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Original Research: PULMONARY PHYSIOLOGY |

Effects of BMI on Static Lung Volumes in Patients With Airway ObstructionBMI Effects on Static Lung Volumes

Denis E. O’Donnell, MD, FCCP; Athavudh Deesomchok, MD; Yuk-Miu Lam, PhD; Jordan A. Guenette, PhD; Naparat Amornputtisathaporn, MD; Lutz Forkert, MD; Katherine A. Webb, MSc
Author and Funding Information

From the Department of Medicine (Drs O’Donnell, Deesomchok, Guenette, Amornputtisathaporn, and Forkert and Ms Webb), Queen’s University and Kingston General Hospital; and the Department of Community Health and Epidemiology (Dr Lam), Queen’s University, Kingston, ON, Canada.

Correspondence to: Denis E. O’Donnell, MD, FCCP, 102 Stuart St, Kingston, ON, K7L 2V6, Canada; e-mail: odonnell@queensu.ca


Funding/Support: The authors have reported to CHEST that no funding was received for this study.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (http://www.chestpubs.org/site/misc/reprints.xhtml).


© 2011 American College of Chest Physicians


Chest. 2011;140(2):461-468. doi:10.1378/chest.10-2582
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Background:  Both chronic airway obstruction and obesity are increasing in prevalence but the effect of their combination on pulmonary function parameters across the range of airway obstruction is unknown.

Methods:  We studied the impact of increasing BMI on static lung volumes and airway function in a cohort of 2,265 subjects from a large pulmonary function laboratory database who were 40 to 80 years of age and met GOLD (Global Initiative for Chronic Obstructive Lung Disease) spirometric criteria for COPD (postbronchodilator FEV1/FVC < 0.7). We also evaluated the influence of severity of airway obstruction (by GOLD criteria) on these relationships.

Results:  With increasing BMI in the group as a whole, functional residual capacity, residual volume, expiratory reserve volume, and specific airway resistance (sRaw) decreased exponentially (all P < .001); total lung capacity (TLC) decreased linearly (P < .001); and inspiratory capacity (IC) and IC/TLC increased linearly (P < .001). However, vital capacity was not influenced significantly. The effects of increasing BMI on FEV1/FVC and sRaw were greatest in GOLD stage III/IV (P < .05), whereas increasing BMI had greater effects on IC in GOLD stage I (P < .001).

Conclusions:  With increasing BMI, subjects with airway obstruction had consistent reductions in lung hyperinflation, with significant improvements in IC and the FEV1/FVC ratio; this effect was greatest in patients with the most severe airway obstruction. These results have important implications for the clinical assessment of patients with combined obesity and airway obstruction.

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