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Systemic Inflammation and Lung Function Impairment in Morbidly Obese Subjects with the Metabolic Syndrome

DOI: 10.1155/2013/131349

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Background. Obesity and asthma are associated. There is a relationship between lung function impairment and the metabolic syndrome. Whether this relationship also exists in the morbidly obese patients is still unknown. Hypothesis. Low-grade systemic inflammation associated with the metabolic syndrome causes inflammation in the lungs and, hence, lung function impairment. Methods. This is cross-sectional study of morbidly obese patients undergoing preoperative screening for bariatric surgery. Metabolic syndrome was assessed according to the revised NCEP-ATP III criteria. Results. A total of 452 patients were included. Patients with the metabolic syndrome ( ) had significantly higher blood monocyte (mean 5.3 versus 4.9, ) and eosinophil percentages (median 1.0 versus 0.8, ), while the total leukocyte count did not differ between the groups. The FEV1/FVC ratio was significantly lower in patients with the metabolic syndrome (76.7% versus 78.2%, ). Blood eosinophils were associated with FEV1/FVC ratio (adj. B ?0.113, ). Conclusion. Although the difference in FEV1/FVC ratio between the groups is relatively small, in this cross-sectional study, and its clinical relevance may be limited, these data indicate that the presence of the metabolic syndrome may influence lung function impairment, through the induction of relative eosinophilia. 1. Introduction Obesity is an increasing worldwide problem that has taken on epidemic proportions [1]. Cross-sectional studies have shown a positive association between obesity and asthma [2]. Weight loss in obese asthma patients improved morbidity and lung function [3]; however, the mechanisms underlying the relationship between asthma and obesity are unclear. It is suggested that low-grade systemic inflammation associated with obesity plays a role. The metabolic syndrome is a common metabolic disorder that may result from the increasing prevalence of obesity. Metabolic syndrome is a cluster of cardiometabolic risk factors characterized by abdominal obesity, insulin resistance, and chronic systemic inflammation [4]. Positive associations with lung function impairment have been reported for components of the metabolic syndrome, such as hypertension [5], type diabetes mellitus [6, 7], low-density lipoprotein cholesterol [8], and overall obesity [9]. In recent large cohort studies, it has been shown that there is also a relationship between lung function impairment and the metabolic syndrome [10–12]. However, all the aforementioned studies included overweight as well as normal weight subjects and were therefore not specifically


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