肺清除率指数：青少年减肥手术后气道功能改善的敏感指标。

IF 3.5 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Respiratory medicine Pub Date : 2025-02-01 DOI:10.1016/j.rmed.2025.107950

Patrick Stafler , Benjamin Rothschild , Yulia Gendler , Emmanuelle Seguier-Lipszyc , Simona Tyroler , Orith Waisbourd-Zinman , Meir Mei-Zahav , Dario Prais , Vered Shkalim Zemer

{"title":"肺清除率指数：青少年减肥手术后气道功能改善的敏感指标。","authors":"Patrick Stafler , Benjamin Rothschild , Yulia Gendler , Emmanuelle Seguier-Lipszyc , Simona Tyroler , Orith Waisbourd-Zinman , Meir Mei-Zahav , Dario Prais , Vered Shkalim Zemer","doi":"10.1016/j.rmed.2025.107950","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Morbid obesity in adolescents impacts respiratory function, often leading to reduced lung volume and obstructive ventilatory defects. However, standard spirometric values frequently remain within normal ranges.</div></div><div><h3>Objectives</h3><div>We hypothesized that Lung Clearance Index (LCI) is a more sensitive marker for detecting airway dysfunction in adolescents with morbid obesity than conventional lung function tests.</div></div><div><h3>Methods</h3><div>A prospective single-center cohort study evaluated adolescents with morbid obesity undergoing laparoscopic sleeve gastrectomy (LSG). Assessments included fractional exhaled nitric oxide, multiple breath washout, spirometry, plethysmography, diffusion capacity, and a 6-min walk test, conducted pre- and post-surgery.</div></div><div><h3>Results</h3><div>Seventeen adolescents (mean age 17.1 years, BMI 45.5 kg/m<sup>2</sup>) were studied. Pre-surgery, LCI was slightly elevated (mean 7, SD ± 0.7), other lung function measures were normal. LCI correlated with BMI (r = 0.637, p = 0.014), no correlation was found between FEV<sub>1</sub> and BMI (r = −0.083, p = 0.752). Post-surgery, mean LCI fell from 7 (±0.7) to 6.5 (±0.7), p = 0.009. The pre-operatively observed correlation between LCI and BMI was no longer present post-operatively (r = 0.362, p = 0.225). LCI changes (r = 0.676, p = 0.011) correlated with BMI changes, whilst FEV<sub>1</sub> did not (r = 0.160, p = 0.540).</div></div><div><h3>Conclusions</h3><div>LCI appeared to be a more sensitive marker than conventional spirometry for detecting airway dysfunction in adolescents with morbid obesity. Significant post-surgery improvements suggested enhanced ventilation homogeneity. LCI may detect subtle airway changes in this population, and be potentially valuable for both clinical assessment and research.</div></div>","PeriodicalId":21057,"journal":{"name":"Respiratory medicine","volume":"237 ","pages":"Article 107950"},"PeriodicalIF":3.5000,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Lung clearance index: A sensitive measure of airway function improvement in adolescents after weight loss from bariatric surgery\",\"authors\":\"Patrick Stafler , Benjamin Rothschild , Yulia Gendler , Emmanuelle Seguier-Lipszyc , Simona Tyroler , Orith Waisbourd-Zinman , Meir Mei-Zahav , Dario Prais , Vered Shkalim Zemer\",\"doi\":\"10.1016/j.rmed.2025.107950\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>Morbid obesity in adolescents impacts respiratory function, often leading to reduced lung volume and obstructive ventilatory defects. However, standard spirometric values frequently remain within normal ranges.</div></div><div><h3>Objectives</h3><div>We hypothesized that Lung Clearance Index (LCI) is a more sensitive marker for detecting airway dysfunction in adolescents with morbid obesity than conventional lung function tests.</div></div><div><h3>Methods</h3><div>A prospective single-center cohort study evaluated adolescents with morbid obesity undergoing laparoscopic sleeve gastrectomy (LSG). Assessments included fractional exhaled nitric oxide, multiple breath washout, spirometry, plethysmography, diffusion capacity, and a 6-min walk test, conducted pre- and post-surgery.</div></div><div><h3>Results</h3><div>Seventeen adolescents (mean age 17.1 years, BMI 45.5 kg/m<sup>2</sup>) were studied. Pre-surgery, LCI was slightly elevated (mean 7, SD ± 0.7), other lung function measures were normal. LCI correlated with BMI (r = 0.637, p = 0.014), no correlation was found between FEV<sub>1</sub> and BMI (r = −0.083, p = 0.752). Post-surgery, mean LCI fell from 7 (±0.7) to 6.5 (±0.7), p = 0.009. The pre-operatively observed correlation between LCI and BMI was no longer present post-operatively (r = 0.362, p = 0.225). LCI changes (r = 0.676, p = 0.011) correlated with BMI changes, whilst FEV<sub>1</sub> did not (r = 0.160, p = 0.540).</div></div><div><h3>Conclusions</h3><div>LCI appeared to be a more sensitive marker than conventional spirometry for detecting airway dysfunction in adolescents with morbid obesity. Significant post-surgery improvements suggested enhanced ventilation homogeneity. LCI may detect subtle airway changes in this population, and be potentially valuable for both clinical assessment and research.</div></div>\",\"PeriodicalId\":21057,\"journal\":{\"name\":\"Respiratory medicine\",\"volume\":\"237 \",\"pages\":\"Article 107950\"},\"PeriodicalIF\":3.5000,\"publicationDate\":\"2025-02-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Respiratory medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0954611125000125\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Respiratory medicine","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0954611125000125","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}

引用次数: 0

摘要

背景：青少年病态肥胖影响呼吸功能，常导致肺容量减少和阻塞性通气缺陷。然而，标准肺活量值经常保持在正常范围内。目的：我们假设肺清除率指数（LCI）是一种比常规肺功能测试更敏感的检测青少年病态肥胖气道功能障碍的指标。方法：一项前瞻性单中心队列研究评估了接受腹腔镜袖式胃切除术（LSG）的病态肥胖青少年。评估包括在术前和术后进行的分数呼出一氧化氮、多次呼吸冲洗、肺活量测定、体积脉搏图、扩散能力和6分钟步行测试。结果：17例青少年（平均年龄17.1岁，体重指数45.5 kg/m2）。术前LCI轻度升高（平均7，SD±0.7），其他肺功能指标正常。LCI与BMI相关（r = 0.637, p = 0.014）， FEV1与BMI无相关性（r = -0.083, p = 0.752）。术后平均LCI由7（±0.7）降至6.5（±0.7），p = 0.009。术前观察到的LCI与BMI之间的相关性在术后不再存在（r = 0.362, p = 0.225）。LCI变化（r = 0.676, p = 0.011）与BMI变化相关，而FEV1变化与BMI变化无关（r = 0.160, p = 0.540）。结论：LCI似乎是一个比传统肺活量测定法更敏感的标志物，用于检测青少年病态肥胖的气道功能障碍。术后显著改善提示通气均匀性增强。LCI可以检测到这一人群气道的细微变化，对临床评估和研究都有潜在的价值。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

Lung clearance index: A sensitive measure of airway function improvement in adolescents after weight loss from bariatric surgery

Background

Morbid obesity in adolescents impacts respiratory function, often leading to reduced lung volume and obstructive ventilatory defects. However, standard spirometric values frequently remain within normal ranges.

Objectives

We hypothesized that Lung Clearance Index (LCI) is a more sensitive marker for detecting airway dysfunction in adolescents with morbid obesity than conventional lung function tests.

Methods

A prospective single-center cohort study evaluated adolescents with morbid obesity undergoing laparoscopic sleeve gastrectomy (LSG). Assessments included fractional exhaled nitric oxide, multiple breath washout, spirometry, plethysmography, diffusion capacity, and a 6-min walk test, conducted pre- and post-surgery.

Results

Seventeen adolescents (mean age 17.1 years, BMI 45.5 kg/m²) were studied. Pre-surgery, LCI was slightly elevated (mean 7, SD ± 0.7), other lung function measures were normal. LCI correlated with BMI (r = 0.637, p = 0.014), no correlation was found between FEV₁ and BMI (r = −0.083, p = 0.752). Post-surgery, mean LCI fell from 7 (±0.7) to 6.5 (±0.7), p = 0.009. The pre-operatively observed correlation between LCI and BMI was no longer present post-operatively (r = 0.362, p = 0.225). LCI changes (r = 0.676, p = 0.011) correlated with BMI changes, whilst FEV₁ did not (r = 0.160, p = 0.540).

Conclusions

LCI appeared to be a more sensitive marker than conventional spirometry for detecting airway dysfunction in adolescents with morbid obesity. Significant post-surgery improvements suggested enhanced ventilation homogeneity. LCI may detect subtle airway changes in this population, and be potentially valuable for both clinical assessment and research.

求助全文

通过发布文献求助，成功后即可免费获取论文全文。去求助

来源期刊

Respiratory medicine 医学-呼吸系统

CiteScore

7.50

自引率

0.00%

发文量

199

审稿时长

38 days

期刊介绍： Respiratory Medicine is an internationally-renowned journal devoted to the rapid publication of clinically-relevant respiratory medicine research. It combines cutting-edge original research with state-of-the-art reviews dealing with all aspects of respiratory diseases and therapeutic interventions. Topics include adult and paediatric medicine, epidemiology, immunology and cell biology, physiology, occupational disorders, and the role of allergens and pollutants. Respiratory Medicine is increasingly the journal of choice for publication of phased trial work, commenting on effectiveness, dosage and methods of action.