Source: Annual Congress 2004 - Lung function technology: beyond the basic test
Disease area: Airway diseases

Abstract

Introduction
The prevalence of obesity (Body Mass Index BMI ≥ 30) is increasing in the western world. In the Netherlands 10% of the population is obese. Dyspnoea is one of the main symptoms.
We tested the hypothesis that dyspnoea in general practice is often related to obesity.
Patients and Methods
We analysed the results of spirometry of 3380 consecutive adults referred by general practitioners in the period 1995-2003. We recruited subjects with normal spirometry.
Measurements included standard spirometry, bronchodilator response (using 400μg salbutamol) and FRC (helium dilution method) or TGV. Tests were performed and reported according to ERS criteria.
Results
2229 subjects were included. 35% had a normal weight (BMI≤25), 38% were overweight (25<BMI<30), 27% were obese (increasing from 20% in 1995-99 to 29% in 1999-2003).
FRC/TLC ratio (tested in 77%) was decreased (< lower limit of 90% CI) in 3%, 21% and 46% in respectively normal weight, overweight and obesity.
Discussion
In our population prevalence of obesity was much higher (27%) than average in the Netherlands (10%).
The proportion of subjects that had a decreased FRC grew with increasing weight to almost half in the obese. A lowered FRC causes dyspnoea due to lowered compliance and increased airway resistance.
Although asthma will not be a major cause (only 5% of 88% tested subjects had significant bronchodilator response) other causes of dyspnoea (e.g. heart failure) can not be excluded.
Conclusion
The prevalence of obesity in dyspnoeic subjects with normal lung function is large and growing implying that this is an important cause of dyspnoea. Half the obese have a decreased FRC.

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Citations should be made in the following way:
E. H. D. Keizer, F. H. C. De Jongh (Enschede, The Netherlands). Dyspnoea in relation to obesity in general practice. Eur Respir J 2004; 24: Suppl. 48, 2497

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