Changes in spirometric parameters with position in asymptomatic Egyptian young males with central obesity
Background: Central obesity is a chronic condition that can contribute to impairments in lung functions. Body position is an important technique that effectively restores and increases lung functions. We aimed to address the possible changes in spirometric parameters in asymptomatic overweight individuals with central obesity with a change in posture from sitting to supine in comparison to normal weight non-obese ones.
Methods: Enrolled subjects were healthy Egyptian males, aged between 20-45 years old, asymptomatic and nonsmokers. They underwent spirometry. The following parameters were measured; forced expiratory volume in one second (FEV1), forced vital capacity (FVC), FEV1/FVC ratio, and forced expiratory flow (FEF)25-75%. They were classified into overweight with central obesity (n=40) and healthy control (n=40) groups based on their body mass index (BMI), weight-hip ratio (WHR), and waist circumference (WC). Spirometric parameters were compared between the 2 groups and in both setting and supine positions.
Results: The central obesity group showed significantly lower all spirometric parameters in comparison to the control one. All measured spirometric parameters had a significant reduction with supine position. There were negative correlations between both the WC and WHR and spirometric parameters.
Conclusion: In this study of young Egyptian males, individuals with central obesity had reduced spirometric parameters in comparison to healthy ones. Change in position from sitting to supine has significant effects on spirometric parameters in both healthy middle age males with normal weight and those with overweight and central obesity. These results could have important clinical implications.
World Health Organization. Obesity and overweight. Available from: https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight
Gregg EW, Shaw JE. Global health effects of overweight and obesity. N Engl J Med 2017;377:80-1. DOI: https://doi.org/10.1056/NEJMe1706095
Fang H, Berg E, Cheng X, Shen W. How to best assess abdominal obesity. Curr Opin Clin Nutr Metab Care 2018;21:360-5. DOI: https://doi.org/10.1097/MCO.0000000000000485
Kivimäki M, Kuosma E, Ferrie JE, Luukkonen R, Nyberg ST, Alfredsson L, et al. Overweight, obesity, and risk of cardiometabolic multimorbidity: pooled analysis of individual-level data for 120 813 adults from 16 cohort studies from the USA and Europe. Lancet Public Health 2017;2:e277-85. DOI: https://doi.org/10.1016/S2468-2667(17)30074-9
Global BMI Mortality Collaboration, Di Angelantonio E, Bhupathiraju SN, Wormser D, Gao P, Kaptoge, S et al. Body-mass index and all-cause mortality: individual-participant-data meta-analysis of 239 prospective studies in four continents. Lancet 2016;388:776-86. DOI: https://doi.org/10.1016/S0140-6736(16)30175-1
Sahakyan KR, Somers VK, Rodriguez-Escudero JP, Hodge DO, Carter RE, Sochor O, et al. Normal-weight central obesity: implications for total and cardiovascular mortality. Ann Intern Med 2015;163:827-35. DOI: https://doi.org/10.7326/M14-2525
Dixon AE, Peters U. The effect of obesity on lung function. Expert Rev Respir Med 2018;12:755-767. DOI: https://doi.org/10.1080/17476348.2018.1506331
Sebo P, Herrmann FR, Haller DM. Accuracy of anthropometric measurements by general practitioners in overweight and obese patients. BMC Obes 2017;4:23. DOI: https://doi.org/10.1186/s40608-017-0158-0
Borruel S, Moltó JF, Alpanes M, Fernández-Durán E, Álvarez-Blasco F, Luque-Ramírez M, Escobar-Morreale HF. Surrogate markers of visceral adiposity in young adults: waist circumference and body mass index are more accurate than waist hip ratio, model of adipose distribution and visceral adiposity index. PLoS One 2014;9:e114112. DOI: https://doi.org/10.1371/journal.pone.0114112
Zammit C, Liddicoat H, Moonsie I, Makker H. Obesity and respiratory diseases. Int J Gen Med 2010;3:335-43.
Parameswaran K, Todd DC, Soth M. Altered respiratory physiology in obesity. Can Respir J 2006;13:203-10. DOI: https://doi.org/10.1155/2006/834786
Salome CM, King GG, Berend N. Physiology of obesity and effects on lung function. J Appl Physiol (1985) 2010;108:206-11. DOI: https://doi.org/10.1152/japplphysiol.00694.2009
Dattani RS, Swerner CB, Stradling JR, Manuel ARG. Exploratory study into the effect of abdominal mass loading on airways resistance and ventilatory failure. BMJ Open Respir Res 2016;3:e000138. DOI: https://doi.org/10.1136/bmjresp-2016-000138
Mafort TT, Rufino R, Costa CH, Lopes AJ. Obesity: systemic and pulmonary complications, biochemical abnormalities, and impairment of lung function. Multidiscip Respir Med 2016;11:28. DOI: https://doi.org/10.1186/s40248-016-0066-z
Sonpeayung R, Tantisuwat A, Janwantanakul P, Thaveeratitham P. Total and compartmental chest wall volumes, lung function, and respiratory muscle strength in individuals with abdominal obesity: Effects of body positions. J Obes 2019;2019:9539846. DOI: https://doi.org/10.1155/2019/9539846
Sonpeayung R, Tantisuwat A, Klinsophon T, Thaveeratitham P. Which body position is the best for chest wall motion in healthy adults? A meta-analysis. Respir Care 2018;63:1439-51. DOI: https://doi.org/10.4187/respcare.06344
Al Lawati RI, Al Atbi AH. Changes in spirometry parameters with the change in posture from sitting to supine positions in asymptomatic normal weight, overweight and obese young Omani males. Iraq Med J 2018;2:64-7.
Katz S, Arish N, Rokach A, Zaltzman Y, Marcus EL. The effect of body position on pulmonary function: a systematic review. BMC Pulm Med 2018;18:159. DOI: https://doi.org/10.1186/s12890-018-0723-4
Nielsen KG, Holte K, Kehlet H. Effects of posture on postoperative pulmonary function. Acta Anaesthesiol Scand 2003;47:1270-5. DOI: https://doi.org/10.1046/j.1399-6576.2003.00240.x
Romei M, Mauro LA, D’Angelo MG, Turconi AC, Bresolin N, Pedotti A, et al. Effects of gender and posture on thoraco-abdominal kinematics during quiet breathing in healthy adults. Respir Physiol Neurobiol 2010;172:184-91. DOI: https://doi.org/10.1016/j.resp.2010.05.018
Peralta GP, Marcon A, Carsin A-E, Abramson MJ, Accordini S, Fs Amaral A, et al. Body mass index and weight change are associated with adult lung function trajectories: the prospective ECRHS study. Thorax 2020;75 313-20. DOI: https://doi.org/10.1136/thoraxjnl-2019-213880
Centers for Disease Control and Prevention (CDC). Defining adult overweight and obesity. Available from: https://www.cdc.gov/obesity/adult/index.html
Alberti KG Zimmet PZ. Definition, diagnosis and classification of diabetes mellitus and its complications. Part 1: diagnosis and classification of diabetes mellitus. Provisional report of a WHO consultation. Diabet Med 1998;15:539-53.
Bacopoulou F, Efthymiou V, Landis G, Rentoumis A, Chrousos GP. Waist circumference, waist-to-hip ratio and waist-to-height ratio reference percentiles for abdominal obesity among Greek adolescents. BMC Pediatrics 2015;15:50. DOI: https://doi.org/10.1186/s12887-015-0366-z
Alberti KGMM, Zimmet P, Shaw J. Metabolic syndrome - a new world‐wide definition. A consensus statement from the international diabetes federation. Diabet Med 2006;23:469-80. DOI: https://doi.org/10.1111/j.1464-5491.2006.01858.x
World Health Organization. Waist circumference and waist-hip ratio: report of a WHO expert consultation. Geneva, 8-11 December 2008. Available from: https://www.who.int/publications/i/item/9789241501491
Graham BL, Steenbruggen I, Miller MR, Barjaktarevic IZ, Cooper BG, Hallet GL, al. Standardization of spirometry 2019 update. An official American thoracic society and European respiratory society technical statement. Am J Respir Crit Care Med 2019;200:e70-88. DOI: https://doi.org/10.1164/rccm.201908-1590ST
Pavana, Bhavya Shree P. Correlation of obesity and peak expiratory flow rate in young adult females. Ind J Physiother Occup Ther 2020;14:2.
Patel AK, Thakar HM. Spirometric values in sitting, standing and supine position. J Lung Pulm Respir Res 2015;2:1-3.
Vilke GM, Chan TC, Neuman T, Clausen JL. Spirometry in normal subjects in sitting, prone, and supine positions. Respir Care 2000;45:407-10.
Magnani KL, Cataneo AJM. Respiratory muscle strength in obese individuals and influence of upper-body fat distribution. Sao Paulo Med J 2007;125:215-9. DOI: https://doi.org/10.1590/S1516-31802007000400004
Chlif M, Keochkerian D, Choquet D, Vaidie A, Ahmaidi S. Effects of obesity on breathing pattern, ventilatory neural drive and mechanics. Respir Physiol Neurobiol 2009;168:198-202. DOI: https://doi.org/10.1016/j.resp.2009.06.012
Steier J, Lunt A, Hart N, Polkey MI, Moxham J. Observational study of the effect of obesity on lung volumes. Thorax 2014;69:752-9. DOI: https://doi.org/10.1136/thoraxjnl-2014-205148
Feng K, Chen L, Han SM, Zhu GJ. Ratio of waist circumference to chest circumference is inversely associated with lung function in Chinese children and adolescents. Respirology 2012;17:1114-8. DOI: https://doi.org/10.1111/j.1440-1843.2012.02219.x
Abdelaleem NA, Mohamed SAA, Abd ElHafeez AS, Bayoumi HA. Value of modified Burns Wean Assessment Program scores in the respiratory intensive care unit: an Egyptian study. Multidiscip Respir Med 2020;15:691. DOI: https://doi.org/10.4081/mrm.2020.691
Centers for Disease Control and Prevention (CDC). COVID-19 (Coronavirus disease); People with certain medical conditions. Available from: https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/people-with-medical-conditions.html
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