Long-Term Improvements in Pulmonary Function 5 Years After Bariatric Surgery
- 587 Downloads
Obesity is associated with reduced pulmonary function. We evaluated pulmonary function and status of asthma and obstructive sleep apnoea syndrome (OSAS) before and 5 years after bariatric surgery.
Spirometry was performed at baseline and 5 years postoperatively. Information of asthma and OSAS were recorded. Of 113 patients included, 101 had undergone gastric bypass, 10 duodenal switch and 2 sleeve gastrectomy.
Eighty (71 %) patients were women, mean preoperative age was 40 years and preoperative weight was 133 kg in women and 158 kg in men. Five years postoperatively, weight reduction was 31 % (42 kg; p < 0.001) in women and 24 % (38 kg; p < 0.001) in men. Forced expiratory volume in 1 s (FEV1) increased 4.1 % (116 ml; p < 0.001) in women and 6.7 % (238 ml; p = 0.003) in men. Forced vital capacity (FVC) increased 5.8 % (209 ml; p < 0.001) in women and 7.6 % (349 ml; p < 0.001) in men. Gender and weight loss were independently associated with the improvements in FEV1 and FVC. At follow-up, FEV1 had increased 36 % of the difference towards the estimated normal FEV1, and there was a corresponding 70 % recovery of FVC. These improvements occurred despite an expected decline in pulmonary function by age during the study period. Of the asthmatics and OSAS patients, 48 and 80 %, respectively, were without symptoms 5 years postoperatively.
Pulmonary function measured with spirometry was significantly improved 5 years after bariatric surgery, despite an expected age-related decline during this period. Symptoms of asthma and OSAS also improved.
KeywordsBariatric surgery Gastric bypass Obesity Weight loss Pulmonary function FEV1 FVC Spirometry Asthma Obstructive sleep apnoea
Conflict of Interest
Jon Kristinsson and Tom Mala received travel support via payments to their institution, given by Covidien and Ethicon Endo-Surgery. Stephen Hewitt, Sjur Humerfelt, Torgeir T Søvik, Erlend T Aasheim and Hilde Risstad did not report any disclosures.
- 19.Sjöstrøm L. Bariatric surgery and reduction in morbidity and mortality: experiences from the SOS study. Int J Obes. 2008 Dec;32(S7):S93–7.Google Scholar
- 20.Anonymous. Gastrointestinal surgery for severe obesity: National Institutes of Health Consensus Development Conference Statement. Am J Clin Nutr. 1992;55:615S–9S.Google Scholar
- 22.American Thoracic Society. Standardization of spirometry, 1994 update. Am J Respir Crit Care Med. 1995 Sep;152(3):1107–36.Google Scholar
- 24.Aftab H, Risstad H, Søvik TT, Bernklev T, Hewitt S, Kristinsson J, et al. Five-year outcome after gastric bypass for morbid obesity in a Norwegian cohort. Surg Obes Relat Dis. 2013. doi:10.1016/j.soard.2013.05.003
- 26.Wei Y-F, Wu H-D. Candidates for bariatric surgery: morbidly obese patients with pulmonary dysfunction. Journal of Obesity 2012; article ID 87837: 1–6. doi:101155/2012/878371.Google Scholar
- 27.From the global strategy for asthma management and prevention, Global Initiative for Asthma (GINA) 2012. http://www.ginasthma.org/. Accessed 2 Jan 2014.