Elsevier

Surgery for Obesity and Related Diseases

Volume 7, Issue 5, September–October 2011, Pages 599-604
Surgery for Obesity and Related Diseases

Original article
Surgically induced weight loss, including reduction in waist circumference, is associated with improved pulmonary function in obese patients

https://doi.org/10.1016/j.soard.2011.04.221Get rights and content

Abstract

Background

Obesity is associated with impaired pulmonary function. We evaluated the effect of bariatric surgery on pulmonary function among obese patients and identified potential anthropometric factors of obesity corresponding to the reversal of impaired pulmonary function.

Methods

Pulmonary function and anthropometric factors were studied in 94 obese patients aged 18–65 years with a body mass index >32 kg/m2. Pulmonary function tests were performed preoperatively and 3 months after bariatric surgery. The measurements included forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), total lung capacity, expiratory reserve volume, residual volume, and diffusing capacity of the lung for carbon monoxide. The anthropometric factors included the body weight, body mass index, waist circumference (WC), hip circumference, waist/height ratio, and waist/hip ratio. The changes in anthropometric parameters were analyzed in relation to pulmonary function test results. Multiple linear regression models were applied to identify the factors that influenced pulmonary function after bariatric surgery.

Results

When measured 3 months after surgery, all anthropometric parameters for the 94 patients studied had significantly decreased, and the pulmonary function test parameters had significantly improved. Of the anthropometric parameters, the reduction in body weight, WC, and waist/height ratio correlated significantly with increases in the FEV1 and FVC. In the multiple linear regression analysis, only the reduction in WC correlated significantly with the reductions in the FEV1 and FVC.

Conclusion

After bariatric surgery, all anthropometric parameters of obesity decreased significantly and the pulmonary function improved. This improvement correlated best with the reduction in the WC and perhaps a decreased intra-abdominal pressure.

Section snippets

Study population

We evaluated patients aged 18–65 years who had a BMI >37 kg/m2 or a BMI of 32–37 kg/m2 with obesity-related co-morbidities. The patients who underwent bariatric surgery at the international endoscopic obesity center of the E-Da Hospital in Southern Taiwan from July 2007 to December 2008 were enrolled in the present study. All obese patients received the same modality of bariatric surgery (laparoscopic Roux-en-Y gastric bypass), and the surgical procedure has been previously described in full

Participant characteristics

From July 2007 to December 2008, 139 consecutive obese Chinese patients underwent bariatric surgery at the obesity center of E-Da Hospital in Southern Taiwan. Of these 139 patients, 30 were excluded because of incomplete PFTs during follow-up and 15 because of inadequate performance of the PFTs at baseline or follow-up. Of the 94 participants, women were predominant (62%), and the age range was 18–59 years (mean 31.2 ± 9.8). A history of smoking was noted in 26% of the patients. None of the

Discussion

The major finding of the present study was that all the anthropometric parameters of obesity, including BW, BMI, WC, HC, WHtR, and WHR, were significantly reduced 3 months after bariatric surgery. The PFT parameters also improved significantly. After adjustment for potential confounding factors, including age, gender, and smoking history, dWC correlated with dFEV1 and dFVC, and dBW correlated with dDLCO. These results indicate that pulmonary function can be improved after bariatric surgery in

Conclusion

Just as in previous studies, surgically induced weight loss was associated with improved pulmonary function. Through careful analysis of the relationship between the changes in the anthropometric parameters and the changes in PFT parameters, this improvement correlated best with a decreased WC and perhaps a decreased intra-abdominal pressure.

Disclosures

The authors have no commercial associations that might be a conflict of interest in relation to this article.

Acknowledgment

This study was supported by E-Da hospital grant E-MRP-096-051.

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