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Cross-sectional assessment of the roles of comorbidities in resting and activity-related dyspnea in severely obese women.

Essalhi, Mohamed; Gillaizeau, Florence; Chevallier, Jean-Marc; Ducloux, Roxane; Chevalier-Bidaud, Brigitte; Callens, Etienne; Graba, Semia; Gillet-Juvin, Karine; Altman, Jean-Jacques; Louis, Bruno; Mahut, Bruno; Delclaux, Christophe.
J Asthma; 50(6): 565-72, 2013 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-23550628

OBJECTIVES:

Obesity has been associated with a lesser degree of asthma control that may be biased by other comorbidities. The objectives of this cross-sectional study were to describe resting and activity-related dyspnea complaints according to the presence of obesity-related comorbidities (asymptomatic airway hyperresponsiveness (AHR), asthma, gastroesophageal reflux disease (GERD) and sleep-disordered breathing (SDB)). We hypothesized that obese women can exhibit both resting and activity-related dyspnea, independently of the presence of asthma.

METHODS:

Severely obese (body mass index (BMI) > 35 kg m(-2)) women prospectively underwent description of resting and activity-related dyspnea (verbal descriptors and Medical Research Council (MRC) scale), pulmonary function testing (spirometry, absolute lung volumes, and methacholine challenge test), oesogastro-duodenal fibroscopy, and overnight polygraphy. Thirty healthy lean women without airway hyperresponsiveness were enrolled.

RESULTS:

Resting dyspnea complaints were significantly more prevalent in obesity (prevalence 41%) than in healthy lean women (prevalence 3%). Chest tightness and the need for deep inspirations were independently associated with both asthma and GERD while wheezing and cough were related to asthma only in obese women. Activity-related dyspnea was very prevalent (MRC score > 1, 75%), associated with obesity, with the exception of wheezing on exertion due to asthma. Asymptomatic AHR and SDB did not affect dyspneic complaints.

CONCLUSIONS:

In severely obese women referred for bariatric surgery, resting dyspnea complaints are observed in association with asthma or GERD, while activity-related dyspnea was mainly related to obesity only. Consequently, asthma does not explain all respiratory complaints of obese women.
Selo DaSilva