Obesity and Lung Disease: A Guide to Management PDF
Preview Obesity and Lung Disease: A Guide to Management
Respiratory Medicine Series editor: Sharon I.S. Rounds For further volumes: http://www.springer.com/series/7665 Anne E. Dixon Emmanuelle M. Clerisme-Beaty (cid:2) Editors Obesity and Lung Disease A Guide to Management Editors Anne E. Dixon Emmanuelle M. Clerisme-Beaty Department of Medicine Clinical Development Medical Affairs, University of Vermont College of Medicine Respiratory Burlington, VT, USA Boehringer Ingelheim Pharmaceuticals, Inc. Ridgefield, CT, USA ISBN 978-1-62703-052-6 ISBN 978-1-62703-053-3 (eBook) DOI 10.1007/978-1-62703-053-3 Springer New York Heidelberg Dordrecht London Library of Congress Control Number: 2012944372 © Springer Science+Business Media New York 2013 This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, speci fi cally the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on micro fi lms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. Exempted from this legal reservation are brief excerpts in connection with reviews or scholarly analysis or material supplied speci fi cally for the purpose of being entered and executed on a computer system, for exclusive use by the purchaser of the work. Duplication of this publication or parts thereof is permitted only under the provisions of the Copyright Law of the Publisher’s location, in its current version, and permission for use must always be obtained from Springer. Permissions for use may be obtained through RightsLink at the Copyright Clearance Center. Violations are liable to prosecution under the respective Copyright Law. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a speci fi c statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. While the advice and information in this book are believed to be true and accurate at the date of publication, neither the authors nor the editors nor the publisher can accept any legal responsibility for any errors or omissions that may be made. The publisher makes no warranty, express or implied, with respect to the material contained herein. Printed on acid-free paper Humana Press is a brand of Springer Springer is part of Springer Science+Business Media (www.springer.com) Preface The prevalence of obesity is increasing at an alarming rate, with more than 300 million obese people worldwide. The increase in the prevalence of obesity has been most pronounced in developed countries. For example, in the United States, the prevalence of obesity has doubled over the past 30 years, with more than a third of adults meeting criteria for obesity based on a body mass index (BMI) >30 kg/m2 . This number is likely to continue to increase in the coming decade, as more than two-thirds of US adults have been shown to be overweight and at risk for becoming obese. Unfortunately, the obesity epidemic has not been limited to adults and developed countries. There has also been parallel increase in the prevalence of obesity among children over the past few decades. Despite controversies regarding the de fi nition of obesity in children, childhood obesity has become a major public health concern worldwide, with nearly 43 million children under the age of 5 being overweight or obese as of 2010. In the United States, the prevalence of childhood obesity has almost tripled over the past two decades with approximately 17% of children (12.5 million) aged 2–19 being obese. The obesity epidemic has also affected devel- oping countries, with as much as a 40% increase in obesity prevalence noted in some countries over the past 20 years. Although the obesity epidemic has affected men, women, and children, several demographic factors have been linked with an increased prevalence of obesity worldwide, including increasing age, female gender, urban lifestyle, and socioeconomic status. However, the association between socio- economic status and obesity risk has been shown to vary between developed and developing countries, with a higher prevalence of obesity being noted among higher socioeconomic class in developing countries, as opposed to developed countries where lower socioeconomic status is linked to higher obesity risk. Obesity is a risk factor for several chronic diseases, including cardiovascular disease, diabetes, arthritis, cancer, and as such is associated with signi fi cant morbid- ity and mortality. In addition, the obesity epidemic has placed a signi fi cant burden on national health-care systems, as a result of direct and indirect costs associated with the diagnosis and treatment of obesity-related chronic conditions, with an esti- mated 41.5% higher medical expenditure cost. Obesity also contributes to a signi fi cant increase in indirect cost due to loss of productivity, absenteeism, disability, and v vi Preface premature death, with a projected cumulative indirect cost due to premature death of $208 billion over the next 30–40 years. Accordingly, there has been increasing scienti fi c and public health interest aimed at understanding the effect of obesity on the prevalence, management, and clinical outcomes of chronic illnesses, including pulmonary diseases. The obesity epidemic has had a major impact on the epidemiology of pulmonary diseases. Obesity has impacted not only the type of diseases commonly encountered by the pulmonary clinician, but has also had a profound impact on the pathophysiol- ogy of common pulmonary diseases. Increased body mass index is associated with changes in resting lung volumes that can lead to respiratory complaints, such as dys- pnea. However, aside from its mechanical effects on the lung, increased adiposity is associated with neural, metabolic, and in fl ammatory dysregulation that can contrib- ute to modifi cations in risk pro fi le, clinical presentation, response to therapy, and clinical outcomes. We have known for many years that obesity is a risk factor for sleep disordered breathing. More recently it has also become increasingly evident that obesity is also a major risk factor for asthma, with 250,000 cases of asthma per year in the United States thought to be related to obesity. Obesity is thought to con- tribute to worse asthma, severity of asthma, decreased response to treatment, and is likely a major modi fi er of the phenotype of asthma. It also appears to affect response to pathogens, and as such has a major in fl uence on response to pneumonia as well as having a signi fi cant impact on outcomes pertaining to acute lung injury in the inten- sive care unit. As a result, this has led scientists and clinicians to struggle in trying to understand how to deal with the obese patient and their pulmonary health. Given the increasing prevalence of obesity and overweight people worldwide and the negative effects of obesity on health, this book is intended to serve as a resource for clinicians and scientists involved in the care and evaluation of pulmo- nary, critical care, and sleep disorders in the twenty- fi rst century. Burlington, VT, USA Anne E. Dixon Ridgefield, CT, USA Emmanuelle M. Clerisme-Beaty Contents 1 Effects of Obesity on Lung Function .................................................... 1 Cheryl M. Salome, Gregory G. King, and Norbert Berend 2 Effects of Obesity on Airway Responsiveness ..................................... 21 Stephanie A. Shore 3 The Effects of Obesity on Immune Function and Pulmonary Host Defense ................................................................ 47 Peter Mancuso 4 Pathogenesis of Obstructive Sleep Apnea in Obesity.......................... 71 Jason Paul Kirkness and Susheel P. Patil 5 Obesity Hypoventilation Syndrome ..................................................... 99 Stephen W. Littleton and Babak Mokhlesi 6 Effect of Obesity on the Development and Clinical Presentation of Asthma ......................................................................... 119 Akshay Sood and Anne E. Dixon 7 Treatment of the Obese Patient with Asthma...................................... 139 E. Rand Sutherland 8 Obesity and Chronic Obstructive Pulmonary Disease ....................... 153 Frits M.E. Franssen and Emiel F.M. Wouters 9 Obesity, the Metabolic Syndrome, and Pulmonary Hypertension ............................................................... 165 Anna Ryan Hemnes and Ivan M. Robbins vii viii Contents 10 Obesity and Acute Lung Injury ............................................................ 183 Renee D. Stapleton and Benjamin T. Suratt 11 Mechanical Ventilation of Patients with Severe Obesity .................... 201 Mikhail Litinski, Robert L. Owens, and Atul Malhotra 12 Obesity and Lung Health in Children .................................................. 217 Jason E. Lang Index ................................................................................................................ 241 Contributors Norbert Berend, MBBS, M.D. Woolcock Institute of Medical Research , Glebe , NSW , Australia Sydney Medical School , University of Sydney , Sydney , NSW , Australia Anne E. Dixon, M.A., BM, BCh. Department of Medicine , University of Vermont College of Medicine , Burlington , VT , USA Frits M.E. Franssen, M.D., Ph.D. Program Development Center , Ciro+, Center of Expertise for Chronic Organ Failure , Limburg , NM , The Netherlands Anna Ryan Hemnes, M.D. Department of Medicine , Vanderbilt University Medical Center , Nashville , TN , USA Gregory G. King, MB ChB, Ph.D. Woolcock Institute of Medical Research , Glebe , NSW , Australia Sydney Medical School , University of Sydney , Sydney , NSW , Australia Department of Respiratory Medicine , Royal North Shore Hospital , St. Leonards , NSW , Australia Jason Paul Kirkness, Ph.D. Division of Pulmonary and Critical Care Medicine , Johns Hopkins School of Medicine , Baltimore , MD , USA Jason E. Lang, M.D. Department of Pulmonology, Allergy & Immunology, Center for Pharmacogenomics & Translational Research , Mayo Clinic College of Medicine, Nemours Children’s Clinic , Jacksonville , FL , USA Mikhail Litinski, M.D. Department of Surgery , Saint Barnabas Medical Center , Livingston , NJ , USA Stephen W. Littleton, M.D. Pulmonary, Critical Care, and Sleep Medicine , Cook County Hospital and Rush University Medical Center , Chicago , IL , USA ix
The list of books you might like
