Impact of bariatric surgery on pulmonary function and nitric oxide in asthmatic and non-asthmatic obese patients

J Asthma. 2011 Aug;48(6):553-7. doi: 10.3109/02770903.2011.587581. Epub 2011 Jun 28.

Abstract

Background: Asthma is an important co-morbidity of obesity. This study evaluated the impact of bariatric surgery on respiratory function in obese patients and compared the outcomes in asthmatic and non-asthmatic subjects.

Methods: The study was observational and prospective and included subjects on waiting list for bariatric surgery. Pulmonary function, symptoms, and exhaled nitric oxide were assessed before surgery and 1 year after.

Results: Twenty-nine severe obese subjects (age range: 25-66 years) with a mean body mass index of 44.8 ± 4.7 kg/m(2) were included. Fourteen of them had also intermittent to moderate asthma. In the whole population, the body mass index decreased from 44.8 ± 4.7 to 41.1 ± 3.9 kg/m(2) (p = .0001) and the forced vital capacity increased from 3.05 ± 0.83 to 3.50 ± 0.81 L (p = .043). No change was seen in forced expiratory volume and oxygen saturation. These results remained valid also analyzing asthmatics and non-asthmatics separately. Concerning nitric oxide, the decrease at 1 year was significantly different between the two populations, since in asthma patients exhaled nitric oxide decreased by 4.86 ppb after bariatric surgery and increased by 0.27 ppb in non-asthmatics (p = .04).

Conclusions: Bariatric surgery significantly reduces the intake of inhaled corticosteroids and the levels of exhaled nitric oxide, thus bronchial inflammation, in asthmatics.

Publication types

  • Clinical Trial

MeSH terms

  • Adult
  • Aged
  • Asthma / complications*
  • Asthma / drug therapy
  • Asthma / metabolism
  • Asthma / physiopathology
  • Bariatric Surgery*
  • Body Mass Index
  • Breath Tests
  • Bronchial Provocation Tests
  • Female
  • Forced Expiratory Volume / physiology
  • Humans
  • Lung / physiology*
  • Lung / physiopathology
  • Male
  • Middle Aged
  • Nitric Oxide / metabolism*
  • Obesity / complications*
  • Obesity / metabolism
  • Obesity / physiopathology
  • Obesity / surgery*
  • Oxygen / blood
  • Steroids / administration & dosage
  • Steroids / therapeutic use
  • Treatment Outcome
  • Vital Capacity / physiology
  • Waist-Hip Ratio

Substances

  • Steroids
  • Nitric Oxide
  • Oxygen