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Abstract(s)
A obesidade é uma doença crónica que afecta todos os grupos etários e cuja prevalência está a aumentar a uma taxa alarmante, incluindo a obesidade infantil. Esta doença multifactorial exerce vários efeitos metabólicos adversos e, apesar do seu impacto no sistema respiratório ser menos evidenciado, a literatura documenta efeitos significativos na função respiratória do adulto. No entanto, dados referentes ao impacto da obesidade infantil na função respiratória são limitados e pouco concordantes. O presente estudo teve como objectivo investigar os efeitos da obesidade infantil de causa exógena nos parâmetros das provas funcionais respiratórias (PFR). Os participantes foram recrutados durante o período de Janeiro a Março de 2009, na Consulta de Obesidade Infantil e Adolescência do Hospital Sousa Martins, na Guarda. Nenhum dos participantes tinha evidência clínica ou diagnóstica de doença cardio-respiratória. Foram estudadas 30 crianças, com idades compreendidas entre os 5 e os 16 anos e com um índice de massa corporal (IMC) médio de 26,6 kg/m2. A investigação teve dois momentos de avaliação distintos: (1) a realização de questionários, anamnese e exame objectivo durante a consulta; e (2) a realização das PFR, incluindo espirometria, pletismografia e capacidade de difusão. O grau de obesidade foi avaliado pelo IMC e pela percentagem de massa gorda corporal obtida por bioimpedância eléctrica.
Verificaram-se como alterações predominantes das PFR a diminuição do fluxo expiratório forçado entre 25-75% da capacidade vital forçada e do pico máximo de fluxo expiratório, com valores inferiores ao limite inferior da normalidade em 43,3% e 40% da amostra, respectivamente. Encontraram-se correlações negativas moderadas entre o IMC e a capacidade de difusão (R=-0,401; p=0,05), e entre esta e a percentagem de massa gorda corporal (R=-0,448; p=0,05). Em conclusão, este estudo sugere uma provável relação entre a obesidade infantil e obstrução das vias aéreas, sobretudo as de pequeno calibre; assim como aponta para um impacto negativo da obesidade na capacidade de difusão, sugerindo que ocorre uma provável diminuição da área disponível para realização das trocas gasosas. Desta forma, o pedido de PFR de rotina em crianças obesas poderá ser útil para uma melhor compreensão das repercussões da obesidade na função respiratória e uma detecção precoce de alterações passíveis de tratamento.
Obesity is a chronic disease that affects all age groups, whose prevalence is increasing at an alarming rate, including childhood obesity. This multifactorial disease leads to several adverse metabolic effects and, despite its impact on the respiratory system being less evident, literature refers to significant effects on the respiratory function of the adult. However, data about the impact of childhood obesity on respiratory function are limited and not very consistent. This study aimed to investigate the effects of exogenous childhood obesity on the respiratory function test (RFT) parameters. Participants were recruited during the period from January to March 2009, in Childhood Obesity and Adolescence Consultation, in Sousa Martins Hospital, in Guarda. None of the participants had clinical evidence or diagnosis of cardio-respiratory disease. Thirty children aged 5 to 16 years old and with an average body mass index (BMI) of 26.6 kg/m2 were studied. The research had two different moments of assessment: (1) completion of questionnaires, clinical history and objective examination during the consultation; and (2) execution of RFT, including spirometry, lung volumes, and diffusion capacity for carbon monoxide. The degree of obesity was assessed by BMI and the percentage of body fat mass obtained by electrical bioimpedance. Reduction in forced expiratory flow between 25 and 75% of forced vital capacity and peak expiratory flow were the commonest abnormalities, with values below the lower limit of normal in 43.3% and 40% of the sample respectively. There were moderate negative correlations between BMI and diffusion capacity (R =- 0.401, p = 0.05), and between this one and the percentage of body fat mass (R =- 0.448, p = 0.05). In conclusion, this study suggests a possible relation between childhood obesity and airway obstruction, especially in small airways; and points out to a negative impact of obesity on diffusion capacity, suggesting that probably occurs a decrease in surface area available to gas exchange. So, a routine respiratory function test in obese children can be useful for better understanding of obesity repercussions on respiratory function and for an early detection of abnormalities susceptible to treatment.
Obesity is a chronic disease that affects all age groups, whose prevalence is increasing at an alarming rate, including childhood obesity. This multifactorial disease leads to several adverse metabolic effects and, despite its impact on the respiratory system being less evident, literature refers to significant effects on the respiratory function of the adult. However, data about the impact of childhood obesity on respiratory function are limited and not very consistent. This study aimed to investigate the effects of exogenous childhood obesity on the respiratory function test (RFT) parameters. Participants were recruited during the period from January to March 2009, in Childhood Obesity and Adolescence Consultation, in Sousa Martins Hospital, in Guarda. None of the participants had clinical evidence or diagnosis of cardio-respiratory disease. Thirty children aged 5 to 16 years old and with an average body mass index (BMI) of 26.6 kg/m2 were studied. The research had two different moments of assessment: (1) completion of questionnaires, clinical history and objective examination during the consultation; and (2) execution of RFT, including spirometry, lung volumes, and diffusion capacity for carbon monoxide. The degree of obesity was assessed by BMI and the percentage of body fat mass obtained by electrical bioimpedance. Reduction in forced expiratory flow between 25 and 75% of forced vital capacity and peak expiratory flow were the commonest abnormalities, with values below the lower limit of normal in 43.3% and 40% of the sample respectively. There were moderate negative correlations between BMI and diffusion capacity (R =- 0.401, p = 0.05), and between this one and the percentage of body fat mass (R =- 0.448, p = 0.05). In conclusion, this study suggests a possible relation between childhood obesity and airway obstruction, especially in small airways; and points out to a negative impact of obesity on diffusion capacity, suggesting that probably occurs a decrease in surface area available to gas exchange. So, a routine respiratory function test in obese children can be useful for better understanding of obesity repercussions on respiratory function and for an early detection of abnormalities susceptible to treatment.
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Keywords
Obesidade infantil - Aspectos respiratórios Obesidade exógena - Função respiratória
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Universidade da Beira Interior