Effects of obesity on pulmonary function considering the transition from obstructive to restrictive pattern from
Li Huang1, Sen-Te Wang1,2, Han-Pin Kuo3
1Department of Family Medicine, Taipei Medical University Hospital, Taipei, Taiwan.
Insights
Obesity impairs lung function in children, causing an obstructive pattern. This pattern shifts to a restrictive pattern in adulthood, with effects changing based on age and sex.
Area of Science:
- Pulmonary Medicine
- Pediatric Obesity
Background:
- Obesity is linked to distinct pulmonary function patterns in adults (restrictive) and children (obstructive).
- The transition of these patterns from childhood to adulthood remains incompletely understood.
Purpose of the Study:
- To systematically review and analyze studies on body mass index and pulmonary function in children and young adults.
- To elucidate the evolving impact of obesity on lung function across different age groups.
Main Methods:
- Systematic literature search for studies correlating body mass index with pulmonary function tests.
- Inclusion of 17 studies comparing pulmonary function (FEV1, FVC, FEV1/FVC) in individuals with and without obesity.
- Application of random-effects models to calculate pooled estimates of mean differences.
Main Results:
- Individuals with obesity exhibited a lower FEV1/FVC ratio and higher percent-predicted FVC compared to normal-weight individuals.
- Obesity induced an obstructive pulmonary function pattern in childhood, peaking around age 16 in boys and 20 in girls.
- Pulmonary effects shifted towards a restrictive pattern after age 30-40, varying by sex.
Conclusions:
- Obesity significantly impairs pulmonary function, initiating with an obstructive pattern in youth and transitioning to a restrictive pattern in adulthood.
- The age and sex-specific progression of obesity-related pulmonary dysfunction highlights the need for tailored interventions.
Abstract:
Adults with obesity exhibit a restrictive pattern, whereas children with obesity exhibit an obstructive pattern. However, the transition process remains unclear. We performed a systematic search for studies reporting on body mass index and pulmonary function in children. The main outcomes were forced expiratory volume in 1 s (FEV1 ), forced vital capacity (FVC), and their ratio (FEV1 /FVC). We compared individuals with overweight or with obesity with individuals with normal weight. Random-effects models were used to calculate pooled estimates. A total of 17 studies were included. Individuals with obesity had a lower FEV1 /FVC ratio (mean difference [MD] = -3.61%; 95% confidence interval [CI] = -4.58%, -2.64%) and a higher percent-predicted FVC (MD = 3.33%; 95% CI = 0.79%, 5.88%) than those with normal weight. Obesity impaired pulmonary function in the obstructive pattern during childhood to young adulthood, and the maximum obstruction was observed at the age of 16 years in boys and 20 years in girls. The effects attenuated at approximately 30 years and then shifted to the restrictive pattern after 35 years of age in men and 40 years in women. The effects of obesity on pulmonary function change from the obstructive pattern in childhood to the restrictive pattern in adulthood.
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