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Obesity and The Lung2022
Obesity and The Lung2022
Obesity and The Lung2022
Teerawattananon, Y. and A. Luz. 2017. Obesity in Thailand. ADBI Working Paper 703.
Obesity Definition
18.5-22.9
23.0-24.9
25.0-29.9
30.0-39.9
Health Risks associated with Obesity
• Type 2 Diabetes
• Risk for diabetes increases linearly with BMI
• Overweight adolescents had a nearly a 2x higher risk of IFPG.
• Dyslipidemia
• ↑triglycerides, ↓HDL and ↑LDL
• Hypertension
• Enhanced sympathetic tone, RAS activation, ↑insulin, ↑leptin and impaired renal function
• Coronary artery disease
• ↑Markers of inflammation, endothelial dysfunction,
• even after correction for other known risk factors
• Obstructive sleep apnea
• Non-alcoholic fatty liver disease
• App. 20% of obese pt
• Cancer
• Increases in death rates for all cancers combined.
IRV
TV
ERV
RV
CV
CC
FRC
Normal Obese
Paul D Robinson.
Paediatric Respiratory Reviews 15 (2014) 219–226
F Crummy et al. Obesity and the lung2. Thorax 2008;63:738–46
Obesity
and
Exercise Capacity
https://www.weightofthenation.org/symptoms-or-signs-of-obesity/
Effect on Cardiopulmonary Exercise Testing
Paul D Robinson.
Paediatric Respiratory Reviews 15 (2014) 219–226
Obesity
displaces
the ṼO2
-work
rate
relation
upward
Increased IL-17
leptin, associated
decreased inflammation
adiponectin in the airways
Low L arginine/
Decreased FRC
ADMA ratio,
increased and ERV due
oxidative stress to abdominal
and lower NO adiposity
• Prevalence of PH in obese
▪ A retrospective single center - 5% of otherwise healthy individuals with a BMI
> 30 kg/m2 had PASP greater than 50 mm Hg on echocardiogram
B. M. McQuillan, et al. Circulation.2001(104)23pp. 2797–802
https://health.clevelandclinic.org/sleep-testing-at-home-vs-in-the-lab/
Obstructive Sleep Apnea
• Obstructive Sleep Apnea : OSA
A medical disorder characterized by repeated episodes of an intermittent decrease or absence of
inspiratory air flow due to upper airway closure during sleep
• Obstructive Sleep Apnea (Hypopnea) Syndrome : OSA(H)S
▪ 5 or more episodes of apnoea or hypopnoea per hour of sleep with associated symptoms
▪ 15 or more obstructive apnea-hypopnea events per hour of sleep regardless of associated
symptoms
• The Wisconsin Sleep Cohort data
For moderate-to-severe OSAS
10 % in men and 3 % in women among the ages of 30–49 years
17 % in men and 9 % in women among the ages of 50–70 years
Nearly 1 in 15 affected by at least moderate sleep apnea
Peppard et al. Am J Epi 2013
Beaudin et al. Exp Physiol 102.7 (2017) pp 743–63
Prevalence of Obstructive Sleep Apnea