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• W3205897277 abstract "TOPIC: Pulmonary Physiology TYPE: Original Investigations PURPOSE: Obesity is an ever-growing public health threat. The effects of obesity on basic lung function tests have been well characterized. The expected changes in the diffusion capacity of Carbon Monoxide (DLCO) and the CO transfer coefficient (KCO) in the obese patient are less well described. In a large, well described study population we describe the relationships between BMI, obesity, DLCO, and KCO, with robust adjustment for underlying physiologic derangements. We also report patterns of abnormality in the obese patient when existing reference equations for normal are applied. METHODS: The STAMPEDE study prospectively enrolled 380 service members with respiratory symptoms after deployment to South West Asia (SWA). All patients had spirometry, diffusion capacity, plethysmography, trans-thoracic echocardiogram (TTE), and high-resolution CT scan (HRCT) performed, along with hemoglobin (Hgb). We modeled the effect that BMI has on raw values of DLCO and KCO, using linear regression, with adjustment for age, gender, Hgb, and height. We then referenced DLCO and KCO to normal using equations by Miller, ERS, GLI, and Crapo, and compared patterns of abnormality for each reference in obese (BMI > 30 kg/m2) versus non-obese patients. All analyses were then repeated among only those with normal TTE and HRCT. RESULTS: There were 380 patients with data available for analysis. Obese patients had significantly higher raw KCO values than the non-obese (5.5 vs 4.9, p < 0.01), but differences in DLCO were not significant (30.7 vs 29.6, p = 0.15). After controlling for age, gender, Hgb, and height, increased BMI showed a trend toward predicting DLCO (β=0.15, p=0.097) and was significantly associated with KCO (β=0.09, p<0.01). In obese patients referenced to Miller, ERS, GLI, and Crapo; DLCO and KCO were 111.3, 93.8, 100.4, and 77.7 and 118.8, 117.6, 102.5, and 96.3 respectively. When compared to the non-obese, obese patients were less likely to fall below the LLN for DLCO when ERS and Crapo were applied. For KCO, when compared to the non-obese, obese patients were less likely to fall below the LLN when GLI was used. When patients with abnormal findings on TTE and HRCT were excluded (n=231 patients remaining), obese patients were less likely to be abnormal when Miller equations were applied, and showed a trend toward being less likely to be abnormal when ERS was used. CONCLUSIONS: We found KCO was more predictably affected by BMI than DLCO. When reference equations were applied, obese patients were less likely to fall below the LLN for DLCO and KCO, especially when controlling for abnormal cardiac and pulmonary baseline function. CLINICAL IMPLICATIONS: Elevation in BMI has a predictable effect on DLCO and KCO, but patterns of abnormality will vary by which reference equation is applied. Proper interpretation of DLCO and KCO requires integration of multiple patient factors, including BMI/obesity, and knowledge of the reference population used to establish abnormality. DISCLOSURES: No relevant relationships by Thomas Carbone, source=Web Response My spouse/partner as a Employee relationship with United Health Group Please note: $20001 - $100000 by Aaron Holley, source=Web Response, value=stock options Provided educational content on nebulized tiotropium relationship with CHEST Please note: approximately 4 months (Jan-Apr 2019) by Aaron Holley, source=Web Response, value=Honoraria Write pieces on journal articles to be published online relationship with WebMD Please note: 5 years by Aaron Holley, source=Web Response, value=Consulting fee Agreed to design COPD web and game-based educational content relationship with CHEST Please note: Hasn't started yet, will occur this Spring by Aaron Holley, source=Web Response, value=Honoraria No relevant relationships by Arthur Holtzclaw, source=Web Response No relevant relationships by John Hunninghake, source=Web Response Speaker/Speaker's Bureau relationship with Janssen Please note: $1001 - $5000 Added 12/02/2020 by Michael Morris, source=Web Response, value=Honoraria Speaker/Speaker's Bureau relationship with GSK Please note: $1001 - $5000 Added 12/02/2020 by Michael Morris, source=Web Response, value=Honoraria No relevant relationships by Rory Wagner, source=Web Response No relevant relationships by Robert Walter, source=Web Response" @default.
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• W3205897277 date "2021-10-01" @default.
• W3205897277 modified "2023-10-16" @default.
• W3205897277 title "OBESITY EXERTS A PREDICTABLE EFFECT ON DIFFUSION CAPACITY OF CARBON MONOXIDE AND DIFFUSION CAPACITY OF CARBONE MONOXIDE ADJUSTED FOR ALVEOLAR VOLUME ACROSS REFERENCE EQUATIONS" @default.
• W3205897277 doi "https://doi.org/10.1016/j.chest.2021.07.1910" @default.
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