title: Systemic inflammation and lung function impairment in morbidly obese subjects with the metabolic syndrome.
abstract: BACKGROUND
  Obesity and asthma are associated. There is a relationship between lung function impairment and the metabolic syndrome. Whether this relationship also exists in the morbidly obese patients is still unknown. Hypothesis. Low-grade systemic inflammation associated with the metabolic syndrome causes inflammation in the lungs and, hence, lung function impairment.
  
  
  METHODS
  This is cross-sectional study of morbidly obese patients undergoing preoperative screening for bariatric surgery. Metabolic syndrome was assessed according to the revised NCEP-ATP III criteria.
  
  
  RESULTS
  A total of 452 patients were included. Patients with the metabolic syndrome (n = 293) had significantly higher blood monocyte (mean 5.3 versus 4.9, P = 0.044) and eosinophil percentages (median 1.0 versus 0.8, P = 0.002), while the total leukocyte count did not differ between the groups. The FEV1/FVC ratio was significantly lower in patients with the metabolic syndrome (76.7% versus 78.2%, P = 0.032). Blood eosinophils were associated with FEV1/FVC ratio (adj. B -0.113, P = 0.018).
  
  
  CONCLUSIONS
  Although the difference in FEV1/FVC ratio between the groups is relatively small, in this cross-sectional study, and its clinical relevance may be limited, these data indicate that the presence of the metabolic syndrome may influence lung function impairment, through the induction of relative eosinophilia.
authors.affiliation: Department of Pulmonology, Sint Franciscus Gasthuis, Kleiweg 500, 3045 PM Rotterdam, The Netherlands.
authors.forename: Astrid
authors.initials: A
authors.lastname: van Huisstede
authors.forename: Manuel Castro
authors.initials: MC
authors.lastname: Cabezas
authors.forename: Erwin
authors.initials: E
authors.lastname: Birnie
authors.forename: Gert-Jan M
authors.initials: GJ
authors.lastname: van de Geijn
authors.forename: Arjan
authors.initials: A
authors.lastname: Rudolphus
authors.forename: Guido
authors.initials: G
authors.lastname: Mannaerts
authors.forename: Tjin L
authors.initials: TL
authors.lastname: Njo
authors.forename: Pieter S
authors.initials: PS
authors.lastname: Hiemstra
authors.forename: Gert-Jan
authors.initials: GJ
authors.lastname: Braunstahl
mesh_terms: D000293:Adolescent; D000328:Adult; D001249:Asthma / Q000150:complications; D050110:Bariatric Surgery; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D004804:Eosinophils; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D007249:Inflammation / Q000150:complications*; D007958:Leukocyte Count; D008168:Lung / Q000503:physiopathology*; D008171:Lung Diseases / Q000150:complications* / Q000503:physiopathology; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications*; D008875:Middle Aged; D009000:Monocytes; D009767:Obesity, Morbid / Q000150:complications* / Q000601:surgery; D014797:Vital Capacity