title: Dose-response relationship and irreversible obstructive ventilatory defect in patients with consumption of Sauropus androgynus.
abstract: OBJECTIVE
  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, > or =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.
authors.affiliation: Department of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan. hsiue@mail.ncku.edu.tw
authors.forename: T R
authors.initials: TR
authors.lastname: Hsiue
authors.forename: Y L
authors.initials: YL
authors.lastname: Guo
authors.forename: K W
authors.initials: KW
authors.lastname: Chen
authors.forename: C W
authors.initials: CW
authors.lastname: Chen
authors.forename: C H
authors.initials: CH
authors.lastname: Lee
authors.forename: H Y
authors.initials: HY
authors.lastname: Chang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D018450:Disease Progression; D004305:Dose-Response Relationship, Drug; D004417:Dyspnea / Q000209:etiology / Q000503:physiopathology; D019665:Euphorbiaceae; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008168:Lung / Q000187:drug effects* / Q000503:physiopathology; D008173:Lung Diseases, Obstructive / Q000209:etiology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010939:Plant Poisoning / Q000209:etiology* / Q000503:physiopathology; D011379:Prognosis; D012123:Pulmonary Ventilation / Q000187:drug effects* / Q000502:physiology; D012129:Respiratory Function Tests; D012189:Retrospective Studies; D011795:Surveys and Questionnaires