Effect of overweight and obesity on spirometric parameters in children and adolescent with asthma

Q4 Biochemistry, Genetics and Molecular Biology

Exploration of medicine Pub Date : 2023-05-30 DOI:10.37349/emed.2023.00143

R. N. Khramova, T. Eliseeva, E. Tush, D. Ovsyannikov, V. Bulgakova, Georgii S. Ignatov, Lamara A. Oganyan, O. Khaletskaya

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Abstract

Aim: Being overweight and obesity are factors in the negative modification of bronchial asthma (BA). The mechanisms of the aggravating effect of obesity on the course of BA have not yet been fully determined, but include changes in external respiration. The aim of the study was to study the effect of being overweight/obesity on spirometric parameters and on the occurrence of dysanapsis in children and adolescents with BA. Methods: It was a cross-sectional, open, single-center study. The data were obtained from 428 patients with atopic BA aged 7 years to 17 years, 12.0 [9.0; 14.0], and 72.9% (312/428) of them were boys. The children were divided into 3 groups: group 1—normal body weight; group 2—overweight; and group 3—obesity. All participants underwent spirometry, the ratio of forced expiratory volume in 1 second (FEV1)/forced vital capacity (FVC) was calculated and the diagnosis of dysanapsis was performed. Results: As body weight increases, a progressive decrease in FEV1/FVC is revealed—group 1: 79.55% [71.37; 85.43]; group 2: 76.82% [70.12; 82.03]; and group 3: 76.28% [67.04; 79.89] P = 0.004; as well as a decrease in Z FEV1/FVC: group 1—1.23 [–2.18; –0.28]; group 2—1.54 [–2.19; –0.68]; and group 3—1.75 [–2.63; –0.90] P = 0.02. Dysanapsis was detected in 37.7% (159/428) of patients. The incidence of dysanapsis increased statistically significantly with increasing body mass index (BMI) and amounted to: with normal body weight—31.7% (77/243), with overweight—42.0% (55/131), and with obesity—50% (27/54) P = 0.016. Conclusions: In children and adolescents with BA, as BMI increases, there is a statistically significant decrease in the ratio of FEV1/FVC, and, consequently, bronchial patency; the incidence of dysanapsis also increases statistically significantly. Taken together, this indicates the formation of an obstructive pattern of external respiration under the influence of being overweight and obesity in children and adolescents with BA.

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超重和肥胖对哮喘儿童和青少年肺活量测定参数的影响

目的：超重和肥胖是支气管哮喘（BA）负性改变的因素。肥胖加重BA进程的机制尚未完全确定，但包括外呼吸的变化。本研究的目的是研究超重/肥胖对BA儿童和青少年肺活量测定参数和呼吸功能障碍发生的影响。方法：这是一项横断面、开放式、单中心研究。数据来自428名7岁至17岁的特应性BA患者，12.0[9.0；14.0]，其中72.9%（312/428）为男孩。将儿童分为3组：第一组为正常体重组；第2组——超重；第3组——肥胖。所有参与者都进行了肺活量测定，计算1秒用力呼气量（FEV1）/用力肺活量（FVC）的比值，并诊断为呼吸困难。结果：随着体重的增加，FEV1/FVC逐渐降低——第1组：79.55%[71.37；85.43]；第2组：76.82%[70.12；82.03]；第3组：76.28%[67.04；79.89]P=0.004；以及Z FEV1/FVC降低：组1--1.23[-2.18；-0.28]；2--1.54组[-2.19；-0.68]；3--1.75[–2.63；–0.90]组P=0.02。37.7%（159/428）的患者出现无菌异常。随着体重指数（BMI）的增加，味觉障碍的发生率在统计学上显著增加，达到：正常体重为31.7%（77/243），超重为42.0%（55/131），肥胖为50%（27/54）P=0.016。结论：在患有BA的儿童和青少年中，随着BMI的增加，FEV1/FVC的比率在统计学上显著降低，从而导致支气管通畅；斜视的发生率在统计学上也显著增加。总之，这表明患有BA的儿童和青少年在超重和肥胖的影响下形成了外呼吸阻塞模式。

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