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González-Islas D, Robles-Hernández R, Flores-Cisneros L, Orea-Tejeda A, Galicia-Amor S, Hernández-López N, Valdés-Moreno MI, Sánchez-Santillán R, García-Hernández JC, Castorena-Maldonado A. Association between muscle quality index and pulmonary function in post-COVID-19 subjects. BMC Pulm Med 2023; 23:442. [PMID: 37968677 PMCID: PMC10652568 DOI: 10.1186/s12890-023-02745-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 11/02/2023] [Indexed: 11/17/2023] Open
Abstract
BACKGROUND The SARS-CoV2 pandemic impacted many critically ill patients, causing sequelae, affecting lung function, and involving the musculoskeletal system. We evaluated the association between lung function and muscle quality index in severely ill post-COVID-19 patients. METHODS A cross-sectional study was conducted on a post-COVID-19 cohort at a third-level center. The study included patients who had experienced severe-to-critical COVID-19. Anthropometric measurements, such as body mass index (BMI) and handgrip strength, were obtained to calculate the muscle quality index (MQI). Additionally, spirometry, measurements of expiratory and inspiratory pressure, and an assessment of DLCO in the lungs were performed. The MQI was categorized into two groups: low-MQI (below the 50th percentile) and high-MQI (above the 50th percentile), based on sex. Group differences were analyzed, and a multivariate linear regression analysis was performed to assess the association between respiratory function and MQI. RESULTS Among the 748 patients analyzed, 61.96% required mechanical ventilation, and the median hospital stay was 17 days. In patients with a low MQI, it was observed that both mechanical respiratory function and DLCO were lower. The multivariate analysis revealed significantly lower findings in mechanical respiratory function among patients with a low MQI. CONCLUSION The Low-MQI is an independent predictor associated with pulmonary function parameters in subjects with Post-COVID-19 syndrome.
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Affiliation(s)
- Dulce González-Islas
- Heart Failure and Respiratory Distress Clinic at the Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas", Calzada de Tlalpan 4502 Col Sec XVI CP 14080 Del Tlalpan, Mexico City, Mexico
| | - Robinson Robles-Hernández
- Department of Research in Tobacco Smoking and COPD at the Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas", Mexico City, Mexico
| | - Laura Flores-Cisneros
- Department of Epidemiological Information Analysis at Dirección General de Epidemiología, Secretaría de Salud, Gobierno de México, Mexico City, 01480, Mexico
| | - Arturo Orea-Tejeda
- Heart Failure and Respiratory Distress Clinic at the Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas", Calzada de Tlalpan 4502 Col Sec XVI CP 14080 Del Tlalpan, Mexico City, Mexico.
| | - Susana Galicia-Amor
- Pulmonary Rehabilitation Department at the Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas", Mexico City, Mexico
| | - Nadia Hernández-López
- Heart Failure and Respiratory Distress Clinic at the Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas", Calzada de Tlalpan 4502 Col Sec XVI CP 14080 Del Tlalpan, Mexico City, Mexico
| | - Mariana I Valdés-Moreno
- Licenciatura en Nutriología Facultad de Estudios Superiores Zaragoza Universidad Nacional Autónoma de México, C.P. 09230, Mexico City, Mexico
| | - Rocío Sánchez-Santillán
- Heart Failure and Respiratory Distress Clinic at the Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas", Calzada de Tlalpan 4502 Col Sec XVI CP 14080 Del Tlalpan, Mexico City, Mexico
| | - Juan Carlos García-Hernández
- Pulmonary Rehabilitation Department at the Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas", Mexico City, Mexico
| | - Armando Castorena-Maldonado
- Direction for Medical Care in Pneumology at the Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas"|, Mexico City, Mexico
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Pi YY, Hu WX, Jiao ZM, Hou PY, Zhang YH, Zhao Y, Li XX, Yu J, Chen F, Jing JY, Wang FX. Relationship between body composition and pulmonary function in the general population-a cross-sectional study in Ningxia. Sci Rep 2023; 13:17877. [PMID: 37857639 PMCID: PMC10587154 DOI: 10.1038/s41598-023-44486-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Accepted: 10/09/2023] [Indexed: 10/21/2023] Open
Abstract
Studies considering the relationship between non-obesity-related body composition and lung function are few; therefore, this study aimed to explore these correlations and effects. This cross-sectional study conducted in rural Qingtongxia City and Pingluo County, Ningxia, China, included 776 participants aged 30-75 years. Body composition and lung function were measured using direct segmental multifrequency bioelectrical impedance analysis and a digital spirometer, respectively. Their correlation was assessed using partial correlation analysis, controlling for age and smoking status, and the body composition effect on lung function was analyzed using binomial logistic regression analysis. The body components total body water content, protein content, mineral content, muscle mass, fat-free mass (FFM), skeletal muscle mass, basal metabolic volume, and chest circumference (CC) positively correlated with pulmonary function (forced vital capacity and forced expiratory volume in one second) in both sexes. Neck circumference and hip circumference positively correlated with pulmonary function in women. Additionally, lung function declines more slowly in women (odds ratio [OR] = 0.66, 95% confidence interval [CI] = 0.44-0.98, p = 0.04); CC (OR = 0.92, 95% CI = 0.86-0.98, p = 0.01) increased as a protective factor for decreased lung function. Increased waist circumference (OR = 1.04, 95% CI = 1.00-1.09, p = 0.04) was a risk factor for reduced lung function. FFM contains body composition indicators positively correlating with lung function, excluding fat-related body composition. Abdominal obesity increases the risk of decreased lung function.
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Affiliation(s)
- Yang-Yang Pi
- NHC Key Laboratory of Metabolic Cardiovascular Diseases Research, Ningxia Medical University, Yinchuan, 750004, People's Republic of China
- School of Public Health, Ningxia Medical University, Yinchuan, 750004, People's Republic of China
| | - Wen-Xuan Hu
- NHC Key Laboratory of Metabolic Cardiovascular Diseases Research, Ningxia Medical University, Yinchuan, 750004, People's Republic of China
- School of Public Health, Ningxia Medical University, Yinchuan, 750004, People's Republic of China
| | - Zi-Ming Jiao
- NHC Key Laboratory of Metabolic Cardiovascular Diseases Research, Ningxia Medical University, Yinchuan, 750004, People's Republic of China
- School of Public Health, Ningxia Medical University, Yinchuan, 750004, People's Republic of China
| | - Peng-Yi Hou
- NHC Key Laboratory of Metabolic Cardiovascular Diseases Research, Ningxia Medical University, Yinchuan, 750004, People's Republic of China
- School of Public Health, Ningxia Medical University, Yinchuan, 750004, People's Republic of China
| | - Yu-Hong Zhang
- NHC Key Laboratory of Metabolic Cardiovascular Diseases Research, Ningxia Medical University, Yinchuan, 750004, People's Republic of China
- School of Public Health, Ningxia Medical University, Yinchuan, 750004, People's Republic of China
| | - Yi Zhao
- NHC Key Laboratory of Metabolic Cardiovascular Diseases Research, Ningxia Medical University, Yinchuan, 750004, People's Republic of China
- School of Public Health, Ningxia Medical University, Yinchuan, 750004, People's Republic of China
| | - Xiao-Xia Li
- NHC Key Laboratory of Metabolic Cardiovascular Diseases Research, Ningxia Medical University, Yinchuan, 750004, People's Republic of China
- School of Public Health, Ningxia Medical University, Yinchuan, 750004, People's Republic of China
| | - Jing Yu
- NHC Key Laboratory of Metabolic Cardiovascular Diseases Research, Ningxia Medical University, Yinchuan, 750004, People's Republic of China
- School of Public Health, Ningxia Medical University, Yinchuan, 750004, People's Republic of China
| | - Fang Chen
- NHC Key Laboratory of Metabolic Cardiovascular Diseases Research, Ningxia Medical University, Yinchuan, 750004, People's Republic of China
- School of Public Health, Ningxia Medical University, Yinchuan, 750004, People's Republic of China
| | - Jin-Yun Jing
- Ningxia Hui Autonomous Region Maternal and Child Health Care Hospital, Yinchuan, 750004, People's Republic of China
| | - Fa-Xuan Wang
- NHC Key Laboratory of Metabolic Cardiovascular Diseases Research, Ningxia Medical University, Yinchuan, 750004, People's Republic of China.
- School of Public Health, Ningxia Medical University, Yinchuan, 750004, People's Republic of China.
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Orea-Tejeda A, Robles-Hernández R, González-Islas D, Jimenez-Gallardo L, Gochicoa-Rangel L, Castorena-Maldonado A, Hernández-Zenteno R, Montañez-Orozco A, Valderrábano-Salas B. Dynapenia and Sarcopenia in Post-COVID-19 Syndrome Hospitalized Patients Are Associated with Severe Reduction in Pulmonary Function. J Clin Med 2023; 12:6466. [PMID: 37892604 PMCID: PMC10607104 DOI: 10.3390/jcm12206466] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 09/29/2023] [Accepted: 09/30/2023] [Indexed: 10/29/2023] Open
Abstract
BACKGROUND After hospital discharge, post-COVID-19 syndrome has been observed to be associated with impaired diffusing capacity, respiratory muscle strength, and lung imaging abnormalities, in addition to loss of muscle mass/strength, sarcopenia, and obesity impact exercise tolerance, pulmonary functions, and overall prognosis. However, the relationship between lung function and the coexistence of obesity with low muscle strength and sarcopenia in post-COVID-19 patients remains poorly investigated. Therefore, our aim was to evaluate the association between lung function and the coexistence of obesity with dynapenia and sarcopenia in post-COVID-19 syndrome patients. METHODS This cross-sectional study included subjects who were hospitalized due to moderate to severe COVID-19, as confirmed by PCR testing. Subjects who could not be contacted, declined to participate, or died before the follow-up visit were excluded. RESULTS A total of 711 subjects were evaluated; the mean age was 53.64 ± 13.57 years, 12.4% had normal weight, 12.6% were dynapenic without obesity, 8.3% had sarcopenia, 41.6% had obesity, 21.2% had dynapenic obesity, and 3.8% had sarcopenic obesity. In terms of pulmonary function, the dynapenic subjects showed decreases of -3.45% in FEV1, -12.61 cmH2O in MIP, and -12.85 cmH2O in MEP. On the other hand, the sarcopenic subjects showed decreases of -6.14 cmH2O in MIP and -11.64 cmH2O in MEP. The dynapenic obesity group displayed a reduction of -12.13% in PEF. CONCLUSIONS In post-COVID-19 syndrome, dynapenia and sarcopenia-both with and without obesity-have been associated with lower lung function.
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Affiliation(s)
- Arturo Orea-Tejeda
- Heart Failure and Respiratory Distress Clinic, Cardiology Service, Instituto Nacional de Enfermedades Respiratorias “Ismael Cosío Villegas”, Mexico City 14080, Mexico; (A.O.-T.)
| | - Robinson Robles-Hernández
- Department of Research in Tobacco Smoking and COPD at Instituto Nacional de Enfermedades Respiratorias “Ismael Cosío Villegas” 2, Mexico City 14080, Mexico;
| | - Dulce González-Islas
- Heart Failure and Respiratory Distress Clinic, Cardiology Service, Instituto Nacional de Enfermedades Respiratorias “Ismael Cosío Villegas”, Mexico City 14080, Mexico; (A.O.-T.)
| | - Luz Jimenez-Gallardo
- Heart Failure and Respiratory Distress Clinic, Cardiology Service, Instituto Nacional de Enfermedades Respiratorias “Ismael Cosío Villegas”, Mexico City 14080, Mexico; (A.O.-T.)
| | - Laura Gochicoa-Rangel
- Department of Pulmonary Physiology at Instituto Nacional de Enfermedades Respiratorias “Ismael Cosío Villegas”, Mexico City 14080, Mexico
| | - Armando Castorena-Maldonado
- Direction for Medical Care in Pneumology at Instituto Nacional de Enfermedades Respiratorias “Ismael Cosío Villegas” 4, Mexico City 14080, Mexico
| | - Rafael Hernández-Zenteno
- COPD Clinic at Instituto Nacional de Enfermedades Respiratorias “Ismael Cosío Villegas”, Mexico City 14080, Mexico
| | - Alvaro Montañez-Orozco
- Heart Failure and Respiratory Distress Clinic, Cardiology Service, Instituto Nacional de Enfermedades Respiratorias “Ismael Cosío Villegas”, Mexico City 14080, Mexico; (A.O.-T.)
| | - Benigno Valderrábano-Salas
- Heart Failure and Respiratory Distress Clinic, Cardiology Service, Instituto Nacional de Enfermedades Respiratorias “Ismael Cosío Villegas”, Mexico City 14080, Mexico; (A.O.-T.)
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Song JE, Bak SH, Lim MN, Lee EJ, Cha YK, Yoon HJ, Kim WJ. CT-Derived Deep Learning-Based Quantification of Body Composition Associated with Disease Severity in Chronic Obstructive Pulmonary Disease. JOURNAL OF THE KOREAN SOCIETY OF RADIOLOGY 2023; 84:1123-1133. [PMID: 37869106 PMCID: PMC10585079 DOI: 10.3348/jksr.2022.0152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 02/24/2023] [Accepted: 05/16/2023] [Indexed: 10/24/2023]
Abstract
Purpose Our study aimed to evaluate the association between automated quantified body composition on CT and pulmonary function or quantitative lung features in patients with chronic obstructive pulmonary disease (COPD). Materials and Methods A total of 290 patients with COPD were enrolled in this study. The volume of muscle and subcutaneous fat, area of muscle and subcutaneous fat at T12, and bone attenuation at T12 were obtained from chest CT using a deep learning-based body segmentation algorithm. Parametric response mapping-derived emphysema (PRMemph), PRM-derived functional small airway disease (PRMfSAD), and airway wall thickness (AWT)-Pi10 were quantitatively assessed. The association between body composition and outcomes was evaluated using Pearson's correlation analysis. Results The volume and area of muscle and subcutaneous fat were negatively associated with PRMemph and PRMfSAD (p < 0.05). Bone density at T12 was negatively associated with PRMemph (r = -0.1828, p = 0.002). The volume and area of subcutaneous fat and bone density at T12 were positively correlated with AWT-Pi10 (r = 0.1287, p = 0.030; r = 0.1668, p = 0.005; r = 0.1279, p = 0.031). However, muscle volume was negatively correlated with the AWT-Pi10 (r = -0.1966, p = 0.001). Muscle volume was significantly associated with pulmonary function (p < 0.001). Conclusion Body composition, automatically assessed using chest CT, is associated with the phenotype and severity of COPD.
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Zhang H, Hu Z, Wang S, Xu J, Li S, Song X. Association of general and abdominal obesity with lung function, FeNO, and blood eosinophils in adult asthmatics: Findings from NHANES 2007-2012. Front Physiol 2023; 14:1019123. [PMID: 36846327 PMCID: PMC9950393 DOI: 10.3389/fphys.2023.1019123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Accepted: 02/02/2023] [Indexed: 02/12/2023] Open
Abstract
Purpose: Obesity is considered a risk factor for asthma exacerbation. However, limited studies have focused on the association of different levels of weight clusters with asthma. As such, we study the associations between different weight clusters with FeNO, blood eosinophils, and lung function among adult asthmatics. Methods: Data from 789 participants aged 20 years or older in the National Health and Nutrition Examination Survey 2007-2012 were analyzed. Body mass index (BMI) and waist circumference (WC) were used to determine the weight status. The study population was divided into five groups, including normal weight and low WC (153), normal weight and high WC (43), overweight and high WC (67), overweight and abdominal obesity (128), and general and abdominal obesity (398). A Multivariate linear regression model was used to evaluate the abovementioned associations after adjusting for potential confounding factors. Results: The adjusted models showed that general and abdominal obesity cluster (adjusted β = -0.63, 95% confidence interval (CI): -1.08, -0.17 p < 0.01), and the normal weight with high WC cluster (adjusted β = -0.96, 95% CI: -1.74, -0.19 p < 0.05) were associated with lower levels of blood eosinophils percentage than normal weight and low WC cluster. A similar tendency was shown in the levels of FeNO, but the differences were not significant (p > 0.05). Furthermore, abdominal obesity clusters were significantly associated with lower FVC, FVC% predicted, and FEV1 measures than normal weight and low WC cluster, especially those individuals with general and abdominal obesity cluster. No association was found between different weight clusters and FEV1/FVCF ratio. The two other weight clusters did not show the association with any of the lung function measures. Conclusion: General and abdominal obesity were associated with lung function impairment and a significant reduction of FeNO and blood eosinophil percentage. This study emphasized the importance of concurrent determination of BMI and WC in asthma clinical practice.
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Affiliation(s)
- Haoyu Zhang
- Department of Respiratory and Critical Care Medicine, The First College of Clinical Medicine Science, China Three Gorges University, Yichang, China,Department of Respiratory and Critical Care Medicine, Yichang Central People’s Hospital, Yichang, China
| | - Zhigang Hu
- Department of Respiratory and Critical Care Medicine, The First College of Clinical Medicine Science, China Three Gorges University, Yichang, China,Department of Respiratory and Critical Care Medicine, Yichang Central People’s Hospital, Yichang, China
| | - Sufei Wang
- Department of Respiratory and Critical Care Medicine, NHC Key Laboratory of Pulmonary Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Jiangli Xu
- Department of Respiratory and Critical Care Medicine, The First College of Clinical Medicine Science, China Three Gorges University, Yichang, China,Department of Respiratory and Critical Care Medicine, Yichang Central People’s Hospital, Yichang, China
| | - Sijia Li
- Department of Respiratory and Critical Care Medicine, The First College of Clinical Medicine Science, China Three Gorges University, Yichang, China,Department of Respiratory and Critical Care Medicine, Yichang Central People’s Hospital, Yichang, China
| | - Xinyu Song
- Department of Respiratory and Critical Care Medicine, The First College of Clinical Medicine Science, China Three Gorges University, Yichang, China,Department of Respiratory and Critical Care Medicine, Yichang Central People’s Hospital, Yichang, China,*Correspondence: Xinyu Song,
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Association between waist circumference change and incident chronic obstructive pulmonary disease among Chinese adults: a 10-year cohort study. Sci Rep 2022; 12:18402. [PMID: 36319731 PMCID: PMC9626450 DOI: 10.1038/s41598-022-23248-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 10/27/2022] [Indexed: 11/11/2022] Open
Abstract
The aim of our study was to investigate waist circumference (WC) change and the risk of incident chronic obstructive pulmonary disease (COPD) among Chinese adults. A total of 8164 participants aged > 18 years who attended health examinations with repeat measurements of WC and lung function [forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1)] from 2010 to 2019 were recruited. WC change was categorized as ≤ - 2.5%, - 2.5 to 2.5%, 2.5% to 5% and > 5% according to sex. Modified Poisson regression models were used to assess the association of WC gain and the risk of COPD. During the 10-year follow-up, a total of 917 COPD cases were identified. From baseline to follow-up, the mean FEV1 decreased from 3.20 to 2.79L among male participants and 2.28-1.95L among female participants. Compared with participants who did not have abdominal obesity, at either, baseline or follow-up, participants with abdominal obesity of both sexes after the follow-up were associated with a greater risk of COPD regardless of abdominal obesity at baseline. The risk of incident COPD increased 19% among male participants (RR = 1.19, 95%CI = 1.04-1.48) and 14% among female participants (RR = 1.14, 95%CI = 1.01-1.40) when WC gain increased > 5% during the 10-year follow-up. The COPD risk decreased 18% among male participants with a WC change ≤ - 2.5% (RR = 0.82, 95%CI = 0.67-0.99). The risk of incident COPD was positively associated with increasing WC among Chinese adults of both sexes.
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Tang X, Lei J, Li W, Peng Y, Wang C, Huang K, Yang T. The Relationship Between BMI and Lung Function in Populations with Different Characteristics: A Cross-Sectional Study Based on the Enjoying Breathing Program in China. Int J Chron Obstruct Pulmon Dis 2022; 17:2677-2692. [PMID: 36281228 PMCID: PMC9587705 DOI: 10.2147/copd.s378247] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Accepted: 09/17/2022] [Indexed: 11/05/2022] Open
Abstract
Purpose To analyze the relationship between body mass index (BMI) and lung function, which may help optimize the screening and management process for chronic obstructive pulmonary disease (COPD) in the early stages. Patients and Methods In this cross-sectional study using data from the Enjoying Breathing Program in China, participants were divided into two groups according to COPD Screening Questionnaire (COPD-SQ) scores (at risk and not at risk of COPD) and three groups based on lung function (normal lung function, preserved ratio impaired spirometry [PRISm], and obstructive lung function). Results A total of 32,033 subjects were enrolled in the current analysis. First, in people at risk of COPD, overweight and obese participants had better forced expiratory volume in one second (FEV1; overweight: 0.33 liters (l), 95% confidence interval [CI]: 0.27 to 0.38; obesity: 0.31 L, 95% CI: 0.22 to 0.39) values than the normal BMI group. Second, among people with PRISm, underweight participants had a lower FEV1 (−0.56 L, 95% CI: −0.86 to −0.26) and forced vital capacity (FVC; −0.33 L, 95% CI: −0.55 to −0.11) than participants with a normal weight, and obese participants had a higher FEV1 (0.22 L, 95% CI: 0.02 to 0.42) and FVC (0.16 L, 95% CI: 0.02 to 0.30) than participants with a normal weight. Taking normal BMI as the reference group, lower FEV1 (−0.80 L, 95% CI: −0.97 to −0.63) and FVC (−0.53 L, 95% CI: −0.64 to −0.42) were found in underweight participants with obstructive spirometry, and better FEV1 (obesity: 0.26 L, 95% CI: 0.12 to 0.40) was found in obese participants with obstructive spirometry. Conclusion Being underweight and severely obese are associated with reduced lung function. Slight obesity was shown to be a protective factor for lung function in people at risk of COPD and those with PRISm.
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Affiliation(s)
- Xingyao Tang
- Department of Pulmonary and Critical Care Medicine, China-Japan Friendship Hospital, Beijing, 100029, People’s Republic of China,National Center for Respiratory Medicine, Beijing, 100029, People’s Republic of China,National Clinical Research Center for Respiratory Diseases, Beijing, 100029, People’s Republic of China,Capital Medical University, Beijing, 10069, People’s Republic of China
| | - Jieping Lei
- National Center for Respiratory Medicine, Beijing, 100029, People’s Republic of China,National Clinical Research Center for Respiratory Diseases, Beijing, 100029, People’s Republic of China,Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, 100029, People’s Republic of China,Department of Clinical Research and Data Management, Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, 100029, People’s Republic of China
| | - Wei Li
- Department of Pulmonary and Critical Care Medicine, China-Japan Friendship Hospital, Beijing, 100029, People’s Republic of China,National Center for Respiratory Medicine, Beijing, 100029, People’s Republic of China,National Clinical Research Center for Respiratory Diseases, Beijing, 100029, People’s Republic of China,Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, 100029, People’s Republic of China
| | - Yaodie Peng
- Department of Pulmonary and Critical Care Medicine, China-Japan Friendship Hospital, Beijing, 100029, People’s Republic of China,Peking University Health Science Center, Beijing, 10029, People’s Republic of China
| | - Chen Wang
- Department of Pulmonary and Critical Care Medicine, China-Japan Friendship Hospital, Beijing, 100029, People’s Republic of China,National Center for Respiratory Medicine, Beijing, 100029, People’s Republic of China,National Clinical Research Center for Respiratory Diseases, Beijing, 100029, People’s Republic of China,Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, 100029, People’s Republic of China
| | - Ke Huang
- Department of Pulmonary and Critical Care Medicine, China-Japan Friendship Hospital, Beijing, 100029, People’s Republic of China,National Center for Respiratory Medicine, Beijing, 100029, People’s Republic of China,National Clinical Research Center for Respiratory Diseases, Beijing, 100029, People’s Republic of China,Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, 100029, People’s Republic of China,Correspondence: Ke Huang; Ting Yang, China-Japan Friendship Hospital, Beijing, 100029, People’s Republic of China, Tel +010-8420 6275, Email ;
| | - Ting Yang
- Department of Pulmonary and Critical Care Medicine, China-Japan Friendship Hospital, Beijing, 100029, People’s Republic of China,National Center for Respiratory Medicine, Beijing, 100029, People’s Republic of China,National Clinical Research Center for Respiratory Diseases, Beijing, 100029, People’s Republic of China,Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, 100029, People’s Republic of China
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Fuzhi Y, Dongfang T, Wentao F, Jing W, Yingting W, Nianping M, Wen G, Xiaoyong S. Rapid Recovery of Postoperative Pulmonary Function in Patients With Lung Cancer and Influencing Factors. Front Oncol 2022; 12:927108. [PMID: 35898890 PMCID: PMC9309725 DOI: 10.3389/fonc.2022.927108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Accepted: 06/13/2022] [Indexed: 12/24/2022] Open
Abstract
Among malignant tumors, lung cancer has the highest morbidity and mortality worldwide. Surgery is the first-line treatment for early-stage lung cancers, and has gradually advanced from conventional open-chest surgery to video-assisted thoracic surgery (VATS). Additionally, increasingly smaller surgical incisions and less surgical trauma have resulted in reduced pulmonary function damage. Previous studies have found that the level of pulmonary function loss and recovery is significantly correlated with postoperative complications and the quality of life. Thus, an accurate assessment of the preoperative pulmonary function and effective rehabilitation of postoperative pulmonary function are highly important for patients undergoing lung surgery. In addition, pulmonary function assessment after pulmonary rehabilitation serves as an objective indicator of the postoperative pulmonary rehabilitation status and is crucial to facilitating pulmonary function recovery. Furthermore, a complete preoperative assessment and effective rehabilitation are especially critical in elderly patients with pulmonary tumors, poor basic physiological functions, comorbid lung diseases, and other underlying diseases. In this review, we summarize the clinical significance of pulmonary function assessment in patients undergoing lung cancer surgery, postoperative changes in pulmonary function, effective pulmonary function rehabilitation, and the influencing factors of pulmonary function rehabilitation.
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Martinez-Arnau FM, Buigues C, Fonfría-Vivas R, Cauli O. Respiratory function correlates with fat mass index and blood triglycerides in institutionalized older individuals. Endocr Metab Immune Disord Drug Targets 2022; 22:1029-1039. [PMID: 35352657 DOI: 10.2174/1871530322666220329150813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 01/09/2022] [Accepted: 01/19/2022] [Indexed: 11/22/2022]
Abstract
BACKGROUND We investigated the relationship between respiratory function measured by spirometry analysis and anthropometric variables (skeletal and fat mass) and nutritional status in the institutionalized elderly, particularly at high risk of adverse outcomes after respiratory infections and malnutrition. DESIGN A multicenter cross-sectional study with quantitative approach among older people institutionalized living in nursing homes. METHODS Respiratory function was assessed by measuring the forced vital capacity, forced expiratory volume in the first second, the ratio between FEV1 and FVC (FEV1/FVC), and peak expiratory flow in percentage by means of spirometric analysis (values of the forced expiratory volume measured during the first second of the forced breath (FEV1) and forced vital capacity (FVC)). Nutritional assessment and anthropometry analysis were done to evaluate under or over nutrition/weight. RESULTS There was a significant (p<0.05) and positive correlation between FEV1 and skeletal muscle mass index, whereas fat mass index correlated significantly (p<0.01) with the FEV1/FVC index. FEV1/FVC values were both significantly (p<0.05) associated with high body mass index and triglyceride levels in blood. The prevalence of individuals with ventilator restrictive pattern (FEV1/FVC>70% with FEV1 and FVC<80%) was 27.6% and 12 individuals (21.1%) receive daily bronchodilators as part of the pharmacological treatment for respiratory disorders. A logistic regression was performed to identify predictors of restrictive respiratory pattern. The following variables were entered into the model: age group, female gender, Charlson comorbidity index, body-mass index (BMI), fat mass index, skeletal muscle mass index, total cholesterol and triglycerides concentration. The model was statistically significant (p < 0.05; R2 = 0.39), correctly classifying 70.0% of cases, with a sensitivity of 89.3% and a specificity of 50.0%. Area under curve was 0.71 (IC95% 0.54-0.88; p=0.023). The highest OR for restrictive respiratory pattern were for BMI (OR=5.09) and triglycerides concentration in blood (>150 mg/dl) (OR=5.59). CONCLUSION The relationship between a restrictive pattern of respiratory function and fat mass which deserves future investigation to manage these parameters as possible modifiable factor of altered respiratory function in overweight institutionalized older individuals.
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Affiliation(s)
- Francisco Miguel Martinez-Arnau
- Department of Physiotherapy, University of Valencia, Valencia, Spain
- Frailty and Cognitive Impairment Research Group (FROG), University of Valencia, Valencia, Spain
| | - Cristina Buigues
- Frailty and Cognitive Impairment Research Group (FROG), University of Valencia, Valencia, Spain
- Department of Medicine and Nursing, University of Valencia, Spain
| | - Rosa Fonfría-Vivas
- Frailty and Cognitive Impairment Research Group (FROG), University of Valencia, Valencia, Spain
- Department of Medicine and Nursing, University of Valencia, Spain
| | - Omar Cauli
- Frailty and Cognitive Impairment Research Group (FROG), University of Valencia, Valencia, Spain
- Department of Medicine and Nursing, University of Valencia, Spain
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10
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Martínez-Luna N, Orea-Tejeda A, González-Islas D, Flores-Cisneros L, Keirns-Davis C, Sánchez-Santillán R, Pérez-García I, Gastelum-Ayala Y, Martínez-Vázquez V, Martínez-Reyna Ó. Association between body composition, sarcopenia and pulmonary function in chronic obstructive pulmonary disease. BMC Pulm Med 2022; 22:106. [PMID: 35346135 PMCID: PMC8962175 DOI: 10.1186/s12890-022-01907-1] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Accepted: 03/21/2022] [Indexed: 12/25/2022] Open
Abstract
Background Chronic Obstructive Pulmonary Disease (COPD) is characterized by progressive and irreversible airflow limitation. Different factors that modify pulmonary function include age, sex, muscular strength, and a history of exposure to toxic agents. However, the impact of body composition compartments and sarcopenia on pulmonary function is not well-established. This study aimed to evaluate how body composition compartments and sarcopenia affect pulmonary function in COPD patients. Methods In a cross-sectional study, patients with a confirmed diagnosis of COPD, > 40 years old, and forced expiratory volume in the first second /forced vital capacity ratio (FEV1/FVC) < 0.70 post-bronchodilator were included. Patients with cancer, HIV, and asthma were excluded. Body composition was measured with bioelectrical impedance. Sarcopenia was defined according to EWGSOP2, and pulmonary function was assessed by spirometry. Results 185 patients were studied. The mean age was 72.20 ± 8.39 years; 55.14% were men. A linear regression adjusted model showed associations between body mass index, fat-free mass, skeletal muscle mass index, appendicular skeletal muscle mass index, and phase angle (PhA), and sarcopenia with FEV1 (%). As regards FVC (%), PhA and exercise tolerance had positive associations. Conclusion Body composition, especially PhA, SMMI, ASMMI, and sarcopenia, has a significant impact on pulmonary function. Early detection of disturbances of these indexes enables the early application of such therapeutic strategies in COPD patients.
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Affiliation(s)
- Nathalie Martínez-Luna
- Heart Failure and Respiratory Distress Clinic, Cardiology Service, Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas", Calzada de Tlalpan 4502 Col Sec XVI CP, 14080, Del Tlalpan, Mexico City, Mexico
| | - Arturo Orea-Tejeda
- Heart Failure and Respiratory Distress Clinic, Cardiology Service, Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas", Calzada de Tlalpan 4502 Col Sec XVI CP, 14080, Del Tlalpan, Mexico City, Mexico
| | - Dulce González-Islas
- Heart Failure and Respiratory Distress Clinic, Cardiology Service, Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas", Calzada de Tlalpan 4502 Col Sec XVI CP, 14080, Del Tlalpan, Mexico City, Mexico.
| | - Laura Flores-Cisneros
- Department of Clinical Research, Instituto Nacional de Cancerología, Mexico City, Mexico
| | - Candace Keirns-Davis
- Heart Failure and Respiratory Distress Clinic, Cardiology Service, Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas", Calzada de Tlalpan 4502 Col Sec XVI CP, 14080, Del Tlalpan, Mexico City, Mexico
| | - Rocío Sánchez-Santillán
- Heart Failure and Respiratory Distress Clinic, Cardiology Service, Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas", Calzada de Tlalpan 4502 Col Sec XVI CP, 14080, Del Tlalpan, Mexico City, Mexico
| | - Ilse Pérez-García
- Heart Failure and Respiratory Distress Clinic, Cardiology Service, Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas", Calzada de Tlalpan 4502 Col Sec XVI CP, 14080, Del Tlalpan, Mexico City, Mexico
| | - Yael Gastelum-Ayala
- Heart Failure and Respiratory Distress Clinic, Cardiology Service, Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas", Calzada de Tlalpan 4502 Col Sec XVI CP, 14080, Del Tlalpan, Mexico City, Mexico
| | - Valeria Martínez-Vázquez
- Heart Failure and Respiratory Distress Clinic, Cardiology Service, Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas", Calzada de Tlalpan 4502 Col Sec XVI CP, 14080, Del Tlalpan, Mexico City, Mexico
| | - Óscar Martínez-Reyna
- Heart Failure and Respiratory Distress Clinic, Cardiology Service, Instituto Nacional de Enfermedades Respiratorias "Ismael Cosío Villegas", Calzada de Tlalpan 4502 Col Sec XVI CP, 14080, Del Tlalpan, Mexico City, Mexico
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11
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Ohara DG, Moreira YP, Silva CFR, Matos AP, Gama TO, Jamami M, Pinto ACPN, Pegorari MS. Impaired pulmonary function is associated with dynapenia, but not with abdominal obesity and dynapenic abdominal obesity in older adults. Eur Geriatr Med 2021; 13:475-482. [PMID: 34550559 DOI: 10.1007/s41999-021-00560-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 09/03/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE No studies have previously analyzed the association between dynapenic abdominal obesity (DAO) and pulmonary function in older adults. The aim of this study was to analyze whether there is an association between pulmonary function and abdominal obesity, dynapenia, and DAO in community-dwelling older adults. METHODS A cross-sectional study was conducted with community-dwelling older adults (n = 383) of Macapá, Amapá, Brazil. Pulmonary function variables were evaluated with spirometry; and DAO was evaluated with the combination of dynapenia and abdominal obesity. Cutoff points for handgrip strength, 26 kg force for men and 16 kg force for women, were used to detect dynapenia; and cutoff points of abdominal circumference of > 102 cm for men and > 88 cm for women were used to identify abdominal obesity. RESULTS Most of the studied pulmonary function variables (obtained values and obtained versus predicted values) were associated with abdominal obesity, dynapenia, and DAO. However, in the adjusted model, there was an association of FVC (β = - 0.163; p < 0.001), FEV1 (β = - 0.119; p = 0.006), and PEF (β = - 0.110; p = 0.017) only with dynapenia. CONCLUSIONS Older adults with abdominal obesity, dynapenia, and DAO presented impaired pulmonary function when compared to those without these conditions. Most of the pulmonary function variables were associated with abdominal obesity, dynapenia, and DAO conditions. However, in the adjusted model, there was an association of reduced FVC, FEV1, and PEF values only with dynapenia.
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Affiliation(s)
- Daniela G Ohara
- Department of Biological and Health Sciences, Physical Therapy Course, Federal University of Amapá, Road Juscelino Kubitschek, Km-02, Jardim Marco Zero, Macapá, AP, CEP 68903-419, Brazil
| | - Yasmin P Moreira
- Department of Biological and Health Sciences, Physical Therapy Course, Federal University of Amapá, Road Juscelino Kubitschek, Km-02, Jardim Marco Zero, Macapá, AP, CEP 68903-419, Brazil
| | - Caroline F R Silva
- Department of Biological and Health Sciences, Physical Therapy Course, Federal University of Amapá, Road Juscelino Kubitschek, Km-02, Jardim Marco Zero, Macapá, AP, CEP 68903-419, Brazil
| | - Areolino P Matos
- Department of Biological and Health Sciences, Physical Therapy Course, Federal University of Amapá, Road Juscelino Kubitschek, Km-02, Jardim Marco Zero, Macapá, AP, CEP 68903-419, Brazil
| | - Tatiana O Gama
- Department of Biological and Health Sciences, Physical Therapy Course, Federal University of Amapá, Road Juscelino Kubitschek, Km-02, Jardim Marco Zero, Macapá, AP, CEP 68903-419, Brazil
| | - Maurício Jamami
- Department of Physical Therapy, Federal University of São Carlos, São Carlos, São Paulo, Brazil
| | - Ana Carolina P N Pinto
- Department of Biological and Health Sciences, Physical Therapy Course, Federal University of Amapá, Road Juscelino Kubitschek, Km-02, Jardim Marco Zero, Macapá, AP, CEP 68903-419, Brazil
| | - Maycon S Pegorari
- Department of Biological and Health Sciences, Physical Therapy Course, Federal University of Amapá, Road Juscelino Kubitschek, Km-02, Jardim Marco Zero, Macapá, AP, CEP 68903-419, Brazil.
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12
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Zeng X, Liu D, An Z, Li H, Song J, Wu W. Obesity parameters in relation to lung function levels in a large Chinese rural adult population. Epidemiol Health 2021; 43:e2021047. [PMID: 34353001 PMCID: PMC8602009 DOI: 10.4178/epih.e2021047] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Accepted: 08/03/2021] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES The association between obesity parameters and lung function indicators in the general Chinese rural adult population remains unclear. METHODS In total, 8,284 Chinese adults aged 20 years to 80 years old from Xinxiang were recruited. Obesity-related parameters, including body mass index (BMI), waist circumference (WC), hip circumference (HC), waist-to-hip ratio (WHR), waistto-height ratio (WHtR), body fat percentage (BFP), basal metabolism, and visceral fat index, and lung function parameters such as forced vital capacity and forced expiratory volume in first second were measured. RESULTS The total prevalence of obesity defined by BMI, WC, WHR, WHtR, and BFP was 23.2%, 58.2%, 66.7%, 69.2%, and 56.5%, respectively. Spearman correlation analyses showed significant correlations between all obesity-related parameters and lung function. Linear regression analyses further demonstrated that BMI, WHtR, BFP, and general obesity defined using those indicators were negatively associated with lung function, while WC, WHR, and central obesity defined accordingly were positively associated with lung function. The relationship between general obesity and lung function was more evident in women than in men, while the link between central obesity and lung function was more obvious in men than in women. CONCLUSIONS Obesity is closely related to lung function in the general Chinese adult population. Weight control and loss are important strategies to improve lung function and respiratory health.
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Affiliation(s)
- Xiang Zeng
- School of Public Health, Xinxiang Medical University, 601 Jinsui Road, Xinxiang 453003, Henan, China.,Laboratory of Environmental Medicine and Developmental Toxicology, Guangdong Key Laboratory of Environmental Pollution and Health, School of Environment, Jinan University, Guangzhou 511443, Guangdong, China
| | - Dongling Liu
- Henan Key Laboratory of Medical Tissue Regeneration, Xinxiang Medical University, 601 Jinsui Road, Xinxiang 453003, China
| | - Zhen An
- School of Public Health, Xinxiang Medical University, 601 Jinsui Road, Xinxiang 453003, Henan, China
| | - Huijun Li
- School of Public Health, Xinxiang Medical University, 601 Jinsui Road, Xinxiang 453003, Henan, China
| | - Jie Song
- School of Public Health, Xinxiang Medical University, 601 Jinsui Road, Xinxiang 453003, Henan, China
| | - Weidong Wu
- School of Public Health, Xinxiang Medical University, 601 Jinsui Road, Xinxiang 453003, Henan, China
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13
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Molani Gol R, Rafraf M. Association between abdominal obesity and pulmonary function in apparently healthy adults: A systematic review. Obes Res Clin Pract 2021; 15:415-424. [PMID: 34261619 DOI: 10.1016/j.orcp.2021.06.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Revised: 06/06/2021] [Accepted: 06/27/2021] [Indexed: 01/10/2023]
Abstract
BACKGROUND Obesity, especially abdominal obesity as a chronic disorder is associated with a high risk of developing non-communicable diseases such as respiratory diseases. Impaired lung function is a sign of early respiratory injury. This review summarizes the current knowledge of the effects of abdominal obesity on pulmonary function in apparently healthy adults. METHODS Google Scholar, PubMed, Science Direct, and Scopus databases were searched from 2014 up to August 2020 using relevant keywords. All original articles written in English evaluating the effects of abdominal obesity on pulmonary function in apparently healthy adults were eligible for this review. RESULTS A total of 26 studies (23 cross-sectional and three cohort) involving 68,024 participants were included in this review. More than 88% of the included studies reported that abdominal obesity significantly inversely was associated with pulmonary function. CONCLUSION The findings indicate that in subjects with abdominal obesity respiratory function decline possibly due to mechanical compression and obesity-induced airway inflammation. Therefore, nutrition and lifestyle interventions are required for the reduction of abdominal obesity that leads to improving pulmonary function and metabolic disease.
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Affiliation(s)
- Roghayeh Molani Gol
- Student Research Committee, Tabriz university of Medical Sciences, Tabriz, Iran; Nutrition Research Center, Department of Community Nutrition, Faculty of Nutrition and Food Science, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Maryam Rafraf
- Nutrition Research Center, Department of Community Nutrition, Faculty of Nutrition and Food Science, Tabriz University of Medical Sciences, Tabriz, Iran.
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14
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Hanafi NS, Agarwal D, Chippagiri S, Brakema EA, Pinnock H, Sheikh A, Liew SM, Ng CW, Isaac R, Chinna K, Wong LP, Hussein N, Abu Bakar AI, Pang YK, Juvekar S, Khoo EM. Chronic respiratory disease surveys in adults in low- and middle-income countries: A systematic scoping review of methodological approaches and outcomes. J Glob Health 2021; 11:04026. [PMID: 34221357 PMCID: PMC8248510 DOI: 10.7189/jogh.11.04026] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Background Chronic respiratory diseases (CRDs) contribute significantly towards the global burden of disease, but the true prevalence and burden of these conditions in adults is unknown in the majority of low- and middle-income countries (LMICs). We aimed to identify strategies - in particular the definitions, study designs, sampling frames, instruments, and outcomes - used to conduct prevalence surveys for CRDs in LMICs. The findings will inform a future RESPIRE Four Country ChrOnic Respiratory Disease (4CCORD) study, which will estimate CRD prevalence, including disease burden, in adults in LMICs. Methods We conducted a scoping review to map prevalence surveys conducted in LMICs published between 1995 and 2018. We followed Arksey and O'Malley's six-step framework. The search was conducted in OVID Medline, EMBASE, ISI Web of Science, Global Health, WHO Global Index Medicus and included three domains: CRDs, prevalence and LMICs. After an initial title sift, eight trained reviewers undertook duplicate study selection and data extraction. We charted: country and populations, random sampling strategies, CRD definitions/phenotypes, survey procedure (questionnaires, spirometry, tests), outcomes and assessment of individual, societal and health service burden of disease. Results Of 36 872 citations, 281 articles were included: 132 from Asia (41 from China). Study designs were cross-sectional surveys (n = 260), cohort studies (n = 11) and secondary data analysis (n = 10). The number of respondents in these studies ranged from 50 to 512 891. Asthma was studied in 144 studies, chronic obstructive pulmonary disease (COPD) in 112. Most studies (100/144) based identification of asthma on symptom-based questionnaires. In contrast, COPD diagnosis was typically based on spirometry findings (94/112); 65 used fixed-ratio thresholds, 29 reported fixed-ratio and lower-limit-of-normal values. Only five articles used the term 'phenotype'. Most studies used questionnaires derived from validated surveys, most commonly the European Community Respiratory Health Survey (n = 47). The burden/impact of CRD was reported in 33 articles (most commonly activity limitation). Conclusion Surveys remain the most practical approach for estimating prevalence of CRD but there is a need to identify the most predictive questions for diagnosing asthma and to standardise diagnostic criteria.
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Affiliation(s)
- Nik Sherina Hanafi
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | | | | | - Evelyn A Brakema
- Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden, the Netherlands
| | - Hilary Pinnock
- NIHR Global Health Research Unit on Respiratory Health (RESPIRE), Usher Institute, The University of Edinburgh, Edinburgh, UK
| | - Aziz Sheikh
- NIHR Global Health Research Unit on Respiratory Health (RESPIRE), Usher Institute, The University of Edinburgh, Edinburgh, UK
| | - Su-May Liew
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Chiu-Wan Ng
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Rita Isaac
- Christian Medical College, Vellore, India
| | - Karuthan Chinna
- School of Medicine, Faculty of Health and Medical Sciences, Taylor's University, Subang Jaya, Malaysia
| | - Li Ping Wong
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Norita Hussein
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Ahmad Ihsan Abu Bakar
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.,Pusrawi Hospital Sdn Bhd, Kuala Lumpur, Malaysia
| | - Yong-Kek Pang
- Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | | | - Ee Ming Khoo
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
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15
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Udomittipong K, Thabungkan T, Nimmannit A, Tovichien P, Charoensitisup P, Mahoran K. Obesity Indices for Predicting Functional Fitness in Children and Adolescents With Obesity. Front Pediatr 2021; 9:789290. [PMID: 34976898 PMCID: PMC8714884 DOI: 10.3389/fped.2021.789290] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2021] [Accepted: 11/15/2021] [Indexed: 12/30/2022] Open
Abstract
Objectives: We aimed to determine the obesity indices that affect 6-min walk test (6-MWT) distance in children and adolescents with obesity and to compare the 6-MWT distance of obese subjects with that of normal-weight subjects. Methods: Obese children and adolescents aged 8-15 years and normal-weight age- and gender-matched controls were enrolled. All participants performed the 6-MWT; respiratory muscle strength (RMS), including maximal inspiratory pressure and maximal expiratory pressure; and spirometry. Data between groups were compared. In the obesity group, correlation between obesity indices and pulmonary function testing (6-MWT, RMS, and spirometry) was analyzed. Results: The study included 37 obese and 31 normal-weight participants. The following parameters were all significantly lower in the obesity group than in the normal-weight group: 6-MWT distance (472.1 ± 66.2 vs. 513.7 ± 72.9 m; p = 0.02), forced expiratory volume in one second/forced vital capacity (FEV1/FVC) (85.3 ± 6.7 vs. 90.8 ± 4.5%; p < 0.001), forced expiratory flow rate within 25-75% of vital capacity (FEF25-75%) (89.8 ± 23.1 vs. 100.4 ± 17.3 %predicted; p = 0.04), and peak expiratory flow (PEF) (81.2 ± 15 vs. 92.5 ± 19.6 %predicted; p = 0.01). The obesity indices that significantly correlated with 6-MWT distance in obese children and adolescents were waist circumference-to-height ratio (WC/Ht) (r = -0.51; p = 0.001), waist circumference (r = -0.39; p = 0.002), body mass index (BMI) (r = -0.36; p = 0.03), and chest circumference (r = -0.35; p = 0.04). WC/Ht was the only independent predictor of 6-MWT distance by multiple linear regression. Conclusions: Children and adolescents with obesity had a significantly shorter 6-MWT distance compared with normal-weight subjects. WC/Ht was the only independent predictor of 6-MWT distance in the obesity group.
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Affiliation(s)
- Kanokporn Udomittipong
- Division of Pulmonology, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Teerapat Thabungkan
- Division of Pulmonology, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Akarin Nimmannit
- Division of Clinical Epidemiology, Office for Research and Development, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Prakarn Tovichien
- Division of Pulmonology, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Pawinee Charoensitisup
- Division of Pulmonology, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Khunphon Mahoran
- Division of Pulmonology, Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
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16
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Svartengren M, Cai GH, Malinovschi A, Theorell-Haglöw J, Janson C, Elmståhl S, Lind L, Lampa E, Lindberg E. The impact of body mass index, central obesity and physical activity on lung function: results of the EpiHealth study. ERJ Open Res 2020; 6:00214-2020. [PMID: 33263030 PMCID: PMC7682662 DOI: 10.1183/23120541.00214-2020] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 06/03/2020] [Indexed: 12/21/2022] Open
Abstract
Study objectives Obesity is often associated with lower lung function; however, the interaction of lung function with central obesity and physical inactivity is less clear. As such, we investigated the effect on lung function of body size (body mass index (BMI)), central obesity (waist circumference (WC)) and self-reported physical activity. Methods Lung function, height, weight and WC were measured in 22 743 participants (12 791 women), aged 45–75 years, from the EpiHealth cohort study. Physical activity, gender and educational level were assessed using a questionnaire. Results Obesity, central obesity and physical inactivity were all associated with lower forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC). However, in participants without central obesity there was an increase in both FEV1 and FVC by BMI (% predicted FVC increasing from median 98%, interquartile range (IQR) 89–110% in underweight participants (BMI <20) to 103%, IQR 94–113% in obese participants (BMI ≥30)). In contrast, there was a decrease in % predicted FVC in participants with central obesity (from 98%, IQR 89–109% in the normal weight group to 95%, IQR 85–105% in the obese weight group). We further found a negative association between physical activity and lung function among those with low and high levels of physical activity (% predicted FEV1 97%, IQR 86–107% versus 103%, IQR 94–113%, respectively and % predicted FVC 96%, IQR 85–106% versus 103%, IQR 94–113%, respectively). All results remained when calculated by z-scores. Conclusions The association between BMI and lung function is dependent on the presence of central obesity. Independent of obesity, there is an association between physical activity and lung function. BMI and central obesity are related to lung function in the middle-aged and elderly. BMI association with lung function is dependent on the presence of central obesity, while the association of physical activity and lung function is independent of obesity.https://bit.ly/3eQl86C
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Affiliation(s)
- Magnus Svartengren
- Dept of Medical Sciences, Occupational and Environmental Medicine, Uppsala University, Uppsala, Sweden
| | - Gui-Hong Cai
- Dept of Medical Sciences, Occupational and Environmental Medicine, Uppsala University, Uppsala, Sweden.,Dept of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
| | - Andrei Malinovschi
- Dept of Medical Sciences, Clinical Physiology, Uppsala University, Uppsala, Sweden
| | - Jenny Theorell-Haglöw
- Dept of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
| | - Christer Janson
- Dept of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
| | - Sölve Elmståhl
- Dept of Health Sciences, Division of Geriatric Medicine, Lund University, Lund, Sweden.,Clinical Research Centre (CRC), Skåne University Hospital, Malmö, Sweden
| | - Lars Lind
- Dept of Medical Sciences, Cardiovascular Epidemiology, Uppsala University, Uppsala, Sweden
| | - Erik Lampa
- Uppsala Clinical Research Center (UCR), Uppsala University, Uppsala, Sweden
| | - Eva Lindberg
- Dept of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
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17
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Gómez-Ochoa SA, Van Poll N, Franco OH. COVID-19: Is there a weaker sex? Case Rep Womens Health 2020; 28:e00263. [PMID: 33072527 PMCID: PMC7553101 DOI: 10.1016/j.crwh.2020.e00263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
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18
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Pan J, Adab P, Cheng KK, Jiang CQ, Zhang WS, Zhu F, Jin YL, Thomas GN, Steyerberg EW, Lam TH. Development and validation of a prediction model for airflow obstruction in older Chinese: Guangzhou Biobank Cohort Study. Respir Med 2020; 173:106158. [PMID: 33011445 DOI: 10.1016/j.rmed.2020.106158] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 09/02/2020] [Accepted: 09/15/2020] [Indexed: 11/16/2022]
Abstract
OBJECTIVE To develop and validate a prediction model for airflow obstruction (AO) in older Chinese. METHODS DESIGN Multivariable logistic regression analysis in large population cohort of Chinese aged ≥50 years. PARTICIPANTS Model development: 8762 Chinese aged ≥50 years were selected from the early phase recruits to the Guangzhou Biobank Cohort Study (GBCS) (recruited from September 2003 to May 2006). Internal validation: 100 bootstrap samples drawn with replacement from the development sample. External validation: 8395 Chinese aged ≥50 years from later phase GBCS (recruited from September 2006 to January 2008). OUTCOMES AO was defined by a forced expiratory volume in 1 s/forced vital capacity ratio < lower limits of normal. RESULTS 839 (9.6%) and 764 (9.1%) individuals had AO in the development and temporal validation samples respectively. The predictors in the prediction model included sex, age, body mass index groups, smoking status, presence of respiratory symptoms, and history of asthma. Model development and validation was stratified by sex. Model performance including calibration (calibration-in-the-large -0.017 vs. -0.157; and calibration slope 0.88 vs. 1.02), discrimination (C-statistic 0.72 vs. 0.63 with 95% confidence interval 0.69-0.75 vs. 0.62-0.73) and clinical usefulness (decision curve analysis) in the external temporal validation sample were more satisfactory in men than that in women. Prediction models with risk thresholds (13% in men and 7% in women) and easy-to-use nomograms were developed to assess the probability of AO. CONCLUSION The diagnostic models based on readily available epidemiologic and clinical information with satisfactory performance can assist physicians to identify older individuals at high risk of AO and may improve the efficiency of spirometry for active case finding. Further validation beyond the Chinese population is warranted.
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Affiliation(s)
- Jing Pan
- Molecular Epidemiology Research Center, Guangzhou Twelfth People's Hospital, Guangzhou, Guangdong, China
| | - Peymane Adab
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK.
| | - K K Cheng
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Chao Qiang Jiang
- Molecular Epidemiology Research Center, Guangzhou Twelfth People's Hospital, Guangzhou, Guangdong, China
| | - Wei Sen Zhang
- Molecular Epidemiology Research Center, Guangzhou Twelfth People's Hospital, Guangzhou, Guangdong, China
| | - Feng Zhu
- Molecular Epidemiology Research Center, Guangzhou Twelfth People's Hospital, Guangzhou, Guangdong, China
| | - Ya Li Jin
- Molecular Epidemiology Research Center, Guangzhou Twelfth People's Hospital, Guangzhou, Guangdong, China
| | - G Neil Thomas
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Ewout W Steyerberg
- Department of Public Health, Erasmus MC, Rotterdam, Netherlands; Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, Netherlands
| | - Tai Hing Lam
- Molecular Epidemiology Research Center, Guangzhou Twelfth People's Hospital, Guangzhou, Guangdong, China; School of Public Health, The University of Hong Kong, Hong Kong, China
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He H, Wang B, Zhou M, Cao L, Qiu W, Mu G, Chen A, Yang S, Chen W. Systemic Inflammation Mediates the Associations Between Abdominal Obesity Indices and Lung Function Decline in a Chinese General Population. Diabetes Metab Syndr Obes 2020; 13:141-150. [PMID: 32021360 PMCID: PMC6980850 DOI: 10.2147/dmso.s229749] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Accepted: 11/29/2019] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Previous studies reported that obesity indices were inversely associated with lung function. However, the underlying mechanisms remain unclear. We aimed to assess the potential mediating effect of systemic inflammation in the associations between obesity indices and lung function decline among a general population. METHODS We conducted a cross-sectional study among 3442 participants from the Wuhan-Zhuhai cohort. Plasma C-reactive protein (CRP) was assayed as a marker of systemic inflammation. The relationships among several obesity indices (body mass index, BMI; waist circumference, WC; waist-to-hip ratio, WHR; waist-to-height ratio, WHtR), plasma CRP and lung function were assessed by generalized linear models. The role of CRP in the associations between obesity indices and lung function was analyzed using mediation analysis. RESULTS We observed inverse associations between abdominal obesity indices (WC, WHR and WHtR) and lung function parameters, including forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC) (all P<0.05). Each 1-unit increase in WC was associated with a 3.39 mL decrease in FEV1 and a 3.96 mL decrease in FVC (all P<0.05). Each 1% increase in WHR and WHtR was associated with a 5.42 mL and a 14.23 mL decrease in FEV1, and a 5.70 mL and a 16.92 mL decrease in FVC (all P<0.05). Mediation analysis indicated that plasma CRP partly mediated the associations between abdominal obesity and lung function. The mediated proportions of CRP in associations of WC, WHR and WHtR with FEV1 were 7.96%, 9.59% and 5.76%, respectively. The mediated proportions of CRP in associations of WC and WHR with FVC were 8.33% and 11.40%, respectively. CONCLUSION Abdominal obesity indices were negatively associated with lung function, and the associations may be partly mediated by systemic inflammation.
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Affiliation(s)
- Heng He
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei430030, People’s Republic of China
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei430030, People’s Republic of China
| | - Bin Wang
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei430030, People’s Republic of China
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei430030, People’s Republic of China
| | - Min Zhou
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei430030, People’s Republic of China
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei430030, People’s Republic of China
| | - Limin Cao
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei430030, People’s Republic of China
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei430030, People’s Republic of China
| | - Weihong Qiu
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei430030, People’s Republic of China
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei430030, People’s Republic of China
| | - Ge Mu
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei430030, People’s Republic of China
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei430030, People’s Republic of China
| | - Ailian Chen
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei430030, People’s Republic of China
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei430030, People’s Republic of China
| | - Shijie Yang
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei430030, People’s Republic of China
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei430030, People’s Republic of China
| | - Weihong Chen
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei430030, People’s Republic of China
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei430030, People’s Republic of China
- Correspondence: Weihong Chen Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei430030, People’s Republic of ChinaTel +86 27 83691677 Email
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20
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Bokov P, Delclaux C. [The impact of obesity on respiratory function]. Rev Mal Respir 2019; 36:1057-1063. [PMID: 31522948 DOI: 10.1016/j.rmr.2019.07.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Accepted: 07/06/2019] [Indexed: 01/28/2023]
Abstract
The respiratory impact of obesity can be both symptomatic (resting and exertional breathlessness) and functional (pulmonary function at rest and on exercise). The prevalence of breathlessness is increased in adult obese individuals, ∼50% at rest and ∼75% on exertion (mMRC score>0). Pulmonary function abnormalities in obese adults include reduced functional residual capacity (FRC) and expiratory residual volume (ERV), and less frequently reduced total lung capacity (a restrictive defect, with TLC below the 5th percentile of predicted is present in around 15% in severe obese adults), with normal residual volume (RV). Airflows are barely affected by obesity, but bronchial hyperresponsiveness (BHR) is very prevalent, which may be due to the loss of bronchoprotective effect of deep inspiration in obesity (mechanical pathophysiology of BHR). In children, the modifications of lung volumes seen are quite different: TLC is normal while FRC and RV are reduced, explaining the increase in FVC. FEV1/FVC is therefore reduced by obesity, without true airflow obstruction (dysanaptic growth). Resting oxygen consumption (V'O2) is increased due to obesity and normally increases with exercise. Maximum V'O2 is normal or weakly reduced in obese patients; on the other hand, the increase in respiratory load increases the oxygen cost of ventilation, which tends to be rapid, both at rest and during exertion. Finally, it should be noted that there is only limited statistical correlation between exercise dyspnoea and respiratory function abnormalities in obesity.
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Affiliation(s)
- P Bokov
- Service de physiologie pédiatrique, centre pédiatrique des pathologies du sommeil, hôpital Robert-Debré, AP-HP, 48, boulevard Sérurier, 75019 Paris, France; Université Paris-Diderot, Sorbonne Paris Cité, faculté de médecine, 75018 Paris, France; Inserm, UMR1141, 75019 Paris, France
| | - C Delclaux
- Service de physiologie pédiatrique, centre pédiatrique des pathologies du sommeil, hôpital Robert-Debré, AP-HP, 48, boulevard Sérurier, 75019 Paris, France; Université Paris-Diderot, Sorbonne Paris Cité, faculté de médecine, 75018 Paris, France; Inserm, UMR1141, 75019 Paris, France.
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21
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Abstract
PURPOSE OF REVIEW Asthma, a common respiratory disease that affects about 10% of the US population, represents a significant public health issue. In the last decade, cumulative evidence has demonstrated sex disparities in asthma, including significant differences in epidemiology, clinical presentation, response to therapies, and health outcomes. Understanding sex-related differences in asthma enables clinicians to provide personalized asthma care and improve asthma outcome. RECENT FINDINGS Recent studies on sex-related differences in asthma inform us on mechanism underlying asthma pathogenesis across all age groups. Sex hormones directly modulate immune pathways crucial in asthma pathogenesis and affect individual's response to environmental triggers and medications, such as leukokotriene inhibitors. Not surprisingly, the use of external sex hormone supplementations appears to modulate asthma risk. Identification of sex-specific asthma risk loci through genome-wide association studies also provides supporting evidence on sex-related differences in asthma. There is an interaction between sex and obesity, an interaction that could place females at higher risk for systemic inflammation and, consequently, asthma. In this article, we review epidemiological and clinical studies on sex-related differences in asthma, with a special focus on the role of sex hormones, including hormonal therapies and the asthma-obesity interaction.
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Affiliation(s)
- Peng Zhang
- From the Respiratory Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44106, USA
| | - Joe Zein
- From the Respiratory Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44106, USA.
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22
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Pan J, Adab P, Jiang CQ, Zhang WS, Zhu F, Jin YL, Thomas GN, Lam TH. All-cause and cause-specific mortality from restrictive and obstructive spirometric patterns in Chinese adults with and without dyspnea: Guangzhou Biobank Cohort Study. Respir Med 2019; 151:66-80. [PMID: 31047120 DOI: 10.1016/j.rmed.2019.04.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2018] [Revised: 03/30/2019] [Accepted: 04/01/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To study whether abnormal spirometric patterns were associated with differential mortality in Chinese adults with and without dyspnea. METHODS Guangzhou Biobank Cohort Study (GBCS) participants were classified by spirometric patterns and presence of dyspnea into 6 groups: normal spirometry (NS), restriction on spirometry (ROS) and airflow obstruction (AO), each with and without dyspnea. Adjusted hazard ratios (aHRs) were calculated for mortality using Cox models. RESULTS Among 16777 subjects, 1595 (9.5%) had ROS, 1036 (6.2%) had AO and 1009 (6.0%) had dyspnea. A total of 1993 deaths (11.9%) occurred during 11-year follow-up. Using NS without dyspnea as reference, NS with dyspnea was significantly associated with increased cardiovascular mortality risk (aHRs 1.61 (95% confidence interval (CI) 1.18-2.19); ROS with and without dyspnea were associated with increased risks of all-cause (aHRs 1.46 (95% CI 1.28-1.66) and 1.81 (95% CI 1.33-2.47)) and cardiovascular mortality (aHRs 1.89 (95% CI 1.55-2.31) and 1.85 (95% CI 1.12-3.03)), but not of lung cancer mortality (aHRs 1.33 (95% CI 0.91-1.94) and 1.35 (95% CI 0.49-3.70)); AO with and without dyspnea were associated with increased risks of all-cause (aHRs 1.59 (95% CI 1.36-1.86) and 2.36 (95% CI 1.77-3.15)), cardiovascular (aHRs 1.43 (95% CI 1.08-1.90) and 1.61 (95% CI 0.91-2.82)) and lung cancer mortality (aHRs 1.91 (95% CI 1.29-2.84) and 3.01 (95% CI 1.46-6.23)). These associations did not vary by sex or smoking status (all P-values for interaction >0.05). CONCLUSION Both ROS and AO, with and without dyspnea, were associated with increased all-cause and cardiovascular disease mortality. The increased risk of all-cause was greater and that of cardiovascular mortality was lower for AO than ROS. AO showed significantly increased risk of lung cancer but ROS did not. (272 words).
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Affiliation(s)
- Jing Pan
- Guangzhou No.12 Hospital, Guangzhou, Guangdong, China.
| | - Peymane Adab
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK.
| | | | - Wei Sen Zhang
- Guangzhou No.12 Hospital, Guangzhou, Guangdong, China.
| | - Feng Zhu
- Guangzhou No.12 Hospital, Guangzhou, Guangdong, China.
| | - Ya Li Jin
- Guangzhou No.12 Hospital, Guangzhou, Guangdong, China.
| | - G Neil Thomas
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK.
| | - Tai Hing Lam
- School of Public Health, The University of Hong Kong, Hong Kong, China; Guangzhou No.12 Hospital, Guangzhou, Guangdong, China.
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23
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Wan ES, Fortis S, Regan EA, Hokanson J, Han MK, Casaburi R, Make BJ, Crapo JD, DeMeo DL. Longitudinal Phenotypes and Mortality in Preserved Ratio Impaired Spirometry in the COPDGene Study. Am J Respir Crit Care Med 2018; 198:1397-1405. [PMID: 29874098 PMCID: PMC6290948 DOI: 10.1164/rccm.201804-0663oc] [Citation(s) in RCA: 124] [Impact Index Per Article: 20.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Accepted: 06/04/2018] [Indexed: 12/22/2022] Open
Abstract
RATIONALE Increasing awareness of the prevalence and significance of Preserved Ratio Impaired Spirometry (PRISm), alternatively known as restrictive or Global Initiative for Chronic Obstructive Lung Disease (GOLD)-unclassified spirometry, has expanded the body of knowledge on cross-sectional risk factors. However, longitudinal studies of PRISm remain limited. OBJECTIVES To examine longitudinal patterns of change in lung function, radiographic characteristics, and mortality of current and former smokers with PRISm. METHODS Current and former smokers, aged 45 to 80 years, were enrolled in COPDGene (phase 1, 2008-2011) and returned for a 5-year follow-up (phase 2, 2012-2016). Subjects completed questionnaires, spirometry, chest computed tomography scans, and 6-minute-walk tests at both study visits. Baseline characteristics, longitudinal change in lung function, and mortality were assessed by post-bronchodilator lung function categories: PRISm (FEV1/FVC < 0.7 and FEV1 < 80%), GOLD0 (FEV1/FVC > 0.7 and FEV1 > 80%), and GOLD1-4 (FEV1/FVC < 0.7). MEASUREMENTS AND MAIN RESULTS Although the prevalence of PRISm was consistent (12.4-12.5%) at phases 1 and 2, subjects with PRISm exhibited substantial rates of transition to and from other lung function categories. Among subjects with PRISm at phase 1, 22.2% transitioned to GOLD0 and 25.1% progressed to GOLD1-4 at phase 2. Subjects with PRISm at both phase 1 and phase 2 had reduced rates of FEV1 decline (-27.3 ± 42.1 vs. -33.0 ± 41.7 ml/yr) and comparable proportions of normal computed tomography scans (51% vs. 52.7%) relative to subjects with stable GOLD0 spirometry. In contrast, incident PRISm exhibited accelerated rates of lung function decline. Subjects with PRISm at phase 1 had higher mortality rates relative to GOLD0 and lower rates relative to the GOLD1-4 group. CONCLUSIONS PRISm is highly prevalent, is associated with increased mortality, and represents a transitional state for significant subgroups of subjects. Additional studies to characterize longitudinal progression in PRISm are warranted.
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Affiliation(s)
- Emily S. Wan
- Channing Division of Network Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
- Pulmonary and Critical Care Section, VA Boston Healthcare System, Boston, Massachusetts
| | - Spyridon Fortis
- Department of Pulmonary, Critical Care, and Occupational Medicine, University of Iowa, Iowa City, Iowa
| | | | - John Hokanson
- Department of Epidemiology, Colorado School of Public Health, University of Colorado, Denver, Colorado
| | | | - Richard Casaburi
- Rehabilitation Clinical Trials Center, Los Angeles Biomedical Research Institute at Harbor–University of California Los Angeles Medical Center, Torrance, California
| | | | | | - Dawn L. DeMeo
- Channing Division of Network Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
| | - for the COPDGene Investigators
- Channing Division of Network Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
- Pulmonary and Critical Care Section, VA Boston Healthcare System, Boston, Massachusetts
- Department of Pulmonary, Critical Care, and Occupational Medicine, University of Iowa, Iowa City, Iowa
- National Jewish Health, Denver, Colorado
- Department of Epidemiology, Colorado School of Public Health, University of Colorado, Denver, Colorado
- University of Michigan, Ann Arbor, Michigan; and
- Rehabilitation Clinical Trials Center, Los Angeles Biomedical Research Institute at Harbor–University of California Los Angeles Medical Center, Torrance, California
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24
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Stanaway IB, Hall TO, Rosenthal EA, Palmer M, Naranbhai V, Knevel R, Namjou-Khales B, Carroll RJ, Kiryluk K, Gordon AS, Linder J, Howell KM, Mapes BM, Lin FTJ, Joo YY, Hayes MG, Gharavi AG, Pendergrass SA, Ritchie MD, de Andrade M, Croteau-Chonka DC, Raychaudhuri S, Weiss ST, Lebo M, Amr SS, Carrell D, Larson EB, Chute CG, Rasmussen-Torvik LJ, Roy-Puckelwartz MJ, Sleiman P, Hakonarson H, Li R, Karlson EW, Peterson JF, Kullo IJ, Chisholm R, Denny JC, Jarvik GP, Crosslin DR. The eMERGE genotype set of 83,717 subjects imputed to ~40 million variants genome wide and association with the herpes zoster medical record phenotype. Genet Epidemiol 2018; 43:63-81. [PMID: 30298529 PMCID: PMC6375696 DOI: 10.1002/gepi.22167] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Revised: 08/10/2018] [Accepted: 08/28/2018] [Indexed: 12/30/2022]
Abstract
The Electronic Medical Records and Genomics (eMERGE) network is a network of medical centers with electronic medical records linked to existing biorepository samples for genomic discovery and genomic medicine research. The network sought to unify the genetic results from 78 Illumina and Affymetrix genotype array batches from 12 contributing medical centers for joint association analysis of 83,717 human participants. In this report, we describe the imputation of eMERGE results and methods to create the unified imputed merged set of genome‐wide variant genotype data. We imputed the data using the Michigan Imputation Server, which provides a missing single‐nucleotide variant genotype imputation service using the minimac3 imputation algorithm with the Haplotype Reference Consortium genotype reference set. We describe the quality control and filtering steps used in the generation of this data set and suggest generalizable quality thresholds for imputation and phenotype association studies. To test the merged imputed genotype set, we replicated a previously reported chromosome 6 HLA‐B herpes zoster (shingles) association and discovered a novel zoster‐associated loci in an epigenetic binding site near the terminus of chromosome 3 (3p29).
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Affiliation(s)
- Ian B Stanaway
- Department of Biomedical Informatics Medical Education, School of Medicine, University of Washington, Seattle, Washington
| | - Taryn O Hall
- Department of Biomedical Informatics Medical Education, School of Medicine, University of Washington, Seattle, Washington
| | - Elisabeth A Rosenthal
- Division of Medical Genetics, School of Medicine, University of Washington, Seattle, Washington
| | - Melody Palmer
- Division of Medical Genetics, School of Medicine, University of Washington, Seattle, Washington
| | - Vivek Naranbhai
- Department of Biomedical Informatics Medical Education, School of Medicine, University of Washington, Seattle, Washington.,Harvard Medical School, Harvard University, Cambridge, Massachusetts
| | - Rachel Knevel
- Harvard Medical School, Harvard University, Cambridge, Massachusetts
| | - Bahram Namjou-Khales
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Robert J Carroll
- Departments of Biomedical Informatics and Medicine, Vanderbilt University, Nashville, Tennessee
| | - Krzysztof Kiryluk
- Department of Medicine, Columbia University, New York City, New York
| | - Adam S Gordon
- Division of Medical Genetics, School of Medicine, University of Washington, Seattle, Washington
| | - Jodell Linder
- Vanderbilt Institute for Clinical and Translational Research, School of Medicine, Vanderbilt University, Nashville, Tennessee
| | - Kayla Marie Howell
- Vanderbilt Institute for Clinical and Translational Research, School of Medicine, Vanderbilt University, Nashville, Tennessee
| | - Brandy M Mapes
- Vanderbilt Institute for Clinical and Translational Research, School of Medicine, Vanderbilt University, Nashville, Tennessee
| | - Frederick T J Lin
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | | | - M Geoffrey Hayes
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Ali G Gharavi
- Department of Medicine, Columbia University, New York City, New York
| | | | - Marylyn D Ritchie
- Department of Genetics, University of Pennsylvania, Philadelphia, Pennsylvania
| | | | | | - Soumya Raychaudhuri
- Harvard Medical School, Harvard University, Cambridge, Massachusetts.,Program in Medical and Population Genetics, Broad Institute of Massachusetts Technical Institute and Harvard University, Cambridge, Massachusetts
| | - Scott T Weiss
- Harvard Medical School, Harvard University, Cambridge, Massachusetts
| | - Matt Lebo
- Harvard Medical School, Harvard University, Cambridge, Massachusetts
| | - Sami S Amr
- Harvard Medical School, Harvard University, Cambridge, Massachusetts
| | - David Carrell
- Kaiser Permanente Washington Health Research Institute (Formerly Group Health Cooperative-Seattle), Kaiser Permanente, Seattle, Washington
| | - Eric B Larson
- Kaiser Permanente Washington Health Research Institute (Formerly Group Health Cooperative-Seattle), Kaiser Permanente, Seattle, Washington
| | - Christopher G Chute
- Schools of Medicine, Public Health, and Nursing, Johns Hopkins University, Baltimore, Maryland
| | | | | | - Patrick Sleiman
- Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | | | - Rongling Li
- National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland
| | - Elizabeth W Karlson
- Department of Genetics, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Josh F Peterson
- Departments of Biomedical Informatics and Medicine, Vanderbilt University, Nashville, Tennessee
| | | | - Rex Chisholm
- Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Joshua Charles Denny
- Departments of Biomedical Informatics and Medicine, Vanderbilt University, Nashville, Tennessee
| | - Gail P Jarvik
- Division of Medical Genetics, School of Medicine, University of Washington, Seattle, Washington
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- National Human Genome Research Institute, National Institutes of Health, Bethesda, Maryland
| | - David R Crosslin
- Department of Biomedical Informatics Medical Education, School of Medicine, University of Washington, Seattle, Washington
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