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

摘要

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.