Effects of obesity on respiratory resistance

To assess the effects of obesity on pulmonary function, 46 healthy subjects exhibiting various degrees of obesity underwent lung function tests. Subjects were divided into three groups according to body mass index (BMI): 13 had minimal obesity (BMI, 25 to 29 kg/m2, group 1); 24 had a BMI in the 30 to 40 range (group 2); and 9 displayed to morbid obesity (BMI > 40, group 3). Respiratory resistance was estimated by the forced random noise oscillation technique and airway resistance was determined by body plethysmography. Lung volumes and expiratory flows were also determined and significant negative correlations with BMI were found. Expiratory flows diminished in proportion to lung volumes, and the ratio of forced expiratory volume in 1 s to forced vital capacity was within normal limits. Although expiratory flows did not suggest bronchial obstruction, both respiratory resistance and airway resistance rose significantly with the level of obesity (p < 0.005 and p < 0.025, respectively), from 3.2 (+/- 0.02) and 3.2 (+/- 0.02) cm H2O.s.L-1, respectively, in group 1, to 5.5 (+/- 0.06) and 5.0 (+/- 0.05), respectively, in group 3. Evaluation of the factors responsible for this increased resistance disclosed a significant linear correlation between airway conductance and functional residual capacity (r = 0.70, p < 10(-4)), but specific airway conductance was found to be independent of the degree of obesity. The difference between respiratory resistance and airway resistance did not widen significantly according to the level of obesity, suggesting that chest wall resistance was not a factor enhancing these resistances. Taken together, these findings suggest that in addition to the elastic load, obese subjects have to overcome increased respiratory resistance resulting from the reduction in lung volumes related to being overweight.