveness in nonasthmatic children with and without obesity.
Seventy nonasthmatic children, 8-12 years old, without (n = 19) and with (n = 51) obesity, completed spirometry, impulse oscillometry, and airway resistance measurements through plethysmography pre/post 360 µg of inhaled albuterol. FRC was assessed pre albuterol. A two-way analysis of variance determined the effects of obesity (group) and inhaled albuterol (pre-post) on outcome measures.
FRC (%total lung capacity) was 16% lower in children with obesity compared with those without obesity. There was no significant group by pre-post albuterol interaction on any outcome variables. Albuterol inhalation reduced total, central and peripheral airway resistance and increased airway reactance (i.e., less negative) to a similar degree in children with and without obesity. In children with obesity, airway resistance was increased whether measured by impulse oscillometry or plethysmography. However, once airway resistance was adjusted for lung volumes (i.e., specific airway resistance or sR ), there were no differences between children with and without obesity. In addition, significant but moderate associations were detected between chest mass and FRC (r = -0.566; p < 0.001), FRC and total airway resistance (i.e., R ; r = -0.445; p < 0.001).
In nonasthmatic early pubescent children, obesity increases total, central, and peripheral respiratory system resistance. However, the added respiratory system resistance and low lung volume breathing with obesity are not sufficient to reduce bronchodilator responsiveness.
在儿童中，肥胖通常会降低功能残气量（FRC），从而缩小气道口径并增加气道阻力。尚不清楚这些与肥胖相关的呼吸功能变化是否会改变支气管扩张剂的反应性。
研究有无肥胖的非哮喘儿童的支气管扩张剂反应性。
70 名 8-12 岁的非哮喘儿童，无肥胖（n=19）和肥胖（n=51），分别在吸入 360µg 沙丁胺醇前后完成了肺活量测定、脉冲振荡法和体积描记法气道阻力测量。在吸入沙丁胺醇之前评估 FRC。双因素方差分析确定了肥胖（组）和吸入沙丁胺醇（前后）对结果测量的影响。
肥胖儿童的 FRC（%总肺活量）比无肥胖儿童低 16%。在吸入沙丁胺醇前后，肥胖与非肥胖儿童之间的组间交互作用无显著差异。在有和没有肥胖的儿童中，吸入沙丁胺醇都能同等程度地降低总气道、中央气道和外周气道阻力，并使气道反应性（即负值降低）增加。在肥胖儿童中，通过脉冲振荡法或体积描记法测量的气道阻力都增加了。但是，一旦气道阻力根据肺容积（即比气道阻力或 sR）进行调整，肥胖儿童与非肥胖儿童之间就没有差异。此外，胸部质量与 FRC（r=-0.566；p<0.001）、FRC 与总气道阻力（即 R；r=-0.445；p<0.001）之间存在显著但中度的相关性。
在非哮喘的青春期早期儿童中，肥胖会增加总、中央和外周呼吸系统阻力。然而，肥胖引起的呼吸系统阻力增加和低肺容量呼吸不足以降低支气管扩张剂的反应性。
