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(Chest. 2006;130:834-840.)
© 2006 American College of Chest Physicians

Simulated Obesity-Related Changes in Lung Volume Increases Airway Responsiveness in Lean, Nonasthmatic Subjects*

Li-Ying Wang, PhD; Frank J. Cerny, PhD; Thomas J. Kufel, MD and Brydon J. B. Grant, MD, FCCP

* From the School and Graduate Institute of Physical Therapy (Dr. Wang), College of Medicine, National Taiwan University, Taiwan; and the Department of Exercise and Nutritional Sciences (Dr. Cerny), and Section of Pulmonary, Critical Care, and Sleep Medicine (Drs. Kufel and Grant), Veterans Administration Medical Center, Buffalo, NY.

Correspondence to: Li-Ying Wang, PhD, School and Graduate Institute of Physical Therapy, College of Medicine, National Taiwan University, No. 1 Jen-Ai Rd, Section 1, Taipei 100, Taiwan, ROC; e-mail: liying{at}ntu.edu.tw

Abstract

Study objective: To determine if obesity-related changes in lung volume might contribute to airway reactivity, we investigated the effects of simulated mild obesity-related lung volume reductions on airway responsiveness in lean, nonasthmatic subjects.

Participants and methods: We simulated the lung volume reductions of class 1 obesity in eight lean, nonasthmatic subjects by externally mass loading the chest wall and abdomen, and shifting blood volume into the lung with lower limb compression (LLC). Airway responsiveness was assessed by measuring FEV1 before and after methacholine challenge tests (1, 2.5, 5, 10, and 25 mg/mL) with the following: (1) no intervention (control); (2) external chest loading (CL); (3) LLC; and (4) CL and LLC (COMB) on separate days. Lung function was measured before and after CL, LLC, and COMB were applied.

Results: The application of CL, LLC, and COMB decreased expiratory reserve volume, functional residual capacity, and total lung capacity compared with baseline. FVC and FEV1 decreased significantly with CL and COMB, while FEV1/FVC did not change compared to baseline. The maximal response to the methacholine challenge increased with CL, LLC, and COMB, with a mean maximal fall of FEV1 of 9%, 11%, and 18%, respectively, compared to a 6% fall with control.

Conclusions: We conclude that decreases in lung volume increase airway responsiveness and may account for the increased propensity for increased airway responsiveness in the obese.

Key Words: asthma • bronchial provocation tests • lung volume reduction • obesity






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