TY - JOUR
T1 - Dysanapsis in men and women with obesity
AU - Stickford, Jonathon L.
AU - Wilhite, Daniel P.
AU - Bhammar, Dharini M.
AU - Balmain, Bryce N.
AU - Babb, Tony G.
N1 - Funding Information:
This work was supported in part by the American Lung Association Career Investigator Award, American Heart Association Grant in Aid, the National Institutes of Health Grant HL096782, King Charitable Foundation, Atwell Gift for Pulmonary Research, Cain Foundation, and Texas Health Presbyterian Hospital Dallas. B.N. Balmain is funded by an American Physiological Society Postdoctoral Fellowship.
Publisher Copyright:
Copyright © 2021 the American Physiological Society.
PY - 2021/8
Y1 - 2021/8
N2 - Obesity alters chest wall mechanics, reduces lung volumes, and increases airway resistance. In addition, the luminal area of the larger conducting airways is smaller in women than in men when matched for lung size. We examined whether differences in pulmonary mechanics with obesity and sex were associated with the dysanapsis ratio (DR), an estimate of airway size when the expiratory flow is maximal, in men and women with and without obesity. In addition, we examined the ability to estimate DR using predicted versus measured static recoil pressure at 50% forced vital capacity (FVC; Pst50FVC). Participants completed pulmonary function testing and measurements of pulmonary mechanics. Flow, volume, and transpulmonary pressure were recorded while completing forced vital capacity (FVC) maneuvers in a body plethysmograph. Static compliance curves were collected using the occlusion technique. DR was calculated using measured values of forced midexpiratory flow and Pst50FVC. DR was also calculated using Pst predicted from previously reported data. There was no significant group (lean vs. obese) by sex interaction or main effect of group on DR. However, women displayed significantly larger DR compared with men. Predicted Pst50FVC was significantly greater than measured Pst50FVC. DR calculated from measured Pst was significantly greater than when using predicted Pst. In conclusion, although obesity does not appear to alter airway size, women may have larger airways compared with men when midexpiratory flow is maximal. In addition, DR estimated using predicted Pst should be used with caution. NEW & NOTEWORTHY It is unclear whether obesity in combination with sex influences the dysanapsis ratio (DR). These data indicate that DR is unaltered in adults with obesity and is greater in women than in men but similar between sexes when matched for lung volume. We also report a significant difference between predicted and measured static recoil pressure. Thus, we caution against predicting static recoil pressure in the calculation of DR.
AB - Obesity alters chest wall mechanics, reduces lung volumes, and increases airway resistance. In addition, the luminal area of the larger conducting airways is smaller in women than in men when matched for lung size. We examined whether differences in pulmonary mechanics with obesity and sex were associated with the dysanapsis ratio (DR), an estimate of airway size when the expiratory flow is maximal, in men and women with and without obesity. In addition, we examined the ability to estimate DR using predicted versus measured static recoil pressure at 50% forced vital capacity (FVC; Pst50FVC). Participants completed pulmonary function testing and measurements of pulmonary mechanics. Flow, volume, and transpulmonary pressure were recorded while completing forced vital capacity (FVC) maneuvers in a body plethysmograph. Static compliance curves were collected using the occlusion technique. DR was calculated using measured values of forced midexpiratory flow and Pst50FVC. DR was also calculated using Pst predicted from previously reported data. There was no significant group (lean vs. obese) by sex interaction or main effect of group on DR. However, women displayed significantly larger DR compared with men. Predicted Pst50FVC was significantly greater than measured Pst50FVC. DR calculated from measured Pst was significantly greater than when using predicted Pst. In conclusion, although obesity does not appear to alter airway size, women may have larger airways compared with men when midexpiratory flow is maximal. In addition, DR estimated using predicted Pst should be used with caution. NEW & NOTEWORTHY It is unclear whether obesity in combination with sex influences the dysanapsis ratio (DR). These data indicate that DR is unaltered in adults with obesity and is greater in women than in men but similar between sexes when matched for lung volume. We also report a significant difference between predicted and measured static recoil pressure. Thus, we caution against predicting static recoil pressure in the calculation of DR.
KW - Airway size
KW - Forced expiration
KW - Pulmonary function
KW - Static pressure
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U2 - 10.1152/japplphysiol.00133.2021
DO - 10.1152/japplphysiol.00133.2021
M3 - Article
C2 - 34166096
AN - SCOPUS:85113614609
SN - 0161-7567
VL - 131
SP - 496
EP - 503
JO - Journal of Applied Physiology
JF - Journal of Applied Physiology
IS - 2
ER -