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Transfer factor of the lung for carbon monoxide (TLCO) in morbid obese subjects

Ebymar Arismendi, José Ríos, Josep Roca, Felip Burgos, Eva Rivas, Roberto Rodriguez-Roisin
European Respiratory Journal 2015 46: PA4615; DOI: 10.1183/13993003.congress-2015.PA4615
Ebymar Arismendi
1Servei de Pneumologia, Hospital Clínic, Barcelona, Spain
2Fundació Clínic per a la Recerca Biomèdica, FCRB, Barcelona, Spain
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José Ríos
3Institut d’Investigacions Biomédiques August Pi i Sunyer, IDIBAPS, Universitat de Barcelona, Barcelona, Spain
4Biostatistics and Data Management Core Facility Biostatistics Unit, Universitat Autònoma de Barcelona, Barcelona, Spain
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Josep Roca
1Servei de Pneumologia, Hospital Clínic, Barcelona, Spain
3Institut d’Investigacions Biomédiques August Pi i Sunyer, IDIBAPS, Universitat de Barcelona, Barcelona, Spain
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Felip Burgos
1Servei de Pneumologia, Hospital Clínic, Barcelona, Spain
5CIBER de Enfermedades Respiratorias, CIBERES, Barcelona, Spain
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Eva Rivas
6Servei de Anestesiologia, Hospital Clínic, Barcelona, Spain
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Roberto Rodriguez-Roisin
1Servei de Pneumologia, Hospital Clínic, Barcelona, Spain
2Fundació Clínic per a la Recerca Biomèdica, FCRB, Barcelona, Spain
3Institut d’Investigacions Biomédiques August Pi i Sunyer, IDIBAPS, Universitat de Barcelona, Barcelona, Spain
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Abstract

Rationale and objectives: The impact of severe obesity on transfer factor of the lung for carbon monoxide (TLCO) remains uncertain. We hypothesized that, in addition to the potential intrinsic effects of obesity on lung function, morbidly obese subjects may require specific TLCO reference values. To this end, TLCO was measured in obese subjects before and after bariatric surgery (BS) and adjustment of the data to reported TLCO reference values was assessed.

Methods: We explored 220 morbidly obese subjects (BMI ≥40 kg/m2) before BS and 129 of them were studied one year after BS. The Lin's concordance coefficient (LCC) (1) was used to assess adjustment between TLCO measurements and the corresponding predicted values derived from different sets of reference equations.

Results: TLCO measurements significantly increased after BS (p<0.001). A poor LCC (between 0.25 to 0.58) was observed for most of the reference equations analyzed. Accordingly, we calculated a set of new reference equations using a cohort of 148 obese non-smokers before BS (123 were females; 43±13 yrs; BMI, 46±6 kg/m2) which markedly increased LCC (0.74, from 0.67-0.79).

Conclusions: The results indicate that obesity has a significant negative impact on TLCO. Moreover, current reference equations are not adequate for lung function assessment of these subjects. The new TLCO reference equations herein developed may contribute to enhance evaluation of morbidly obese subjects.

References:

  • 1) Lin LI. A note on the concordance correlation coefficient. Biometrics 2000; 56:324-325.

  • Lung function testing
  • Comorbidities
  • Extrapulmonary impact
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Transfer factor of the lung for carbon monoxide (TLCO) in morbid obese subjects
Ebymar Arismendi, José Ríos, Josep Roca, Felip Burgos, Eva Rivas, Roberto Rodriguez-Roisin
European Respiratory Journal Sep 2015, 46 (suppl 59) PA4615; DOI: 10.1183/13993003.congress-2015.PA4615

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Transfer factor of the lung for carbon monoxide (TLCO) in morbid obese subjects
Ebymar Arismendi, José Ríos, Josep Roca, Felip Burgos, Eva Rivas, Roberto Rodriguez-Roisin
European Respiratory Journal Sep 2015, 46 (suppl 59) PA4615; DOI: 10.1183/13993003.congress-2015.PA4615
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