title: Risk factors for airway hyperresponsiveness in severely obese women.
abstract: Obesity affects airway diameter and tidal ventilation pattern, which could perturb smooth muscle function. The objective was to assess the pathophysiology of airway hyperresponsiveness in obesity while controlling for gastro-oesophageal reflux disease. Obese women (n=118, mean±SD BMI 46.1±6.8kg/m(-2)) underwent pulmonary function testing (including tidal ventilation monitoring and methacholine challenge) and oesogastro-duodenal fibroscopy. Fifty-seven women (48%, 95% CI: 39-57%) exhibited hyperresponsiveness (dose-response slope ≥2.39% decrease/μmol) that was independently and positively correlated with predicted % FRC, Raw0.5 and negatively correlated with sigh frequency during tidal ventilation. Obese women had an increased breathing frequency but a similar sigh frequency than healthy lean women (n=30). Twenty-two obese women (19%, 95% CI: 12-26%) were classified as asthmatics (hyperresponsiveness and suggestive symptoms) without confounding effect of gastro-oesophageal reflux disease. In conclusion, in women referred for bariatric surgery, unloading of bronchial smooth muscle (reduced airway calibre and sigh frequency) is associated with hyperresponsiveness.
authors: AP-HP, Hôpital européen Georges-Pompidou, Service de Physiologie - Clinique de la Dyspnée, 75015 Paris, France.
authors: Mohamed
authors: M
authors: Essalhi
authors: Florence
authors: F
authors: Gillaizeau
authors: Jean-Marc
authors: JM
authors: Chevallier
authors: Roxane
authors: R
authors: Ducloux
authors: Brigitte
authors: B
authors: Chevalier-Bidaud
authors: Etienne
authors: E
authors: Callens
authors: Semia
authors: S
authors: Graba
authors: Karine
authors: K
authors: Gillet-Juvin
authors: Jean-Jacques
authors: JJ
authors: Altman
authors: Bruno
authors: B
authors: Louis
authors: Bruno
authors: B
authors: Mahut
authors: Christophe
authors: C
authors: Delclaux
mesh_terms: D000328:Adult; D001249:Asthma / Q000209:etiology* / Q000503:physiopathology*; D016535:Bronchial Hyperreactivity / Q000209:etiology* / Q000503:physiopathology*; D001985:Bronchial Provocation Tests; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D009765:Obesity / Q000150:complications* / Q000503:physiopathology; D012129:Respiratory Function Tests; D012307:Risk Factors