BMI but not central obesity predisposes to airway closure during bronchoconstriction

Peters, U; Subramanian, M; Chapman, DG; Kaminsky, DA; Irvin, CG; Wise, RA; Skloot, GS; Bates, JHT; Dixon, AE

BMI but not central obesity predisposes to airway closure during bronchoconstriction

Peters, U

Subramanian, M Chapman, DG

Kaminsky, DA

Irvin, CG Wise, RA Skloot, GS Bates, JHT

Dixon, AE

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Publication Type:: Journal Article
Citation:: Respirology, 2019, 24 (6), pp. 543 - 550
Issue Date:: 2019-06-01

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Field	Value	Language
dc.contributor.author	Peters, U https://orcid.org/0000-0002-2491-9519	en_US
dc.contributor.author	Subramanian, M	en_US
dc.contributor.author	Chapman, DG https://orcid.org/0000-0002-8211-1817	en_US
dc.contributor.author	Kaminsky, DA https://orcid.org/0000-0002-6515-8023	en_US
dc.contributor.author	Irvin, CG	en_US
dc.contributor.author	Wise, RA	en_US
dc.contributor.author	Skloot, GS	en_US
dc.contributor.author	Bates, JHT https://orcid.org/0000-0002-6062-6377	en_US
dc.contributor.author	Dixon, AE	en_US
dc.date.available	2018-12-12	en_US
dc.date.issued	2019-06-01	en_US
dc.identifier.citation	Respirology, 2019, 24 (6), pp. 543 - 550	en_US
dc.identifier.issn	1323-7799	en_US
dc.identifier.uri	http://hdl.handle.net/10453/134750
dc.description.abstract	© 2019 Asian Pacific Society of Respirology Background and objective: Obesity produces restrictive effects on lung function. We previously reported that obese patients with asthma exhibit a propensity towards small airway closure during methacholine challenge which improved with weight loss. We hypothesized that increased abdominal adiposity, a key contributor to the restrictive effects of obesity on the lung, mediates this response. This study investigates the effect of body mass index (BMI) versus waist circumference (WC) on spirometric lung function, sensitivity to airway narrowing and closure, and airway closure during bronchoconstriction in patients with asthma. Methods: Participants underwent spirometry and methacholine challenge. Sensitivity to airway closure and narrowing was assessed from the dose–response slopes of the forced vital capacity (FVC) and the ratio of forced expiratory volume in 1 s (FEV1) to FVC, respectively. Airway closure during bronchoconstriction (closing index) was computed as the percent reduction in FVC divided by the percent reduction in FEV1 at maximal bronchoconstriction. Results: A total of 116 asthmatic patients (56 obese) underwent methacholine challenge. Spirometric lung function was inversely related to WC (P < 0.05), rather than BMI. Closing index increased significantly during bronchoconstriction in obese patients and was related to increasing BMI (P = 0.01), but not to WC. Sensitivity to airway closure and narrowing was not associated with BMI or WC. Conclusion: Although WC is associated with restrictive effects on baseline lung function, increased BMI, rather than WC, predisposes to airway closure during bronchoconstriction. These findings suggest that obesity predisposes to airway closure during bronchoconstriction through mechanisms other than simple mass loading.	en_US
dc.relation.ispartof	Respirology	en_US
dc.relation.isbasedon	10.1111/resp.13478	en_US
dc.subject.classification	Respiratory System	en_US
dc.title	BMI but not central obesity predisposes to airway closure during bronchoconstriction	en_US
dc.type	Journal Article
utslib.citation.volume	6	en_US
utslib.citation.volume	24	en_US
utslib.for	1103 Clinical Sciences	en_US
utslib.for	11 Medical and Health Sciences	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Science
pubs.organisational-group	/University of Technology Sydney/Faculty of Science/School of Life Sciences
utslib.copyright.status	closed_access
pubs.issue	6	en_US
pubs.publication-status	Published	en_US
pubs.volume	24	en_US

Abstract:

© 2019 Asian Pacific Society of Respirology Background and objective: Obesity produces restrictive effects on lung function. We previously reported that obese patients with asthma exhibit a propensity towards small airway closure during methacholine challenge which improved with weight loss. We hypothesized that increased abdominal adiposity, a key contributor to the restrictive effects of obesity on the lung, mediates this response. This study investigates the effect of body mass index (BMI) versus waist circumference (WC) on spirometric lung function, sensitivity to airway narrowing and closure, and airway closure during bronchoconstriction in patients with asthma. Methods: Participants underwent spirometry and methacholine challenge. Sensitivity to airway closure and narrowing was assessed from the dose–response slopes of the forced vital capacity (FVC) and the ratio of forced expiratory volume in 1 s (FEV1) to FVC, respectively. Airway closure during bronchoconstriction (closing index) was computed as the percent reduction in FVC divided by the percent reduction in FEV1 at maximal bronchoconstriction. Results: A total of 116 asthmatic patients (56 obese) underwent methacholine challenge. Spirometric lung function was inversely related to WC (P < 0.05), rather than BMI. Closing index increased significantly during bronchoconstriction in obese patients and was related to increasing BMI (P = 0.01), but not to WC. Sensitivity to airway closure and narrowing was not associated with BMI or WC. Conclusion: Although WC is associated with restrictive effects on baseline lung function, increased BMI, rather than WC, predisposes to airway closure during bronchoconstriction. These findings suggest that obesity predisposes to airway closure during bronchoconstriction through mechanisms other than simple mass loading.

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http://hdl.handle.net/10453/134750