title: Obesity and asthma: physiological perspective.
abstract: Obesity induces some pertinent physiological changes which are conducive to either development of asthma or cause of poorly controlled asthma state. Obesity related mechanical stress forces induced by abdominal and thoracic fat generate stiffening of the lungs and diaphragmatic movements to result in reduction of resting lung volumes such as functional residual capacity (FRC). Reduced FRC is primarily an outcome of decreased expiratory reserve volume, which pushes the tidal breathing more towards smaller high resistance airways, and consequentially results in expiratory flow limitation during normal breathing in obesity. Reduced FRC also induces plastic alteration in the small collapsible airways, which may generate smooth muscle contraction resulting in increased small airway resistance, which, however, is not picked up by spirometric lung volumes. There is also a possibility that chronically reduced FRC may generate permanent adaptation in the very small airways; therefore, the airway calibres may not change despite weight reduction. Obesity may also induce bronchodilator reversibility and diurnal lung functional variability. Obesity is also associated with airway hyperresponsiveness; however, the mechanism of this is not clear. Thus, obesity has effects on lung function that can generate respiratory distress similar to asthma and may also exaggerate the effects of preexisting asthma.
authors: Chest Research Foundation, Marigold Complex, Kalyani Nagar, Pune, Maharashtra 411014, India.
authors: Bill
authors: B
authors: Brashier
authors: Sundeep
authors: S
authors: Salvi
references: Obes Surg. 2002 Oct;12(5):652-60
references: 12448387
references: Am J Respir Crit Care Med. 2005 Feb 15;171(4):334-9
references: 15557134
references: Am J Epidemiol. 1993 Jul 1;138(1):37-45
references: 8333425
references: Am J Respir Crit Care Med. 2001 Nov 15;164(10 Pt 1):1835-40
references: 11734432
references: Eur Respir J. 2006 Mar;27(3):495-503
references: 16507848
references: Eur Respir J. 2005 May;25(5):896-901
references: 15863649
references: Clin Exp Allergy. 1999 Mar;29(3):323-9
references: 10202338
references: BMC Pulm Med. 2012 Mar 21;12:10
references: 22436173
references: Pediatr Pulmonol. 2009 Oct;44(10):997-1002
references: 19768805
references: J Appl Physiol (1985). 2004 Jul;97(1):260-8
references: 15020576
references: J Appl Physiol (1985). 2003 Sep;95(3):938-45
references: 12794034
references: J Appl Physiol (1985). 2008 Nov;105(5):1533-41
references: 18787093
references: Am J Epidemiol. 2004 Jun 15;159(12):1140-9
references: 15191931
references: Front Physiol. 2012 Jun 11;3:191
references: 22701430
references: Eur J Appl Physiol. 2007 Apr;99(6):567-83
references: 17237952
references: Am J Epidemiol. 2003 Sep 1;158(5):406-15
references: 12936895
references: Gut. 1998 Dec;43(6):770-4
references: 9824603
references: J Appl Physiol. 1960 May;15:377-82
references: 14425845
references: J Allergy Clin Immunol. 2011 Sep;128(3):508-15.e1-2
references: 21782230
references: Am J Clin Nutr. 2007 Jan;85(1):35-9
references: 17209174
references: Respir Med. 2003 Mar;97(3):273-80
references: 12645835
references: J Appl Physiol (1985). 2009 Aug;107(2):408-16
references: 19541741
references: Am J Clin Nutr. 1998 Jul;68(1):35-41
references: 9665094
references: J Appl Physiol (1985). 2008 Jun;104(6):1727-35
references: 18323466
references: Am J Gastroenterol. 2006 Nov;101(11):2619-28
references: 16952280
references: Obes Surg. 2005 May;15(5):641-7
references: 15946454
references: Ann Allergy Asthma Immunol. 2012 Apr;108(4):237-42
references: 22469442
references: J Clin Invest. 1967 Apr;46(4):475-81
references: 6021200
references: Ann Surg. 1990 Apr;211(4):419-27
references: 2181950
references: J Asthma. 2006 Aug;43(6):447-52
references: 16952863
references: Obes Surg. 1999 Aug;9(4):385-9
references: 10484298
references: Eur Respir J. 1994 Oct;7(10):1821-4
references: 7828691
references: Thorax. 2003 Dec;58(12):1031-5
references: 14645967
references: J Clin Invest. 2002 Oct;110(8):1093-103
references: 12393845
references: Int J Obes (Lond). 2013 Jan;37(1):94-100
references: 22846775
references: Pediatr Allergy Immunol Pulmonol. 2012 Sep;25(3):159-167
references: 22970423
references: Acta Anaesthesiol Scand. 1976;20(3):248-54
references: 785930
references: Med J Aust. 1996 Feb 5;164(3):137-40
references: 8628130
references: Am J Epidemiol. 1999 Aug 1;150(3):255-62
references: 10430229
references: Am J Physiol Regul Integr Comp Physiol. 2006 Jan;290(1):R126-33
references: 16002559
references: Chest. 2000 Nov;118(5):1315-21
references: 11083680
references: Respir Med. 2005 Aug;99(8):1010-4
references: 15950142
references: Nat Med. 1995 Nov;1(11):1155-61
references: 7584987
references: Ginecol Obstet Mex. 1999 Sep;67:433-7
references: 10544539
references: Eur Respir J. 2003 May;21(5):827-33
references: 12765429
references: Pediatr Pulmonol. 2003 Dec;36(6):514-21
references: 14618644
references: Am J Epidemiol. 1990 Jul;132(1):67-76
references: 2356815
references: Int J Obes Relat Metab Disord. 2004 Aug;28(8):1048-58
references: 15197412
references: J Appl Physiol (1985). 2004 Jun;96(6):2200-6
references: 14966019
references: Thorax. 1999 May;54(5):396-402
references: 10212102
references: Surg Obes Relat Dis. 2012 Sep-Oct;8(5):582-9
references: 21955746
references: Chest. 1997 Jul;112(1):87-97
references: 9228362
references: Am J Med. 2001 Dec 3;111 Suppl 8A:8S-12S
references: 11749917
references: J Allergy Clin Immunol. 2005 May;115(5):897-909; quiz 910
references: 15867841
references: Clin Exp Allergy. 2013 Jan;43(1):8-21
references: 23278876
references: Arch Intern Med. 2002 Jul 8;162(13):1477-81
references: 12090884
references: Br J Pharmacol. 1983 Feb;78(2):441-5
references: 6299446
references: Tuberc Respir Dis (Seoul). 2012 May;72(5):433-40
references: 23101008
references: Allergy Asthma Clin Immunol. 2008 Jun 15;4(2):51-8
references: 20525125
references: Respir Med. 2007 Nov;101(11):2240-7
references: 17686624
references: Obes Surg. 1993 Feb;3(1):15-21
references: 10757898
references: J Appl Physiol (1985). 2005 Feb;98(2):512-7
references: 15475605
references: N Engl J Med. 1994 Jul 28;331(4):228-33
references: 8015569
references: J Appl Physiol (1985). 1995 Oct;79(4):1199-205
references: 8567562
references: J Appl Physiol (1985). 2008 Oct;105(4):1127-33
references: 18703763
references: Am J Respir Crit Care Med. 2007 Apr 1;175(7):661-6
references: 17234901
references: J Appl Physiol (1985). 2007 Jun;102(6):2217-26
references: 17234804
references: Am J Respir Crit Care Med. 1997 Oct;156(4 Pt 1):1278-81
references: 9351635
references: Int J Obes (Lond). 2006 Jan;30(1):6-13
references: 16344843
references: J Allergy Clin Immunol. 2005 Jan;115(1):103-9
references: 15637554
references: Am J Surg. 2005 Jan;189(1):27-32
references: 15701486
references: Am J Respir Crit Care Med. 1999 May;159(5 Pt 1):1574-9
references: 10228129
references: Thorax. 2007 May;62(5):403-10
references: 17121869
references: Am J Respir Crit Care Med. 2001 May;163(6):1344-9
references: 11371399
references: Respir Res. 2007 Apr 16;8:32
references: 17437645
references: Thorax. 2001 Nov;56(11):839-44
references: 11641507
references: Respir Med. 2004 Nov;98(11):1108-16
references: 15526812
references: Chest. 1993 May;103(5):1470-6
references: 8486029
references: Am J Respir Crit Care Med. 2005 Mar 1;171(5):440-5
references: 15557135
references: Am J Clin Nutr. 2005 Nov;82(5):996-1003
references: 16280430
references: Free Radic Biol Med. 2007 Mar 1;42(5):665-74
references: 17291990
references: Chest. 1997 Apr;111(4):891-8
references: 9106566
references: Am J Respir Crit Care Med. 1999 Aug;160(2):454-7
references: 10430713
references: Chest. 2005 Oct;128(4):3048-54
references: 16236985
references: N Engl J Med. 2006 Jun 1;354(22):2340-8
references: 16738270
references: Thorax. 2002 Jul;57(7):581-5
references: 12096199
references: Can Respir J. 2005 Oct;12(7):371-6
references: 16307028
references: Int J Obes (Lond). 2008 Mar;32(3):502-9
references: 17955030
references: Obes Surg. 2000 Oct;10(5):428-35
references: 11054247
references: J Appl Physiol (1985). 2007 Feb;102(2):516-28
references: 17053103
references: Am J Epidemiol. 2001 Jan 15;153(2):157-63
references: 11159161
references: Int J Obes Relat Metab Disord. 1993 Nov;17(11):631-6
references: 8281221
references: Korean J Intern Med. 2006 Mar;21(1):10-4
references: 16646558
references: J Clin Epidemiol. 2001 Apr;54(4):399-406
references: 11297889
references: Am J Epidemiol. 2004 Nov 15;160(10):969-76
references: 15522853
references: Am J Epidemiol. 2003 Jul 15;158(2):165-74
references: 12851230
references: Am J Physiol Lung Cell Mol Physiol. 2006 May;290(5):L856-65
references: 16373670
references: Clin Endocrinol (Oxf). 2001 Mar;54(3):347-54
references: 11298087
references: J Allergy Clin Immunol. 2008 May;121(5):1075-84; quiz 1085-6
references: 18378287
references: J Appl Physiol Respir Environ Exerc Physiol. 1983 Oct;55(4):1269-76
references: 6629961
references: J Appl Physiol (1985). 2010 Jan;108(1):206-11
references: 19875713
references: Am Rev Respir Dis. 1983 Sep;128(3):501-6
references: 6614644
references: Arch Intern Med. 2002 Oct 14;162(18):2061-9
references: 12374514
references: Ital J Pediatr. 2011 Jan 06;37:1
references: 21208461
references: Am J Respir Crit Care Med. 2013 Apr 1;187(7):697-702
references: 23392439
references: J Clin Endocrinol Metab. 1996 Sep;81(9):3424-7
references: 8784109
references: Proc Am Thorac Soc. 2010 Sep;7(5):325-35
references: 20844291
references: J Appl Physiol (1985). 2004 Sep;97(3):821-6
references: 15107416
references: Eur Respir J. 2008 Jul;32(1):85-91
references: 18353855
references: Pharmacol Ther. 2006 Apr;110(1):83-102
references: 16297979
references: Allergy. 2006 Jan;61(1):79-84
references: 16364160
references: Ann Allergy Asthma Immunol. 2013 May;110(5):340-6
references: 23622004
references: Chest. 2002 Oct;122(4):1256-63
references: 12377850
references: Arch Intern Med. 1999 Nov 22;159(21):2582-8
references: 10573048
references: Thorax. 2003 Dec;58(12):1036-41
references: 14645968
references: Clin Exp Allergy. 2013 Jan;43(1):73-84
references: 23278882
references: Am J Public Health. 1986 Mar;76(3):264-9
references: 3946713
references: Chest. 1996 Jan;109(1):144-51
references: 8549177
references: Paediatr Respir Rev. 2006 Dec;7(4):233-8
references: 17098637
references: Int J Obes Relat Metab Disord. 1995 May;19(5):343-6
references: 7647827
references: Thorax. 2002 Dec;57(12):1028-33
references: 12454296
references: Int J Obes (Lond). 2005 Jul;29(7):804-9
references: 15824747
references: J Appl Physiol (1985). 2010 Mar;108(3):735-43
references: 19875711
references: Obes Surg. 1995 Nov;5(4):399-402
references: 10733835
references: Obes Surg. 2004 Nov-Dec;14(10):1381-8
references: 15603655
references: Eur Respir J. 1992 Sep;5(8):921-9
references: 1426199
references: J Appl Physiol (1985). 2002 Mar;92(3):949-56
references: 11842025
references: J Asthma. 2004 Aug;41(5):521-6
references: 15360059
references: Thorax. 2001 Jan;56(1):4-8
references: 11120896
references: J Gastrointest Surg. 2003 Jan;7(1):102-108
references: 12559191
references: Am J Respir Crit Care Med. 2001 Dec 1;164(11):2045-50
references: 11739133
references: Chest. 2004 Jun;125(6):2046-52
references: 15189920
references: Chest. 1995 May;107(5):1298-302
references: 7750322
references: J Clin Invest. 1995 Nov;96(5):2393-403
references: 7593627
references: Anesth Analg. 1998 Sep;87(3):654-60
references: 9728848
references: Am J Med Sci. 1999 Nov;318(5):293-7
references: 10555090
references: Chest. 2006 Sep;130(3):827-33
references: 16963682
references: Ann Intern Med. 1990 Jun 1;112(11):828-32
references: 2378649
references: ScientificWorldJournal. 2010 Jul 07;10:1339-46
references: 20623094
references: J Appl Physiol (1985). 2007 Aug;103(2):655-63
references: 17478609
references: Am J Respir Crit Care Med. 2007 Oct 1;176(7):650-8
references: 17641156
references: Chest. 2007 Dec;132(6):1890-7
references: 17925423
references: BMJ. 2000 Mar 25;320(7238):827-32
references: 10731173
references: J Allergy Clin Immunol. 2008 Sep;122(3):507-11.e6
references: 18774387
references: Am J Clin Nutr. 2001 Apr;73(4):827-31
references: 11273860
references: J Immunol. 2006 Jun 15;176(12):7745-52
references: 16751422
references: Nature. 1998 Aug 27;394(6696):897-901
references: 9732873