Dynamic hyperinflation with bronchoconstriction - Differences between obese and nonobese women with asthma

Rationale Symptoms and respiratory function tests may be difficult to assess and interpret in obese patients with asthma, particularly if the asthma is severe. It is unclear whether the dynamic changes that occur during bronchoconstriction differ between obese versus non-obese patients with asthma. Objectives: To explore whether the changes in airway caliber and lung volumes that occur with acute bronchoconstriction are different in obese and nonobese patients with asthma and whether any differences contribute to the quality and intensity of symptoms. Methods: Thirty female patients with asthma were studied. Spirometry, lung volume measurements, and dyspnea scores were obtained before and immediately after bronchoconstriction induced by methacholine, aiming to provoke a reduction in FEV1 of 30%. Measurements and Main Results: Body mass index was independently associated with changes in lung volume after adjustment for baseline airway caliber and hyperresponsiveness. Increases in functional residual capacity and decreases in inspiratory capacity were significantly greater in obese participants (P < 0.001 and P = 0.003, respectively). Conclusions: Changes in respiratory function, notably dynamic hyperinflation, are greater in obese individuals with bronchoconstriction. This may potentially alter the perception and assessment of asthma severity in obese patients with asthma.