Pediatrics |

Abnormalities of Pulmonary Function Testing in a Cohort of Obese Children FREE TO VIEW

Angela Webb, MD; Roopa Saddaiah, MBBS; Claudia Halaby, MD; Christina Valsamis, MD; Shahidul Islam, MPH; Melodi Pirzada, MD
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Winthrop University Hospital, Mineola, NY

Chest. 2014;145(3_MeetingAbstracts):453A. doi:10.1378/chest.1822432
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SESSION TYPE: Slide Presentations

PRESENTED ON: Sunday, March 23, 2014 at 12:15 PM - 01:15 PM

PURPOSE: The primary objective of our study is to identify the most common abnormalities of pulmonary function testing (PFT) in a pediatric non-asthmatic obese cohort. We aim to determine a possible correlation between the degree of PFT abnormalities and the severity of obesity.

METHODS: Thirty two patients underwent standardized PFT at the time of enrollment in the study. The PFT consist of measurements in airway flows (spirometry), static lung volumes, and lung diffusion capacity for carbon monoxide (DLCO) determined using a single breath nitrogen washout technique, and was corrected for alveolar volume. All the measurements were reported as percent predicted value for age, gender, height and ethnicity.

RESULTS: Thirteen girls and nineteen boys between 10 and 20 years of age were studied. None of the patients had clinical evidence of cardiopulmonary disease. The average BMI was 34.4 Kg/m2 with a range between 25 and 48 Kg/m2. A reduction in FEF25%-75%(a measure suggestive of small airway obstruction) was observed in eight patients (25%). Other observed abnormalities were a reduction in the functional residual capacity (FRC, a measure of lung parenchymal recoil) in six patients (18%) and an increase in residual volume (suggestive of air trapping) in twelve patients (37.5%). DLCO was increased in twelve patients (37.5%). A negative correlation between BMI and FRC was found (Rho -0.39, p-value 0.021). Similarly there was a negative correlation between BMI and DLCO (Rho -0.42, p-value 0.015).

CONCLUSIONS: In our cohort of obese non-asthmatic subjects we observed PFT changes consistent with small airway obstructive defect. With increasing BMI we observed PFT abnormalities suggestive of diffusion impairment (DLCO) and changes in the elastic recoil properties of the lung (FRC).

CLINICAL IMPLICATIONS: Childhood obesity has doubled in children and tripled in adolescents in the past 30 years. Data on the effects of obesity in children and adolescents on pulmonary function are scarce and controversial. We aim to increase our knowledge regarding the relationship between obesity and pulmonary function in order to improve this population’s potential clinical management.

DISCLOSURE: The following authors have nothing to disclose: Angela Webb, Roopa Saddaiah, Claudia Halaby, Christina Valsamis, Shahidul Islam, Melodi Pirzada

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