We assessed the incidence and degree of reversable airway obstruction in morbidly obese(BMI > 40)patients and the relationships between forced expiratory volume(FEV-1) and forced vital capacity(FVC) and the body mass index in these patients so as to determine the utility of pulmonary function testing in this population.
We performed a retrospective chart review and detailed analysis of spiromentric data on 60 morbidly obese patients without a diagnosis of obstuctive sleep apnea and with a compaint of shortness of breath with activity. We evaluated the data by comparing patients with BMI between 40-50 (group 1)and BMI > 50(group 2).
The average age for the overall study population was 44 years. The average values of FEV-1, FVC as a % predicted value were significantly lower in the higher BMI group(group 2). The percentage of patients showing improvement in response to bronchodilators in the higher BMI group(group 2) was significantly greater. The average percentage improvement for each patient was also significantly higher in the higher BMI group(group 2).
Reversable obstructive airway disease is prevalent among morbidly obese patients. Patients with higher BMIs respond more often and have a better response to brochodilator therapy.
Spirometric analysis and bronchodilator therapy improves pulmonary outcome in morbidly obese patients. Table 1
Relationship between degree of obesity pulmonary functionFEV1 (% of predicted value)FVC (% of predicted value)% improvement in FEV1 with bronchodilators (avg./patient)% of group showing improvement with bronchodilators (BD)AgeGroup 1 (BMI 40-50) n=3392.2 ± 2.294.5 ± 2.34.79 ± 1.2636.4 ± 8.443.1Group 2 (BMI > 50) n=2784.7 ± 2.587.3 ± 2.611.74 ± 1.3966.7 ± 9.345.4P value0.0270.0410.00050.0190.422
Values are Mean (± standard error of the mean), N.S.= Not Significant
A. Chendrasekhar, None.