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Body Composition Analysis and Changes in Airways Function in Obese Adults After Hypocaloric Diet^*

^* From the Human Physiology Division (Drs. De Lorenzo, Maiolo, Mohamed, Andreoli, and Petrone-De Luca) and the Pulmonary Disease Division (Dr. Rossi), University of Rome "Tor Vergata."

Correspondence to: Antonino De Lorenzo, MD, Neuroscience Department, Faculty of Medicine and Surgery, Via di Tor Vergata, 135, 00133 Rome, Italy; e-mail: delorenzo{at}uniroma2.it

Study objectives: To determine the relationship between weight-loss and pulmonary function indexes, focusing on forced expiratory flows (ie, FEV₁, forced expiratory flow at 50% of vital capacity [FEF₅₀], forced expiratory flow at 75% of vital capacity, and forced expiratory flow at 25 to 75% of vital capacity [FEF_25–75]). Specifically, to determine the effect of losses in total and segmental fat mass (FM) and of modifications in lean body mass, after restricted hypocaloric diet, on pulmonary function among obese adults.

Design: Cross-sectional, observational.

Settings: Human Physiology Division, Faculty of Medicine and Surgery, "Tor Vergata" University, Rome, Italy.

Patients: Thirty obese adults (mean [± SD] baseline body mass index [BMI], 32.25 ± 3.99 kg/m²), without significant obstructive airway disease, were selected from among participants in a weight-loss program.

Measurements and results: Anthropometric, body composition (BC), and respiratory parameters of all participants were measured before and after weight loss. Total and segmental lean body and FM were obtained by dual-energy x-ray absorptiometry. Dynamic spirometric tests and maximum voluntary ventilation (MVV) were performed. The BC parameters (ie, body weight [BW], BMI, the sum skinfold thicknesses, thoracic inhalation circumference, thoracic expiration circumference, total FM, and trunk FM [FMtrunk]) were significantly decreased (p 0.0001) after a hypocaloric diet. The mean vital capacity, FEV₁, FEF₅₀, FEF_25–75, expiratory reserve volume, and MVV significantly increased (p 0.05) with weight loss. The correlation coefficient for FEF_25–75 (r = 0.20) was numerically higher than FEF₅₀ and FEV₁ (r = 0.14 and r = 0.08, respectively) for the BW loss. Moreover, the correlation coefficient for FEF_25–75 (r = 0.45) was significantly higher (p 0.02) than those for FEF₅₀ and FEV₁ (r = 0.38 and r = 0.15, respectively) for FMtrunk loss.

Conclusions: This study shows that a decrease in total and upper body fat obtained by restricted diet was not accompanied by a decrease in ventilatory muscle mass. FMtrunk loss was found to have improved airflow limitation, which can be correlated to peripheral airways function.

Key Words: dual-energy radiograph absorptiometry • fat distribution • forced expiratory flows • pulmonary function • weight loss

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