Effects of overweight and obesity on tidal lung function of infants with recurrent wheezing

doi:10.11852/zgetbjzz2020-1558

Abstract

Abstract: Objective To investigate the effect of overweight and obesity on tidal lung function of infants with recurrent wheezing,in order to provide evidence for the prevention and control of asthma. Methods A total of 100 children aged 0 to 3 years with recurrent wheezing were selected in this study from Child Respiratory Department in Guangdong Women and Children Hospital. According to body mass index (BMI),wheezing children were divided into non-overweight group (n=70) and overweight/obesity group (n=30). And 80 children aged 0 to 3 years without respiratory diseases were selected as control group and divided into non-overweight group (n=50) and overweight/obesity group(n=30) according to BMI. The tidal breathing parameters and flow-volume loop of infants in each group were recorded and compared. Results The values oftime to peak tidal expiratory flow as a proportion of expiratory time(TPTEF/TE),volume to peak expiratory flow as a proportion of exhaled volume(VPTEF/VE),inspiratory time/expiratory time(TI∶TE),tidal expiratory flow when 25% of tidal volune remain in the lung/peak tidal expiratory flow(25/PF) of the wheezing infants with non-overweight significantly decreased compared with the control group without wheezing (t=8.518,7.767,3.142,7.860,P<0.05),while peak tidal expiratory flow(PTEF),tidal expiratory flow when 75% of tidal volume remains in the lung(TEF75) increased (t=6.728,8.540,P<0.05). In the control group and the wheezing group,compared with the non-overweight infants,tidal volume/kg(VT/kg) of infants with overweight and obesity decreased (t=2.872,3.048,P<0.05). Conclusion Overweight and obesity have impacts on VT/kg of tidal lung function,but did not affect airway obstruction indicators.

Key words: overweight and obesity, tidal lung function, recurrent wheezing, infants

摘要： 目的分析超重/肥胖对反复喘息婴幼儿潮气肺功能的影响,为哮喘的预防和管理奠定基础。方法选择在广东省妇幼保健院儿童呼吸科就诊的100例0～3岁反复喘息的急性发作期患儿为研究对象,按体重指数(BMI)分为喘息非超重组70例、喘息超重/肥胖组30例;选择80例0～3岁无呼吸系统疾病婴幼儿为对照组,其中非超重组50例,超重/肥胖组30例。测定各组受试患儿潮气呼吸流量-容积曲线(TBFV),记录各参数并进行比较。结果喘息非超重组与对照非超重组比较,达峰时间比(TPTEF/TE)、达峰容积比(VPTEF/VE)、吸呼比(TI∶TE)、呼出75%潮气量时的呼气流速/呼气峰流速(25/PF)均明显下降 (t＝8.518、7.767、3.142、7.860,P＜0.05);呼气峰流速(PTEF)、呼出25%潮气量时的呼气流量(TEF75)显著增加(t=6.728、8.540,P＜0.05)。分别在对照组、喘息组中,与非超重儿童肺功能参数相比,超重/肥胖儿童仅潮气量(VT/kg)显著下降(t=2.872、3.048,P＜0.05)。结论超重/肥胖影响婴幼儿肺功能潮气量(VT/kg),但不影响气道阻塞的指标。

关键词: 超重/肥胖, 潮气肺功能, 反复喘息, 幼儿

CLC Number:

R725.6

ZHOU Zhen, LI Li-yun, TAN Yan-fang, GUO Su-hua , LIN Ying , ZHAO Hui, LI Zeng-qing. Effects of overweight and obesity on tidal lung function of infants with recurrent wheezing[J]. Chinese Journal of Child Health Care, 2021, 29(4): 443-446.

周真, 李丽云, 谭艳芳, 郭素华, 林英, 赵慧, 李增清. 超重/肥胖对反复喘息婴幼儿潮气肺功能的影响[J]. 中国儿童保健杂志, 2021, 29(4): 443-446.

References

[1] Deng XL,Ma J,Yuan Y,et al.Association between overweight or obesity and the risk for childhood asthma and wheeze:An updated meta-analysis on 18 articles and 73 252 children[J].Pediatr Obes,2019,14(9):e12532.
[2] Lang JE,Bunnell HT,Hossain MJ,et al.Being overweight or obese and the development of asthma[J].Pediatrics,2018,142(6):e20182119.
[3] Forno E,Han YY,Mullen J,et al.Overweight,obesity,and lung function in children and adults-A meta-analysis[J].J Allergy ClinImmunol Pract Mar-Apr,2018,6(2):570-581.
[4] Paciência I,CavaleiroRufo J,Silva D,et al.Exposure to indoor endocrine-disrupting chemicals and childhood asthma and obesity[J].Allergy,2019,74(7):1277-1291.
[5] Peters U,Dixon AE,Forno E. Obesity and asthma[J].J Allergy Clin Immunol,2018,141(4):1169-1179.
[6] Mohan A,Grace J,Wang BR. The effects of obesity in asthma[J].Curr Allergy Asthma Rep,2019,19(10):49.
[7] Scott HA,Wood LG,Gibson PG.Role of obesity in asthma:mechanisms and management strategies[J].Curr Allergy Asthma Rep,2017,17(8):53.
[8] Bobolea I,Arismendi E,Valero A,et al.Early life origins of asthma:a review of potential effectors[J].J Investig Allergol Clin Immunol,2019,29(3):168-179.
[9] Bonato M,Tiné M,Bazzan E. Early airway pathological changes in children:new insights into thenatural history of wheezing[J].J Clin Med,2019,8(8):1180.
[10] Hassan MZ,Chowdhury MAB,Hassan I,et al.Respiratory viral infection in early life and development of asthma in childhood:A protocol for systematic review and meta-analysis[J].Medicine,2019,98(18):e15419.
[11] 中华医学会儿科学分会呼吸学组肺功能协作组,《中华实用儿科临床杂志》编辑委员会. 儿童肺功能系列指南(四):潮气呼吸肺功能[J].中华实用儿科临床杂志,2016,31(21):1617-1621
[12] 聂晖,韦红.潮气呼吸肺功能测定在婴幼儿喘息性疾病中的应用及意义[J].国际呼吸杂志,2016, 36(13):1020-1022.
[13] 何春卉,邓力,黄旭强,等.广州地区 1—3岁健康幼儿肺功能测定结果的探讨[J].中国循证儿科杂志,2007,2(1):21-26.
[14] Qi YY,Jiang GL,Wang LB,et al.Lung function in wheezing infants after acute lower respiratory tract infection and its association with respiratory outcome[J].Chin Med J,2017,130(1):4-10.
[15] Hevroni A,Goldman A,Blank-Brachfeld M.Use of tidal breathing curves for evaluating expiratory airway obstruction in infants[J].J Asthma,2018,55(12):1331-1337.
[16] 赵艳,黄英,罗蓉,等,反复喘息婴幼儿潮气呼吸肺功能及其与生长的相关性[J].临床儿科杂志,2017,35(8):561-564..
[17] Dixon AE,Peters U.The effect of obesity on lung function[J].Expert Rev Respir Med,2018,12(9):755-767.
[18] Kasteleyn MJ,Bonten TN,de Mutsert R,et al.Pulmonary function,exhaled nitric oxide and symptoms in asthma patients with obesity:a cross-sectional study[J].Respir Res,2017,18(1):205.
[19] 徐晓雯,黄英,王健,等.肥胖对不同年龄段哮喘患儿肺功能的影响[J].中国当代儿科杂志,2017,19(5):519-523.
[20] Yao TC,Tsai HJ,Chang SW,et al.Obesity disproportionately impacts lung volumes,airflow and exhaled nitric oxide in children[J].PLoS One,2017,12(4):e0174691.
[21] Kim JY,Sohn JH,Lee JH,et al.Obesity increases airway hyperresponsiveness via the TNF-α pathway and treating obesity induces recovery[J].PLoS One,2015,10(2):e0116540.
[22] Gruchała-Niedoszytko M,Małgorzewicz S,Niedoszytko M,et al.The influence of obesity on inflammation and clinical symptoms in asthma[J].Adv Med Sci,2013,58(1):15-21.