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Intragastric Balloon for the Treatment of Obesity: Evaluation of Pulmonary Function Over a 3-Month Period

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Abstract

Background

Obesity has become a global epidemic in the 21st century, and the placement of an intragastric balloon (IB) is a therapeutic modality used to treat it. Our objectives for this study were to evaluate changes in lung function resulting from IB use and to correlate the pattern of body fat distribution with changes in lung function.

Methods

This was an interventional study with 30 overweight and obese patients with metabolic syndrome. All of the subjects underwent anthropometric measurements, assessment of their body fat distribution pattern by dual-energy X-ray absorptiometry, and pulmonary function testing before implantation of the IB.

Results

During the initial evaluations, the main pulmonary function abnormalities observed were decreased expiratory reserve volume (ERV), decreased total lung capacity (TLC), and increased diffusing capacity of carbon monoxide (DLCO), which occurred in 56.7, 40, and 23.3 % of patients, respectively. We observed a statistically significant positive correlation between the DLCO and the percentage of trunk fat mass (ρ = 0.42; p < 0.01). Three months after placement of the IB, there was a significant reduction in the body mass index (p < 0.0001) and the maximal inspiratory pressure (p < 0.009). We also observed a significant increase in the forced vital capacity (p < 0.0001), TLC (p < 0.001), and ERV (p < 0.0001).

Conclusions

Weight loss as a result of IB causes increased static lung volumes and decreased inspiratory muscle strength. Additionally, being overweight and obese is related to increased DLCO, especially in individuals with truncal obesity.

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References

  1. Garrow JS (1988) Obesity and related diseases. Churchill Livingstone, London

    Google Scholar 

  2. Johnson LM (2011) The genetic epidemiology of obesity: a case study. Methods Mol Biol 713:227–237

    Article  PubMed  Google Scholar 

  3. World Health Organization (2000) Obesity: preventing and managing the global epidemic. Report of a WHO consultation. World Health Organ Tech Rep Ser 894:1–253

    Google Scholar 

  4. Ministério da Saúde do Brasil (2012). http://portalsaude.saude.gov.br/portalsaude/noticia/4821/785/quase-metade-da-populacao-brasileira-esta-acima-do-peso.html. Accessed 10 May 2012

  5. Ladosky W, Botelho MAM, Albuquerque JP (2001) Chest mechanics in morbidly obese non-hypoventilated patients. Respir Med 95:281–286

    Article  PubMed  CAS  Google Scholar 

  6. Paisani DM, Chiavegato LD, Faresin SM (2005) Volumes, capacidades pulmonares e força muscular respiratória no pós-operatório de gastroplastia. J Bras Pneumol 31:125–132

    Article  Google Scholar 

  7. Koenig SM (2001) Pulmonary complications of obesity. Am J Med Sci 321:249–279

    Article  PubMed  CAS  Google Scholar 

  8. McClean KM, Kee F, Young IS, Elborn JS (2008) Obesity and the lung: 1. Epidemiology. Thorax 63:649–654

    Article  PubMed  CAS  Google Scholar 

  9. Imaz I, Martínez-Cervell C, García-Álvarez EE, Sendra-Gutiérrez JM, González-Enríquez J (2008) Safety and effectiveness of the intragastric balloon for obesity: a meta-analysis. Obes Surg 18:841–846

    Article  PubMed  Google Scholar 

  10. Haffner S, Taegtmeyer H (2003) Epidemic obesity and the metabolic syndrome. Circulation 108:1541–1545

    Article  PubMed  Google Scholar 

  11. Lin WY, Yao CA, Wang HC, Huang KC (2006) Impaired lung function is associated with obesity and metabolic syndrome in adults. Obesity (Silver Spring) 14:1654–1661

    Article  Google Scholar 

  12. Santana H, Zoico E, Turcato E, Tosoni P, Bissoli L, Olivieri M, Bosello O (2001) Relation between body composition, fat distribution, and lung function in elderly men. Am J Clin Nutr 73:827–831

    PubMed  CAS  Google Scholar 

  13. Kethu SR, Banerjee S, Barth BA, Desilets DJ, Kaul V, Pedrosa MC, Pfau PR, Pleskow DK, Tokar JL, Wang A, Wong Kee Song LM, Rodriguez SA (2012) Endoluminal bariatric techniques. Gastrointest Endosc 76:1–7

    Article  PubMed  Google Scholar 

  14. Thomas PS, Cowen ERT, Hulands G, Milledge JS (1989) Respiratory function in the morbidly obese before and after weight loss. Thorax 44:382–386

    Article  PubMed  CAS  Google Scholar 

  15. International Diabetes Federation (2005) The IDF consensus worldwide definition of the metabolic syndrome. http://www.idf.org/webdata/docs/IDF_Meta_def_final.pdf. Accessed 15 May 2012

  16. Miller MR, Hankinson J, Brusasco V, Burgos F, Casaburi R, Coates A, Crapo R, Enright P, van der Grinten CPM, Gustafsson P, Jensen R, Johnson DC, MacIntyre M, McKay R, Navajas D, Pedersen OF, Pellegrino R, Viegi G, Wanger J (2005) ATS/ERS task force. Standardization of spirometry. Eur Respir J 26:319–338

    Article  PubMed  CAS  Google Scholar 

  17. Pereira CAC, Rodrigues SC, Sato T (2007) Novos valores de referência para espirometria forçada em brasileiros adultos de raça branca. J Bras Pneumol 33:397–406

    Article  PubMed  Google Scholar 

  18. Neder JA, Andreoni S, Peres C, Nery LE (1999) Reference values for lung function tests. I. Static volumes. Braz J Med Biol Res 32:703–717

    PubMed  CAS  Google Scholar 

  19. Neder JA, Andreoni S, Peres C, Nery LE (1999) Reference values for lung function tests. III. Carbon monoxide diffusing capacity (transfer factor). Braz J Med Biol Res 32:729–737

    Article  PubMed  CAS  Google Scholar 

  20. Neder JA, Andreoni S, Lerario MC, Nery LE (1999) Reference values for lung function tests. II. Maximal respiratory pressures and voluntary ventilation. Braz J Med Biol Res 32:719–727

    PubMed  CAS  Google Scholar 

  21. Konopo-Zubryzkam M, Baniukiewicz A, Wróblewski E, Kowalska I, Zarzycki W, Górska M, Dabroiwski A (2009) The effect of intragastric balloon on plasma Ghrelin, leptin, and adiponectin levels in patients with morbid obesity. J Clin Endocrinol Metabol 94:1644–1649

    Article  Google Scholar 

  22. Nikolic M, Boban M, Ljubicic N, Supanc V, Mirosevic G, Nicolic BP, Zjacic-Rotkvic V, Gacina P, Mirkovic M, Bekavac-Beslin M (2011) Position of intragastric balloons in global initiative for obesity treatment. Coll Antropol 35:1353–1362

    PubMed  Google Scholar 

  23. Barreto SSM (2002) Volumes pulmonares. J Bras Pneumol 28(Suppl 3):S83–S94

    Google Scholar 

  24. Unterborn J (2001) Pulmonary function testing in obesity, pregnancy, and extremes of body habitus. Clin Chest Med 22:759–767

    Article  PubMed  CAS  Google Scholar 

  25. Ray CS, Sue DY, Bray G, Hansen JE, Wasserman K (1983) Effects of obesity on respiratory function. Am Rev Respir Dis 128:501–506

    PubMed  CAS  Google Scholar 

  26. Saydain G, Beck KC, Decker PA, Cowl CT, Scanlon PD (2004) Clinical significance of elevated diffusion capacity. Chest 125:446–452

    Article  PubMed  Google Scholar 

  27. Lazarus R, Sparrow D, Weiss ST (1997) Effects of obesity and fat distribution on pulmonary function: the normative aging study. Chest 111:891–898

    Article  PubMed  CAS  Google Scholar 

  28. Scott HA, Gibson PG, Garg ML, Pretto JJ, Morgan PJ, Callister R, Wood LG (2012) Relationship between body composition, inflammation and lung function in overweight and obese asthma. Respir Res 13:10

    Article  PubMed  Google Scholar 

  29. Sutherland TJT, Goulding A, Grant AM, Cowan JO, Williamson A, Willians SM, Skinner MA, Taylor DR (2008) The effect of adiposity measured by dual-energy X-ray absorptiometry on lung function. Eur Respir J 32:85–91

    Article  PubMed  CAS  Google Scholar 

  30. Carvalho MR, Jorge Z, Nobre E, Dias T, Cortez-Pinto H, Machado MV, Camolas J, Neves S, Guerra A, Vieira J, Fagundes MJ, Brito MJ, Almeida Nunes P, do Carmo I (2011) Intra-gastric balloon in the treatment of morbid obesity. Acta Med Port 24:489–498

    PubMed  Google Scholar 

  31. Rubinstein I, Zamel N, DuBarry L, Hoffstein V (1990) Airflow limitation in morbidly obese, nonsmoking men. Ann Intern Med 112:828–832

    PubMed  CAS  Google Scholar 

  32. Guimaraes C, Martins MV, Santos JM (2012) Pulmonary function tests in obese people candidate to bariatric surgery. Rev Port Pneumol 18:115–119

    Article  PubMed  CAS  Google Scholar 

  33. Zerah F, Harf A, Perlemuter L, Lorino H, Lorino AM, Atlan G (1993) Effects of obesity on respiratory resistance. Chest 103:1470–1476

    Article  PubMed  CAS  Google Scholar 

  34. Salome CM, King GG, Berend N (2010) Physiology of obesity and effects on lung function. J Appl Physiol 108:206–211

    Article  PubMed  Google Scholar 

  35. Black LF, Hyatt RE (1969) Maximal respiratory pressures: normal values and relationship to age and sex. Am Rev Respir Dis 103:641–650

    Google Scholar 

  36. Cook CD, Mead J, Orzalesi MM (1964) Static volume pressure characteristics of the respiratory system during maximal efforts. J Appl Physiol 19:1016–1022

    PubMed  CAS  Google Scholar 

  37. Mangelsdorff G, Borzone G, Leiva A, Martínez A, Lisboa C (2001) Strength of inspiratory muscles in chronic heart failure and chronic pulmonary obstructive disease. Rev Med Chil 129:51–59

    PubMed  CAS  Google Scholar 

  38. Pedrozo MD, Trevisan ME, Moraes EZC (2007) Respiratory muscular function of adolescents with overweight/obesity degree I and healthy. Fisioter Mov 20:137–141

    Google Scholar 

  39. Enzi G, Baggio B, Vianello A (1990) Respiratory disturbances in visceral obesity. Int J Obesity 14(Suppl 2):26

    Google Scholar 

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Correspondence to Agnaldo José Lopes.

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Mafort, T.T., Madeira, E., Madeira, M. et al. Intragastric Balloon for the Treatment of Obesity: Evaluation of Pulmonary Function Over a 3-Month Period. Lung 190, 671–676 (2012). https://doi.org/10.1007/s00408-012-9415-7

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  • DOI: https://doi.org/10.1007/s00408-012-9415-7

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