Respir Med. 2025 Jan 14:107950. doi: 10.1016/j.rmed.2025.107950. Online ahead of print.
ABSTRACT
BACKGROUND: Morbid obesity in adolescents impacts respiratory function, often leading to reduced lung volume and obstructive ventilatory defects. However, standard spirometric values frequently remain within normal ranges.
OBJECTIVES: We hypothesized that Lung Clearance Index (LCI) is a more sensitive marker for detecting airway dysfunction in adolescents with morbid obesity than conventional lung function tests.
METHODS: A prospective single-center cohort study evaluated adolescents with morbid obesity undergoing laparoscopic sleeve gastrectomy (LSG). Assessments included fractional exhaled nitric oxide, multiple breath washout, spirometry, plethysmography, diffusion capacity, and a 6-minute walk test, conducted pre- and post-surgery.
RESULTS: Seventeen adolescents (mean age 17.1 years, BMI 45.5 kg/m2) were studied. Pre-surgery, LCI was slightly elevated (mean 7, SD±0.7), other lung function measures were normal. LCI correlated with BMI (r=0.637, p=0.014), no correlation was found between FEV1 and BMI (r= -0.083, p= 0.752). Post-surgery, mean LCI fell from 7 (± 0.7) to 6.5 (± 0.7), p=0.009. The pre-operatively observed correlation between LCI and BMI was no longer present post-operatively (r= 0.362, p= 0.225). LCI changes (r=0.676, p=0.011) correlated with BMI changes, whilst FEV1 did not (r=0.160, p=0.540).
CONCLUSIONS: LCI appeared to be a more sensitive marker than conventional spirometry for detecting airway dysfunction in adolescents with morbid obesity. Significant post-surgery improvements suggested enhanced ventilation homogeneity. LCI may detect subtle airway changes in this population, and be potentially valuable for both clinical assessment and research.
PMID:39818344 | DOI:10.1016/j.rmed.2025.107950
