Peripheral Airway Dysfunction in Obesity and Obese Asthma
Anne E Dixon1, Matthew E Poynter1, Olivia Johnson Garrow1
1Department of Medicine, Larner College of Medicine, University of Vermont, Burlington, VT.
Chest
|January 7, 2023
Summary
Obesity commonly causes peripheral airway reactivity in asthma. Oscillometry reveals distinct asthma subgroups in obesity, with one group showing significant peripheral dysfunction not detected by spirometry.
Area of Science:
- Pulmonary Medicine
- Respiratory Physiology
- Obesity Research
Background:
- Obesity is increasingly prevalent and associated with various health complications, including respiratory diseases.
- Asthma is a chronic respiratory condition that can be exacerbated or influenced by obesity.
- Understanding the physiological interplay between obesity and asthma is crucial for effective management.
Purpose of the Study:
- To investigate the distinct physiological phenotypes of asthma in individuals with obesity.
- To determine if physiological responses during bronchoconstriction differentiate asthma subgroups in obesity.
- To differentiate these responses from those solely related to obesity.
Main Methods:
- A cross-sectional study involving individuals with obesity, including those with and without asthma.
- Methacholine challenge testing was employed to assess airway reactivity.
- Spirometry and oscillometry were used to measure lung function and respiratory system impedance.
Main Results:
- Obesity was found to predispose individuals to peripheral airway reactivity, observable in both control and asthma groups.
- Two distinct asthma subgroups emerged based on respiratory system impedance: one with lower reactance and concordant airway responses, and another with higher reactance and discordant responses.
- The high reactance asthma subgroup, comprising only women, reported more gastroesophageal reflux disease, chest tightness, wheezing, and asthma exacerbations.
Conclusions:
- Peripheral airway reactivity is a common finding in obese individuals, irrespective of asthma status.
- Oscillometry can identify a subgroup of obese asthma with significant peripheral airway dysfunction, which may be underestimated by spirometry alone.
- This peripheral dysfunction signifies clinically relevant respiratory disease that warrants specific assessment beyond standard spirometry.
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