Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2023 Aug 19;12(16):5385.
doi: 10.3390/jcm12165385.

Effect of Obesity on Lung Function in the Pediatric and Adult Populations with Asthma: A Review

Nayely Reyes Noriega  1 , Blanca E Del-Río-Navarro  1 , Arturo Berber  1 , Sergio de Jesús Romero Tapia  2 , Darío Jorge Mario Molina Díaz  3
Affiliations
Review

Effect of Obesity on Lung Function in the Pediatric and Adult Populations with Asthma: A Review

Nayely Reyes Noriega et al. J Clin Med. .

Abstract

Obesity and asthma are major global health concerns, particularly in industrialized nations. Obesity has been shown to have detrimental effects on the respiratory system and lung function owing to metabolic issues and immunological consequences. Research has indicated that obese patients with asthma (atopic or T2-high and non-atopic or T2-low) have diminished lung function in terms of functional residual capacity (FRC), residual volume (RV), expiratory reserve volume (ERV), the FEV1/FVC ratio, and FEF 25-75% due to mechanical fat loading on the diaphragm and central adiposity when compared to non-obese asthmatic patients. Therefore, it is plausible that changes in lung function are the result of a combination of mechanical (fat loading on the diaphragm, central adiposity, bronchial hyper-reactivity, and an increase in cholinergic tone), environmental (diet and exercise), and inflammatory factors (local and systemic), which can lead to the obesity-related asthma phenotype characterized by severe asthma symptoms, poor response to corticosteroid treatment, loss of lung function, and poor quality of life from an early age.

Keywords: asthma; lung function; obesity; pediatric population.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Inflammatory pathways related to asthma phenotypes (Th2, Th17, and Th2/Th17). These pathways can be activated by metabolic alterations, such as hyperinsulinemia and high levels of leptin, due to the meta-inflammation caused by obesity manifesting as severe asthma symptoms and alterations in lung volumes and resistance from an early age. Created with BioRender.com (https://www.biorender.com/, accessed on 17 May 2023).
Figure 2
Figure 2
Obesity and proinflammatory metabolic alterations cause changes in respiratory mechanics, promoting a smaller volume and caliber of the airway in patients with asthma. This is reflected in a decrease in the FEV1/FVC ratio (A) and an increase in the resistances of both the proximal (R20) and distal airways (R5) (B), leading to changes in the reactance area (AX) and resonant frequency (Fres), which is the point where the magnitudes of the capacitive and inertial reactance are equal and have a value of zero at different frequencies (C). Created with BioRender.com (https://www.biorender.com/, accessed on 17 May 2023).
See this image and copyright information in PMC

References

    1. Purnell J.Q. Definitions, Classification, and Epidemiology of Obesity. In: Feingold K.R., Anawalt B., Blackman M.R., Boyce A., Chrousos G., Corpas E., de Herder W.W., Dhatariya K., Dungan K., Hofland J., et al., editors. Endotext. MDText.com, Inc.; South Dartmouth, MA, USA: 2023. - PubMed
    1. Stierman B., Afful J., Carroll M.D., Chen T.C., Davy O., Fink S., Fryar C.D., Gu Q., Hales C., Hughes J.P., et al. National Health and Nutrition Examination Survey 2017–March 2020 Prepandemic Data Files Development of Files and Prevalence Estimates for Selected Health Outcomes. National Center for Health Statistics (U.S.); Hyattsville, MD, USA: 2021. p. 158. National Health Statistics Reports.
    1. Parameswaran K., Todd D.C., Soth M. Altered respiratory physiology in obesity. Can. Respir. J. 2006;13:203–210. doi: 10.1155/2006/834786. - DOI - PMC - PubMed
    1. Reddel H.K., Bacharier L.B., Bateman E.D., Brightling C.E., Brusselle G.G., Buhl R., Cruz A.A., Duijts L., Drazen J.M., FitzGerald J.M., et al. Global Initiative for Asthma (GINA) Strategy 2021—Executive summary and rationale for key changes. Eur. Respir. J. 2021;59:2102730. doi: 10.1183/13993003.02730-2021. - DOI - PMC - PubMed
    1. Asher M.I., Rutter C.E., Bissell K., Chiang C.Y., El Sony A., Ellwood E., Ellwood P., García-Marcos L., Marks G.B., Morales E., et al. Worldwide trends in the burden of asthma symptoms in school-aged children: Global Asthma Network Phase I cross-sectional study. Lancet. 2021;398:1569–1580. doi: 10.1016/S0140-6736(21)01450-1. - DOI - PMC - PubMed

LinkOut - more resources