The Relationship Between Anthropometric Measures, Blood Gases, and Lung Function in Morbidly Obese White Subjects
Obesity may cause adverse effects on the respiratory system. The main purpose of this study was to investigate how various measures of obesity are related to arterial blood gases and pulmonary function.
This is a cross-sectional study of consecutive morbidly obese patients with normal lung function. Blood gas samples were taken from the radial artery after 5 min of rest with subjects sitting upright. Lung function measurements included dynamic spirometry, static lung volumes, and gas diffusing capacity.
The 149 patients (77% women) had a mean (SD) age of 43 years (11 years) and BMI of 45.0 kg/m2 (6.3 kg/m2). The mean expiratory reserve volume (ERV) was less than half (49%) of predicted value, whilst most other lung function values were within predicted range. Forty-two patients had an abnormally low pO2 value (<10.7 kPa [80 mmHg]), while eight patients had a high pCO2 value (>6.0 kPa [45 mmHg]). All anthropometric measures correlated significantly with decreasing pO2 and increasing pCO2 (all P values < 0.05). BMI, neck circumference (NC), and waist circumference (WC) were negatively correlated with ERV (r = −0.25, −0.19, −0.21, respectively, all P values < 0.05). Multiple linear regression showed that BMI, WC, and NC were significantly associated with pO2 after adjustments for age, gender, and pack-years (all P values < 0.001). The models explained 34–36% of the variations in pO2. BMI, NC, and WC were also significantly associated with pCO2 (all P values < 0.05).There was no significant association between waist-to-hip ratio and blood gases (both P values > 0.27).
Both central and overall obesity were associated with unfavorable blood gases and low ERV.
- Bickelmann AG, Burwell CS, Robin ED, et al. Extreme obesity associated with alveolar hypoventilation; a Pickwickian syndrome. Am J Med. 1956;21:811–18. CrossRef
- Naimark A, Cherniack RM. Compliance of the respiratory system and its components in health and obesity. J Appl Physiol. 1960;15:377–82.
- Parameswaran K, Todd DC, Soth M. Altered respiratory physiology in obesity. Can Respir J. 2006;13:203–10.
- Kress JP, Pohlman AS, Alverdy J, et al. The impact of morbid obesity on oxygen cost of breathing (VO(2RESP)) at rest. Am J Respir Crit Care Med. 1999;160:883–6.
- Koenig SM. Pulmonary complications of obesity. Am J Med Sci. 2001;321:249–79. CrossRef
- Laaban JP, Cassuto D, Orvoen-Frija E, et al. Respiratory complications of massive obesity. Rev Prat. 1992;42:469–76.
- Vaughan RW, Cork RC, Hollander D. The effect of massive weight loss on arterial oxygenation and pulmonary function tests. Anesthesiology. 1981;54:325–8. CrossRef
- Collins LC, Hoberty PD, Walker JF, et al. The effect of body fat distribution on pulmonary function tests. Chest. 1995;107:1298–302. CrossRef
- Zavorsky GS, Murias JM, Kim dJ, et al. Waist-to-hip ratio is associated with pulmonary gas exchange in the morbidly obese. Chest. 2007;131:362–7. CrossRef
- Zavorsky GS, Hoffman SL. Pulmonary gas exchange in the morbidly obese. Obes Rev. 2008;9:326–39. CrossRef
- Hofso D, Ueland T, Hager H, et al. Inflammatory mediators in morbidly obese subjects: associations with glucose abnormalities and changes after oral glucose. Eur J Endocrinol. 2009;161:451–8. CrossRef
- GOLD Guidelines. Executive Summary: Global Strategy for Diagnosis, Management, and Prevention of COPD 2010 (http://www.goldcopd.org/Guidelineitem.asp?l1=2&l2=1&intId=2180)
- Quanjer PH, Tammeling GJ, Cotes JE, et al. Lung volumes and forced ventilatory flows. Report working party standardization of lung function tests, European community for steel and coal. Official statement of the European respiratory society. Eur Respir J Suppl. 1993;16:5–40.
- Williams AJ. ABC of oxygen: assessing and interpreting arterial blood gases and acid-base balance. BMJ. 1998;317:1213–16.
- Miller MR, Hankinson J, Brusasco V, et al. Standardisation of spirometry. Eur Respir J. 2005;26:319–38. CrossRef
- Wanger J, Clausen JL, Coates A, et al. Standardisation of the measurement of lung volumes. Eur Respir J. 2005;26:511–22. CrossRef
- MacIntyre N, Crapo RO, Viegi G, et al. Standardisation of the single-breath determination of carbon monoxide uptake in the lung. Eur Respir J. 2005;26:720–35. CrossRef
- Chiang A, Mehrishi S, Ganaraj J et al. Relationship between body mass index and arterial blood gases. Chest. 2003:123S–4S.
- Wei YF, Wu HD, Chang CY, et al. The impact of various anthropometric measurements of obesity on pulmonary function in candidates for surgery. Obes Surg. 2010;20:589–94. CrossRef
- Janssen I, Heymsfield SB, Allison DB, et al. Body mass index and waist circumference independently contribute to the prediction of nonabdominal, abdominal subcutaneous, and visceral fat. Am J Clin Nutr. 2002;75:683–8.
- Saliman JA, Benditt JO, Flum DR, et al. Pulmonary function in the morbidly obese. Surg Obes Relat Dis. 2008;4:632–9. CrossRef
- Jones RL, Nzekwu MM. The effects of body mass index on lung volumes. Chest. 2006;130:827–33. CrossRef
- Shore SA. Obesity and asthma: possible mechanisms. J Allergy Clin Immunol. 2008;121:1087–93. CrossRef
- The Relationship Between Anthropometric Measures, Blood Gases, and Lung Function in Morbidly Obese White Subjects
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Volume 21, Issue 4 , pp 485-491
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- Lung function
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- Author Affiliations
- 1. The Morbid Obesity Center, Vestfold Hospital Trust, Box 2168, 3103, Tønsberg, Norway
- 2. Medical Department, Vestfold Hospital Trust, Box 2168, 3103, Tønsberg, Norway
- 3. Department of Respiratory Medicine, Oslo University Hospital Rikshospitalet, 0027, Oslo, Norway
- 4. Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway