Obesity and the Lung: What We Know Today

Respiration ◽  
2020 ◽  
Vol 99 (10) ◽  
pp. 856-866
Author(s):  
Judith Maria Brock ◽  
Adrian Billeter ◽  
Beat Peter Müller-Stich ◽  
Felix Herth
Keyword(s):  
Weight Loss ◽  
Adipose Tissue ◽  
Lung Function ◽  
Lung Diseases ◽  
Current Knowledge ◽  
Sleep Apnea Syndrome ◽  
Future Research ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Obstructive Sleep

Obesity is becoming more and more prevalent especially in Western industrial nations. The understanding of adipose tissue as an endocrine organ as well as the detection of adipocytokines – hormones that are secreted from the adipose tissue – gave reason to examine the interactions between adipose tissue and target organs. These efforts have been intensified especially in the context of bariatric surgery as promising weight loss therapy. Interactions between the lung and adipose tissue have rarely been investigated and are not well understood. There are obvious mechanical effects of obesity on lung function explaining the associations between obesity and lung diseases, in particular obesity hypoventilation syndrome, obstructive sleep apnea syndrome, asthma, and chronic obstructive pulmonary disease. The rise in the prevalence of obesity affects the epidemiology of pulmonary diseases as well. The aim of this review is to summarize the current knowledge on interactions, associations, and consequences of obesity and weight loss on lung function and lung diseases. Based on these data, areas for future research are identified.

Screening of High-risk Patients for Chronic Obstructive Pulmonary Disease in Primary Care: A Narrative Review (Preprint)

2020 ◽  
Author(s):  
Ponrathi Athilingam ◽  
Andrew Bugajski ◽  
Usha Menon
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Lung Function ◽  
Pulmonary Disease ◽  
Current Knowledge ◽  
Screening Tools ◽  
Chronic Obstructive ◽  
Early Screening ◽  
Obstructive Pulmonary Disease ◽  
Impaired Lung Function ◽  
Risk Patients

UNSTRUCTURED Chronic obstructive pulmonary disease (COPD) predominantly affects older adults, and claimed 3 million lives in 2016, making it the third leading cause of death worldwide. Over 35 million Americans aged 40 or older have lung function consistent with diagnosable COPD. COPD and cardiovascular disease (CVD) have a bidirectional relationship, in that one is a risk factor for developing the other. National and international consortiums recommend early screening of adults at risk of COPD, such as those with CVD. Recommended screening strategies include screening tools to assess symptoms, medical history, and handheld spirometry. Handheld spirometry has high diagnostic accuracy and if impaired lung function is indicated, these patients are referred for pulmonary function testing (PFT), the diagnostic gold standard for COPD. However, there is no clinical consensus for pulmonary screening in people with CVD. Current knowledge relating to the prevalence and incidence of CVD in people with COPD and the mechanisms that underlie their coexistence is key in combating the global burden of COPD.

scholarly journals Circulatory and Adipose Tissue Leptin and Adiponectin in Relationship to Resting Energy Expenditure in Patients With Chronic Obstructive Pulmonary Disease

2012 ◽  
pp. 469-480 ◽  
Author(s):  
M. BRÚSIK ◽  
J. UKROPEC ◽  
P. JOPPA ◽  
B. UKROPCOVÁ ◽  
P. SKYBA ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Weight Loss ◽  
Adipose Tissue ◽  
Energy Expenditure ◽  
Resting Energy Expenditure ◽  
Serum Levels ◽  
Tissue Expression ◽  
Normal Weight ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease

Increases in resting energy expenditure (REE) likely contribute to weight loss in various chronic diseases. In chronic obstructive pulmonary disease (COPD), relationships between the ventilatory impairment and increased REE, and between disturbances in adipokines and weight loss were previously described. Therefore, we investigated serum levels and adipose tissue expression of leptin and adiponectin, and their relationships to REE in patients with COPD. In 44 patients with stable COPD (38 male; age 62.3±7.2 years), REE was assessed using indirect calorimetry. Subcutaneous adipose tissue samples were analyzed using real-time PCR. From underweight [n=9; body mass index (BMI) <20.0 kg.m−2], to normal weight-overweight (n=24, BMI=20.0-29.9 kg.m−2) and obese patients (n=11; BMI≥30 kg.m−2), REE adjusted for body weight decreased (32.9±6.1 vs. 26.2±5.8 vs. 23.9±6.6 kcal.kg−1.24 h−1, p=0.006), serum levels and adipose tissue expression of leptin increased (p<0.001 for both), and serum and adipose tissue adiponectin decreased (p<0.001; p=0.004, respectively). REE was inversely related to serum and adipose tissue leptin (R=−0.547, p<0.001; R=−0.458, p=0.002), and directly to serum adiponectin (R=0.316, p=0.039). Underweight patients had increased REE compared to normal weight-overweight patients, in association with reductions in serum and adipose tissue leptin, and increased serum adiponectin, suggesting a role of adipokines in energy imbalance in COPD-related cachexia.

scholarly journals Revolving door respiratory patients: A rehabilitative perspective

2017 ◽  
Vol 87 (3) ◽  
Author(s):  
Massimiliano Polastri ◽  
Lara Pisani ◽  
Andrea Dell'Amore ◽  
Stefano Nava
Keyword(s):  
Sleep Apnea Syndrome ◽  
Neuromuscular Diseases ◽  
Bed Rest ◽  
Revolving Door ◽  
Pulmonary Diseases ◽  
Chronic Obstructive ◽  
Mobility Limitations ◽  
Obstructive Pulmonary Disease ◽  
Obstructive Sleep ◽  
Chronic Pulmonary Diseases

Rehabilitation is an integral component of care for patients affected by either acute or chronic pulmonary diseases. The key elements of rehabilitation treatment for critical respiratory patients are as follows: weaning from mechanical ventilation, respiratory therapy, physical reconditioning, and occupational therapy. It should be noted that patients affected by pulmonary diseases are prone to hospital re-admission due to frequent exacerbations, especially in cases with more severe stages of chronic obstructive pulmonary disease. A periodical worsening of clinical conditions is common in asthma, acute respiratory distress syndrome survivors, obstructive sleep apnea syndrome, and pulmonary fibrosis, as well as in patients with severe neuromuscular diseases. These patients are often identified as “revolving door patients”. Pulmonary patients are typically forced to maintain bed rest, or at least spend most of their waking hours dealing with mobility limitations, due to various pathological conditions including dyspnea, fatigue, and poor tolerance of movements. Alterations in mood are common in pulmonary patients who experience a decreased quality of life and limited social interactions. These negative emotional and cognitive aspects can be a major limitation to the provision of care, because to enhance and facilitate a degree of autonomy, the patient must be cooperative and pro-active.

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