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Dose-Response Relationship and Irreversible Obstructive Ventilatory Defect in Patients With Consumption of Sauropus androgynus FREE TO VIEW

Tzuen-Ren Hsiue; YueLiang Leon Guo; Kuan-Wen Chen; Chang-Wen Chen; Cheng-Hung Lee; Han-Yu Chang
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From the Departments of Internal Medicine, Environmental and Occupational Health, and Emergency Medicine, National Cheng Kung University Hospital, Tainan, Taiwan

1998 by the American College of Chest Physicians

Chest. 1998;113(1):71-76. doi:10.1378/chest.113.1.71
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Study objectives: To determine the dose-response aspect of pulmonary function impairment in patients with consumption of Sauropus androgynus for weight reduction.

Methods: A questionnaire and pulmonary function tests were performed in 194 patients with a history of consumption of S androgynus with or without chest symptoms. Patients with obstructive ventilatory defect received follow-up spirometry 22 to 24 months after beginning consumption of the vegetable.

Results: Data from 178 patients were analyzed. Patients generally consumed 150 g of S androgynus daily as raw juice (60.7%), sauteed (16.9%), mixed preparation (20.8%), or boiled (1.7%) for various periods of time. We divided patients into five groups according to the total dose consumed (group A, 0 to 1,799 g; group B, 1,800 to 3,599 g; group C, 3,600 to 5,399 g; group D, 5,400 to 7,199 g; and group E, ≥7,200 g). The frequency of obstructive ventilatory defect was higher in the high-dose group than in the low-dose group (A, 4/43=9.3%; B, 13/64=20.3%; C, 14/32=43.8%; D, 5/12=41.7%; and E, 13/27=48.1%; p<0.01). In total, 49 patients (27.5%) had moderate to severe obstructive ventilatory defects without bronchodilator response. The FEV1 and FEV1 percent predicted in these 49 patients were 0.96±0.38 L (mean±SD) and 41.8±16.9%, respectively. Sixty-five percent of these 49 patients began to suffer from dyspnea in the third, fourth, or fifth month after taking the vegetable and no patient began to develop dyspnea later than 7 months after beginning consumption of the vegetable. Using stepwise multiple regression, we found that the FEV1 percent predicted was negatively associated with the total dose ingested (r=0.24, p<0.01). Follow-up spirometry showed that the obstructive ventilatory defect was irreversible in all patients.

Conclusions: Consumption of S androgynus can result in moderate to severe obstructive ventilatory defect within 7 months, and the disorder was irreversible in the observation period for 22 months.




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