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      Lung function in the absence of respiratory symptoms in overweight children and adolescents*

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          Abstract

          OBJECTIVE:

          To describe lung function findings in overweight children and adolescents without respiratory disease.

          METHODS:

          This was a cross-sectional study involving male and female overweight children and adolescents in the 8-18 year age bracket, without respiratory disease. All of the participants underwent anthropometric assessment, chest X-ray, pulse oximetry, spirometry, and lung volume measurements. Individuals with respiratory disease were excluded, as were those who were smokers, those with abnormal chest X-rays, and those with an SpO 2 = 92%. Waist circumference was measured in centimeters. The body mass index-for-age Z score for boys and girls was used in order to classify the individuals as overweight, obese, or severely obese. Lung function variables were expressed in percentage of the predicted value and were correlated with the anthropometric indices.

          RESULTS:

          We included 59 individuals (30 males and 29 females). The mean age was 11.7 ± 2.7 years. Lung function was normal in 21 individuals (35.6%). Of the 38 remaining individuals, 19 (32.2%), 15 (25.4%), and 4 (6.7%) presented with obstructive, restrictive, and mixed ventilatory disorder, respectively. The bronchodilator response was positive in 15 individuals (25.4%), and TLC measurements revealed that all of the individuals with reduced VC had restrictive ventilatory disorder. There were significant negative correlations between the anthropometric indices and the Tiffeneau index in the individuals with mixed ventilatory disorder.

          CONCLUSIONS:

          Lung function was abnormal in approximately 65% of the individuals evaluated here, all of whom were overweight. Obstructive ventilatory disorder and positive bronchodilator response predominated.

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          Most cited references43

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          Waist circumference percentiles in nationally representative samples of African-American, European-American, and Mexican-American children and adolescents.

          To describe and provide estimates of the distribution of waist circumference (WC) according to percentiles in African-, European-, and Mexican-American children, and to test for group differences at different percentiles. Cross-sectional data from the Third National Health and Nutrition Examination Survey (NHANES III) were examined. The sample evaluated included 9713 nonpregnant persons 2 to 18 years of age with measured values of WCs. Age-, sex-, and ethnicity-specific percentiles were estimated via percentile regression. WC measurements increased in a monotonic fashion across ages but at nonconstant rates and in a manner that varied across age and sex. At higher percentiles of the distribution, estimates of WC differ between Mexican-American (MA) and European-American (EA) and between African-American (AA) and European-American (EA), and, in some cases, exceeded the adult cutoff value for obesity-related disease risk at as early as 13 years of age. Age-, sex-, and ethnicity-specific WC percentiles are available for US children and adolescents and can be used as an assessment tool that could impact public health recommendations. Results suggest concern with respect to high WC values among certain ethnic groups.
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            Impact of obesity on respiratory function.

            Obesity has long been recognized as having significant effects on respiratory function. The topic has been studied for at least the last half century, and some clear patterns have emerged. Obese patients tend to have higher respiratory rates and lower tidal volumes. Total respiratory system compliance is reduced for a variety of reasons, which will be discussed. Lung volumes tend to be decreased, especially expiratory reserve volume. Spirometry, gas exchange and airway resistance all tend to be relatively well preserved when adjusted for lung volumes. Patients may be mildly hypoxaemic, possibly due to ventilation-perfusion mismatching at the base of the lungs, where microatelectasis is likely to occur. Weight loss leads to a reversal of these changes. For all of these changes, the distribution of fat, that is, upper versus lower body, may be more important than body mass index. © 2011 The Author. Respirology © 2011 Asian Pacific Society of Respirology.
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              Waist Circumference percentiles in nationally representative samples of African-American, European-American and Mexican-American children and adolescent

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                Author and article information

                Contributors
                Role: Anesthesiologist
                Role: Endocrinologist
                Role: Pediatrician
                Role: Gastroenterologist
                Role: Pulmonologist
                Role: Cytologist
                Role: Pulmonologist
                Journal
                J Bras Pneumol
                J Bras Pneumol
                Jornal Brasileiro de Pneumologia : Publicaça̋o Oficial da Sociedade Brasileira de Pneumologia e Tisilogia
                Sociedade Brasileira de Pneumologia e Tisiologia
                1806-3713
                1806-3756
                Mar-Apr 2014
                Mar-Apr 2014
                : 40
                : 2
                : 134-141
                Affiliations
                Professor Edgard Santos University Hospital, Federal University of Bahia School of Medicine, Salvador, Brazil
                Professor Edgard Santos University Hospital, Federal University of Bahia School of Medicine, Salvador, Brazil
                Professor Edgard Santos University Hospital, Federal University of Bahia School of Medicine, Salvador, Brazil
                Professor Edgard Santos University Hospital, Federal University of Bahia School of Medicine, Salvador, Brazil
                Professor Edgard Santos University Hospital, Federal University of Bahia School of Medicine, Salvador, Brazil
                Professor Edgard Santos University Hospital, Federal University of Bahia School of Medicine, Salvador, Brazil
                Professor Edgard Santos University Hospital, Federal University of Bahia School of Medicine, Salvador, Brazil
                Complexo Hospitalar Universitário Prof. Edgard Santos, Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador (BA) Brasil
                Complexo Hospitalar Universitário Prof. Edgard Santos, Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador (BA) Brasil
                Complexo Hospitalar Universitário Prof. Edgard Santos, Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador (BA) Brasil
                Complexo Hospitalar Universitário Prof. Edgard Santos, Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador (BA) Brasil
                Complexo Hospitalar Universitário Prof. Edgard Santos, Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador (BA) Brasil
                Complexo Hospitalar Universitário Prof. Edgard Santos, Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador (BA) Brasil
                Complexo Hospitalar Universitário Prof. Edgard Santos, Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador (BA) Brasil
                Author notes
                Correspondence to: Silvana Neves Ferraz de Assunção Avenida Juraci Magalhães Júnior, 1665, Quadra 03, Lote 05, Rio Vermelho CEP 40295-140, Salvador, BA, Brasil Tel. 55 71 3283-8034 E-mail: snfassuncao@ 123456oi.com.br
                Endereço para correspondência: Silvana Neves Ferraz de Assunção Avenida Juraci Magalhães Júnior, 1665 Quadra 03, Lote 05, Rio Vermelho CEP 40295-140, Salvador, BA, Brasil Tel. 55 71 3283-8034 E-mail: snfassuncao@ 123456oi.com.br
                Article
                S1806-37132014000200134
                10.1590/S1806-37132014000200006
                4083643
                24831397
                c45a37f6-2620-4f4a-8dbf-d08cd40eaa46

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 30 September 2013
                : 12 December 2013
                Page count
                Tables: 5, References: 29, Pages: 8
                Categories
                Original Articles

                obesity,respiratory function tests,lung diseases,obesidade/complicações,testes de função respiratória,pneumopatias/etiologia

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