Abstract
Background
The purpose of this study is to establish whether the use of an intragastric balloon (IGB) for 6 months improves lung function, metabolic parameters, and body fat distribution in patients with overweight/obesity and metabolic syndrome (MS).
Methods
This is a longitudinal and interventional study on 40 adults, whose anthropometric, laboratory, and lung function parameters were assessed and who underwent dual-energy X-ray absorptiometry (DXA) before implantation and after removal of IGB.
Results
The total lung capacity (TLC) (p = 0.0001), functional residual capacity (FRC) (p = 0.0001), residual volume (p = 0.0005), and expiratory reserve volume (ERV) (p = 0.0001) were significantly reduced by IGB. The body mass index (BMI) significantly decreased from a median of 39.1 kg/m2 at the beginning of the study to 34.5 kg/m2 at the end of the 6-month period (p = 0.0001). At the end of the study, 31 participants (77.5 %) no longer met the diagnostic criteria of MS. The percentage of truncal, android, gynoid, and total fat investigated by DXA exhibited significant reductions (p = 0.0001). Significant correlations were found between delta TLC and delta waist circumference (ρ = −0.34; p = 0.03), delta FRC and delta IMC (ρ = −0.39; p = 0.01), delta ERV and delta BMI (ρ = −0.44; p = 0.005), and delta ERV and delta high-density lipoprotein (HDL) (ρ = −0.37; p = 0.02). Significant correlations were also found between delta ERV and delta truncal (ρ = −0.51; p = 0.004), android (ρ = −0.46; p = 0.01), gynoid (ρ = −0.55; p = 0.001), and total fat (ρ = −0.59; p = 0.0005).
Conclusions
IGB efficiently induced weight loss and promoted the improvement of lung function parameters, with a reduction of the restrictive ventilatory defect. It also promoted improvements of MS and the pattern of body fat distribution.
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References
Aballay LR, Eynard AR, Díaz Mdel P, et al. Overweight and obesity: a review of their relationship to metabolic syndrome, cardiovascular disease, and cancer in South America. Nutr Rev. 2013;71(3):168–79. Epub 2013 Jan 7. PMID 23452284.
World Health Organization. Obesity and overweight. Fact sheet no 311. 2013 http://www.who.int/mediacentre/factsheets/fs311/en/index.html. Accessed 8 Jan 2013
Brazilian Health Ministry. Almost half of the population is overweight. 2012. http://portalsaude.saude.gov.br/portalsaude/noticia/4821/785/quase-metade-da-populacao-brasileira-esta-acima-do-peso.html. Accessed 3 Apr 2013
Imaz I, Martínez-Cervell C, García-Álvarez EE, et al. Safety and effectiveness of the intragastric balloon for obesity: a meta-analysis. Obes Surg. 2008;18(7):841–6. PMID: 18459025.
Ladosky W, Botelho MAM, Albuquerque JP. Chest mechanics in morbidily obese non-hypoventilated patients. Respir Med. 2001;95(4):281–6. PMID: 11316110.
Koenig SM. Pulmonary complications of obesity. Am J Med Sci. 2001;321(4):249–79. PMID: 11307867.
Lin WY, Yao CA, Wang HC, et al. Impaired lung function is associated with obesity and metabolic syndrome in adults. Obesity (Silver Spring). 2006;14(9):1654–61. PMID: 17030977.
Mazess RB, Barden HS, Bisek JP, et al. Dual-energy X-ray absorptiometry for total-body and regional bone-mineral and soft-tissue composition. Am J Clin Nutr. 1990;51(6):1106–12. PMID: 2349926.
Mafort TT, Madeira M, Madeira M, et al. Intragastric balloon for the treatment of obesity: evaluation of pulmonary function over a 3-month period. Lung. 2012;190(6):671–6. Epub 2012 Sep 12. PMID: 22968677.
Santana H, Zoico E, Turcato E, et al. Relation between body composition, fat distribution, and lung function in elderly men. Am J Am J Clin Nutr. 2001;73(4):827–31. PMID: 11273860.
Wannamethee SG, Shaper AG, Whincup PH. Body fat distribution, body composition, and respiratory function in elderly men. Am J Clin Nutr. 2005;82(5):996–1003. PMID: 16280430.
Thomas PS, Cowen ERT, Hulands G, et al. Respiratory function in the morbidly obese before and after weight loss. Thorax. 1989;44(5):382–6. PMID: 2503905.
Alberti KG, Zimmet P, Shaw J. IDF Epidemiology Task Force Consensus Group. The metabolic syndrome: a new worldwide definition. Lancet. 2005;366(9491):1059–62. PMID: 16182882.
Zuccaro AM. A endoscopia digestiva alta na obesidade mórbida. Boletim da Sociedade Brasileira de Endoscopia Digestiva. 2013. http://www.sobedrj.com.br/areamedica.html#. Accessed 15 Feb 2013.
Pereira CAC, Rodrigues SC, Sato T. New reference values for forced spirometry in white adults in Brazil. J Bras Pneumol. 2007;33(4):397–406. PMID: 17982531.
Neder JA, Andreoni S, Peres C, et al. Reference values for lung function tests. I. Static volumes. Braz J Med Biol Res. 1999;32(6):703–17. PMID: 10412549.
Neder JA, Andreoni S, Peres C, et al. Reference values for lung function tests. III. Carbon monoxide diffusing capacity (transfer factor). Braz J Med Biol Res. 1999;32(6):729–37.
Neder JA, Andreoni S, Lerario MC, et al. Reference values for lung function tests. II. Maximal respiratory pressures and voluntary ventilation. Braz J Med Biol Res. 1999;32(6):719–27. PMID: 10412550.
Blouin K, Boivin A, Tchernof A. Androgens and body fat distribution. J Steroid Biochem Mol Bio. 2008;108(3–5):272–80. Epub 2007 Sep 7. PMID: 17945484.
Dumonceau JM. Evidence-based review of the Bioenterics intragastric balloon for weight loss. Obes Surg. 2008;18(12):1611–7. Epub 2008 Jun 21. PMID: 18568377.
Carvalho MR, Jorge Z, Nobre E, et al. Intra-gastric ballon in the treatment of morbid obesity. Acta Med Port. 2011;24(4):489–98. Epub 2011 Dec 12. PMID: 22521004.
Genco A, López-Nava G, Wahlen C, et al. Multi-centre European experience with intragastric balloon in overweight populations: 13 years of experience. Obes Surg. 2013;23(4):515–21. PMID: 23224509.
Lopez-Nava G, Rubio MA, Prados S, et al. BioEnterics® Intragastric Balloon (BIB®): single ambulatory center Spanish experience with 714 consecutive patients treated with one or two consecutive balloons. Obes Surg. 2011;21(1):5–9. Epub 2010 Mar 20. PMID: 20306153.
Mion F, Napoleon B, Roman S, et al. Effects of intragastric balloon on gastric emptying and plasma ghrelin levels in non-morbid obese patients. Obes Surg. 2005;15(4):510–6. PMID: 15946431.
Plank LD. Dual-energy X-ray absorptiometry and body composition. Curr Opin Clin Nutr Metab Care. 2005;8(3):305–9. PMID: 15809534.
Dulloo AG, Jacquet J, Solinas G, et al. Body composition phenotypes in pathways to obesity and the metabolic syndrome. Int J Obes (Lond). 2010;34 Suppl 2:S4–17. PMID: 21151146.
Dulloo AG, Montani JP. Body composition, inflammation and thermogenesis in pathways to obesity and the metabolic syndrome: an overview. Obes Rev. 2012;13 Suppl 2:1–5. PMID: 23107254.
Forlano R, Ippolito AM, Iacobelis A, et al. Effect of the BioEnterics intragastric balloon on weight, insulin resistance, and liver steatosis in obese patients. Gastrointest Endosc. 2010;71:927–33. Epub 2009 Oct 27. PMID: 19863955.
Mui WL, Ng EK, Tsung BY, et al. Impact on obesity-related illnesses and quality of life following intragastric balloon. Obes Surg. 2010;20(8):1128–32. PMID: 19015930.
Crea N, Pata G, Della Casa D, et al. Improvement of metabolic syndrome following intragastric balloon: 1 year follow-up analysis. Obes Surg. 2009;19(8):1084–8. Epub 2009 Jun 9. PMID: 19506981.
Despres JP, Lemieux I, Bergeron J, et al. Abdominal obesity and the metabolic syndrome: contribution to global cardiometabolic risk. Arterioscler, Thromb, Vasc Biol. 2008;28(6):1039–49. PMID: 18356555.
Dodson MV, Mir PS, Hausman GJ, et al. Obesity, metabolic syndrome, and adipocytes. J Lipids. 2011;2011:721686. PMID: 21811683.
Ye J. Emerging role of adipose tissue hypoxia in obesity and insulin resistance. Int J Obes (Lond). 2009;33(1):54–66. PMID: 19050672.
Lazarus R, Gore CJ, Booth M, et al. Effects of body composition and fat distribution on ventilatory function in adults. Am J Clin Nutr. 1998;68(1):35–41. PMID: 96655094.
Ray CS, Sue DY, Bray G, et al. Effects of obesity on respiratory function. Am Rev Respir Dis. 1983;128(3):501–6. PMID: 6614644.
Jenkins SC, Moxham J. The effects of mild obesity on lung function. Respir Med. 1991;85(4):309–11. PMID: 1947368.
Chen Y, Rennie D, Cormier YF, et al. Waist circumference is associated with pulmonary function in normal-weight, overweight, and obese subjects. Am J Clin Nutr. 2007;85(1):35–9. PMID: 17209174.
Dixon AE, Lundblad LK, Suratt BT. The weight of obesity on lung health. Pulm Pharmacol Ther. 2013. doi:10.1016/j.pupt.2013.03.017. PMID: 23548771.
Medoff BD. Fat, fire and muscle—the role of adiponectin in pulmonary vascular inflammation and remodeling. Pulm Pharmacol Ther. 2013;26(4):420-426. PMID: 22750271
Konter J, Baez E, Summer RS. Obesity: “Priming” the lung for injury. Pulm Pharmacol Ther. 26(4):427-429. doi: 10.1016/j.pupt.2012.03.003. PMID: 22449512
Salome CM, King GG, Berend N. Physiology of obesity and effects on lung function. J Appl Physiol. 2010;108(1):206–11. PMID: 19875713.
Klein S, Allison DB, Heymsfield SB, et al. Waist circumference and cardiometabolic risk: a consensus statement from shaping America’s health: Association for Weight Management and Obesity Prevention; NAASO, the Obesity Society; the American Society for Nutrition; and the American Diabetes Association. Obesity (Silver Spring). 2007;15(5):1061–7. PMID: 17455180.
Jones RL, Nzekwu MMU. The effects of body mass index on lung volumes. Chest. 2006;130(3):827–33. PMID: 16963682.
Luce JM. Respiratory complications of obesity. Chest. 1980;78(4):626–31. PMID: 6998667.
Ochs-Balcom HM, Grant BJ, Muti P, et al. Pulmonary function and abdominal obesity in the general population. Chest. 2006;129(4):853–62. PMID: 16608930.
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Mafort, T.T., Madeira, E., Madeira, M. et al. Six-Month Intragastric Balloon Treatment for Obesity Improves Lung Function, Body Composition, and Metabolic Syndrome. OBES SURG 24, 232–240 (2014). https://doi.org/10.1007/s11695-013-1061-5
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DOI: https://doi.org/10.1007/s11695-013-1061-5