Jolene N. Garcia Respiratory Lab Report Lab: Tues.

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Does being obese with asthma give one a greater respiratory tidal volume and decreased vital capacity in comparison to asthmatics within Normal Range of the BMI (Body Mass Index)?

Abstract:
Rationale: Obesity has been implicated to be the cause of asthma by some and vise versa; obesity is the cause for the increasing diagnosis of asthma. This study intends to provide evidence of the effects of obesity on asthma and/or the effects of asthma on obesity, if any; through the measurement of respiratory tidal volume and vital capacity.

Objectives: To determine if there is a correlation between obese asthmatic subjects and their respiratory airflow by measuring their tidal volume and their vital capacity and comparing it to those whom are not obese and have asthma as well as to those who are obese and do not have asthma, and to those who are not obese and do not have asthma.

Methods: Randomized selection of students in Physiology 12 Laboratory class from City College of San Francisco whom are obese and asthmatic; obese non-asthmatic; non-obese asthmatic; and non-obese and non-asthmatic and measure their tidal volume and vital capacity with BIOPAC program and BIOPAC SS11LA Airflow Transducer.

Results: Data depicted with bar graphs showing subjects in groups recorded tidal volume, and vital capacity in comparison to BMI, along with group averages. Conclusions: No significant change in tidal volume or vital capacity but results did show change in that the asthmatic obese group had a slightly lower tidal volume than the non-obese asthmatic group along with a slightly lower vital capacity. Leading to no determination of the effects of asthma on obesity and vise versa.

Introduction:
Being obese is a strain on the support systems of our bodies. It makes the body work harder to breath in enough oxygen to remain healthy, which can be the cause to a wide range of challenges to out systems. Being obese can cause extra pressure on the bodys airway passages causing the airways to narrow and resulting in the lungs to work harder for each breath. More so, it is said that being obese can cause a lowgrade inflammation in the body already, so with the added pressure caused from being over weight and added triggers to asthma from foreign irritants that may be taken in through inhalation, these passage ways when irritated can result in an even more severe asthma attack, and asthma in general. Both obesity and asthma are both chronic diseases with an ever-growing existence in todays youth, adolescence, and adults. It is still undecided today although there have been many studies on the topic if obesity in fact does play a vital role in being diagnosed with asthma. However, in a meta-analysis of epidemiological studies, Beuther and Sutherland demonstrated that the prevalence of asthma was higher by 38% in overweight patients and by 92% in obese patients. [1] In addition to this, another study with 79 women were tested: obese patients with asthma (20), normal-weight patients with asthma (19), obese patients without asthma (20), and normal-weight patients without asthma (20) by enhancement of the "classical" forms of airway inflammation resulting from the systemic inflammatory effects of obesity itself to see what if any correlations to asthma obesity had. [2] Unfortunately it was concluded that the link between obesity and asthma was dubious by this method and could possibly be explained better by another. However, in another study titled Effects of weight loss on peak flow variability, airways obstruction, and lung volumes in obese patients with asthma concluded from the results that weight loss did in fact reduce airway obstruction as well as PEF variability in patients who were obese with asthma. Suggesting that weight loss benefited obese asthmatic patients 2

by improved pulmonary mechanics and better control of airways obstruction. [3] And in another study titled Obesity is a risk factor for dyspnea but not for airflow obstruction found their study to demonstrate that while obesity is a risk factor for self-reported asthma, obese participants are at a lower risk for (objective) airflow obstruction. Many more obese than non-obese participants were using bronchodilators despite a lack of objective evidence for airflow obstruction. These data suggest that mechanisms other than airflow obstruction are responsible for dyspnea genesis in obesity and that asthma might be over diagnosed in the obese population. [4]; Leaving for an even more debatable topic in the medical community. Although, there have been countless studies on those who are obese having a higher risk in being diagnosed with asthma than those who are in the Normal range on the Body Mass Index (BMI) scale; there have been few if any on the relation between those who are obese with asthma and their overall respiratory tidal volume and vital capacity to those who are in the normal range on the BMI scale and their overall tidal volume and vital capacity. Does the difference in tidal volume and vital capacity between those who are obese with asthma, to those who do not, and to those who are in the normal range with asthma and to those who do not have any significance? This study hypothesizes that adults over the age of 18 living in the San Francisco Bay Area with a Body Mass Index (BMI) between 25-40 with reported asthma will have a higher tidal volume and a lower vital capacity than those with a BMI < 25 with asthma, and those without asthma with a BMI < 25 will have a lower tidal volume and a higher vital capacity than those with a BMI ranging from 25-40 will. This study hopes to find any relation between obesity and asthma based on the difference in tidal volume and vital capacity.

Methods & Materials:

BIOPAC program BIOPAC SS11LA Airflow Transducer (SS11LA) Filter Disposable Mouth Piece (BIOPAC AFT2) Nose Clip 3

BIOPAC Calibration Syringe MP35 Data Acquisition Unit Computer Dell Desktop First, six lab students from the local community college, City College of San Francisco (CCSF) between the ages of 20-40 were selected from the Physiology 12 lab class to participate as test subjects for this specific experiment and like experiments using respiratory measurements. Subjects in this particular study have test results particularly from this Physiology 12 Lab class but differ in the semester in which this class was taken. Subjects for this study have been taken from semesters dated as far back as Summer 2007 to present date. These subjects were asked a survey of questions on their personal history and stats pertaining to height, weight, and medical history on their diagnosis of asthma (whether they had been or not). Their BMI was then calculated based on this information provided (using height, weight, and the BMI scale). These subjects were then split into four different groups based on their answers: (Group A) Obese with Asthma, (Group B) Normal-Weight with Asthma, (Group C) Obese without Asthma, and (Group D) Normal-Weight without Asthma. Next the subjects vital capacity was measured by the use of the BIOPAC computer program and a BIOPAC SS11LA airflow transducer. Before each use the transducer was recalibrated by the use of the BIOPAC calibration syringe provided by CCSF, as to obtain the most accurate results in data recording. In each of the recordings the subject was positioned away from the computer as to avoid the subject from subconsciously altering the recordings with the idea out of sight out of mind, so that the subject would be more at their natural state when recording their tidal volume, thus having a more accurate reading. In addition to positioning the subject away from the computer for optimal readings, the subject was asked to relax and to breath normal until we started the recording while deceitfully recording the tidal volume before telling the subject that we had already begun as to not induce any anxiety or

any other external factors resulting in an inaccurate reading. After recording three natural breaths the subject was signaled to inhale at their maximum capacity, then to exhale to their most natural state. Afterwards, when the subject had gone back to their natural breath they were then asked to exhale to their full capacity. Once recorded, the difference of the two (the maximum exhale and inhale recordings) was taken to record the vital capacity for each subject. After all the recordings were made the data was gathered and reviewed as to see the correlation between those who were obese with asthma and without, and to those within normal-range BMIs who had asthma and who did not.

Results:
Below are some depicted graphs of the recorded data on the measurements of each subjects tidal volume, and vital capacity, along with their BMI in relation to the two and their relative standard deviation amongst the subjects.

Figure 1
Subject BMI Body Description TV VC (L) 1 28.5 Overweight 0.50463 3.4923 2 39.6 Obese 0.898 3.25 3 30.7 Obese 1.03515 3.27571 STDEV 5.877357683 N/A 0.275378996 0.1330924

BMI, Subject 2, Obese with Asthma 39.6 BMI, Subject 3, 30.7 TV VC (L) BMI

TV and VC (L) / BMI (kg/m2)

BMI, Subject 1, 28.5

VC (L), Subject 1, 3.4923 TV, Subject 1, 0.50463

VC (L), Subject 2, 3.25 TV, Subject 2, 0.898 Group A

VC (L), Subject 3, 3.27571 TV, Subject 3, 1.03515

Avg. TV = 0.8126; Avg. VC = 3.34; Avg. BMI = 32.9333

Figure 2
Subject BMI Body Description TV VC (L) 1 34.5 Obese 0.70653 2.80865 2 31.1 Obese 1.02 4.86 3 29.3 Overweight 0.63698 3.35358 STDEV 2.640706976 N/A 0.204044507 1.062566605

BMI, Subject 1, 34.5

Obese without Asthma BMI, Subject 2, 31.1 BMI, Subject 3, 29.3 TV

TV and VC (L) / BMI (kg/m2)

VC (L) BMI

VC (L), Subject 1, 2.80865 TV , Subject 1, 0.70653

VC (L), Subject 2, 4.86 TV , Subject 2, 1.02 Group B

VC (L), Subject 3, 3.35358 TV , Subject 3, 0.63698

Avg. TV = 0.7878; Avg. VC = 3.67407; Avg. BMI = 31.633

Figure 3

Subject BMI Body Description TV VC (L)

1 24.5 Normal 0.42461 3.22468

2 23.5 Normal 1.45 3.157

3 23.6 Normal 0.56889 4.40676

STDEV 0.550757055 N/A 0.555066993 0.702826883

BMI, Subject 1, 24.5

In 'Normal Range' with Asthma BMI, Subject 2, 23.5

BMI, Subject 3, 23.6

TV TV and VC (L) / BMI (kg/m2) VC (L) BMI

VC (L), Subject 1, 3.22468 TV, Subject 1, 0.42461

VC (L), Subject 2, 3.157 TV, Subject 2, 1.45 Group C

VC (L), Subject 3, 4.40676 TV, Subject 3, 0.56889

Avg. TV = 0.8145; Avg. VC = 3.596; Avg. BMI = 23.87

Figure 4

Subject BMI Body Description TV VC (L)

1 20.2 Normal 0.9 4.32

2 23.3 Normal 0.64 3.31

3 23.6 Normal 0.41 4.04

STDEV 1.882374387 N/A 0.245153013 0.521440313

In 'Normal Range' without Asthma BMI, Subject 2, 23.3 BMI, Subject 3, 23.6 TV VC BMI

TV and VC (L) / BMI (kg/m2)

BMI, Subject 1, 20.2

VC, Subject 1, 4.32 TV, Subject 1, 0.90

VC, Subject 2, 3.31 TV, Subject 2, 0.64 Group D

VC, Subject 3, 4.04 TV, Subject 3, 0.41

Avg. TV = 0.65; Avg. VC = 3.89; Avg. BMI = 22.37

Figure 5
Obese with Asthma Avg. TV Avg. VC Avg. BMI 0.8126 3.34 32.9333 Obese without Asthma 0.7878 3.67407 31.633 In Normal Rangewith Asthma 0.8145 3.596 23.87 In Normal Range without Asthma 0.65 3.89 22.37

STDEV 0.078432237 0.227082117 5.352062156

TV and VC (L) / BMI (kg/m2)

Avg. BMI, Obese with Asthma, 32.9333

Total Averages
Avg. Avg. BMI, In TV Normal Range Avg. without Asthma, VC 22.37 Avg. BMI Avg. VC, In Normal Avg. VC, In Normal Range Avg. VC, Obese Avg. TV, In Normal Avg. TV, In Normal Range Range Avg. TV, Obese Range without Asthma, without with Asthma, with Asthma, without without Asthma, 3.89 Asthma, 3.67407 3.596 0.8145 Asthma, 0.7878 0.65 Avg. BMI, In Normal Range with Asthma, 23.87 Avg. BMI, Obese without Asthma, 31.633

Avg. VC, Obese Avg. TV, Obese with with Asthma, 3.34 Asthma, 0.8126

Figure 5

Avg. TV = 0.8126; Avg. VC = 3.34; Avg. BMI = 32.9333 Obese with Asthma Avg. TV = 0.7878; Avg. VC = 3.67407; Avg. BMI = 31.633 Obese without Asthma Avg. TV = 0.8145; Avg. VC=3.596; Avg. BMI = 23.87 In Normal Range with Asthma Avg. TV = 0.65; Avg. VC = 3.89; Avg. BMI = 22.37 In Normal Range without Asthma

Discussion:
After reviewing the above-recorded measurements it has been concluded that with the subjects used there was not much of a significant change in tidal volume between the obese subjects with asthma and the normal ranged subjects with asthma. However the result is that those who were grouped as obese with 10

asthma (Group A) had a slightly lower average tidal volume than those who were in the normal range of the BMI with asthma (Group C). In addition to this conclusion the average vital capacity of (Group A) was slightly lower than those in (Group C). As for the two groups without asthma, (Group B) and (Group D), the obese group (Group B) had a higher tidal volume than the group in normal range of the BMI (Group D) did. In addition to this (Group B) had a lower vital capacity than (Group D) did. These results overturned part of my hypothesis in that from looking at the averages those who are asthmatic and obese hold a lower TV than those within the Normal Range who have asthma, oppose to the other way around in which I had hypothesized. As for those who were asthmatic and obese, these averages held a lower VC than those who were in Normal Range with asthma, which was what I had presumed to be true in my hypothesis initially. Bringing me to the ultimate conclusion of a similar study that much work still remains to be done to elucidate the relationship between obesity and asthma. However, investigations suggest that there is an association between the two, and can be modified by such factors such as age, and sex. [5]

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Bibliography
[1] B e u t h e r , D a v i d A . , a n d E . R a n d S u t h e r l a n d . " O v e r w e i g h t , O b e s i t y, a n d I n c i d e n t A s t h m a A M e t a - a n a l y s i s o f Prospective Epidemiologic Studies." American Journal of Respiratory and Critical Medicine . 175. (2007): 661-666. We b . 2 0 S e p t e m b e r . 2 0 1 1 . <http://171.66.122.149/cgi/reprint/175/7/661 >. [2] S u t h e r l a n d , T i m J . T, J a n O . C o w a n , S a r a h Yo u n g , A l i s a G o u l d i n g , A n d r e a M . G r a n t , Av i s W i l l i a m s o n , K a r e n B r a s s e t t , a n d D . R o b i n Ta y l o r . " T h e A s s o c i a t i o n b e t w e e n Obesit y and Asthma - Interactions between Systemic and Airway Inflamation." American Journal of Respiratory a n d C r i t i c a l M e d i c i n e . 1 7 8 . ( 2 0 0 8 ) : 4 6 9 - 4 7 5 . We b . 2 3 S e p t e m b e r. 2 0 11 . <h tt p: // 1 71 .6 6 . 12 2 .1 4 9/ cgi / rep ri nt /1 7 5/ 7/ 6 61 >. [3] H a j a l a , K , B S t e n i u s - A a r n i a l a , a n d A S o v i j a r v i . " E f f e c t s o f w e i g h t l o s s o n p e a k f l o w v a r i a b i l i t y, a i r w a y s o b s t r u c t i o n , and lung volumes in obese patients with asthma.." Chest J o u r n a l . 1 1 8 . ( 2 0 0 0 ) : 1 3 1 5 - 1 3 2 1 . We b . 2 7 S e p t . 2 0 11 . <h tt p: // ch estj o u rn al . ch est p ub s. o rg/ co nt en t/ 118 /5 / 13 1 5.long>. [4] S i n , D o n D . , R i c h a r d L . J o n e s , a n d S . F. P a u l M a n . " O b e s i t y is a risk factor for dyspnea but not for airflow obst ructi on.." Archi ves o f Int er na l Med i cin e . 1 6 2. (20 0 2 ): 1 4 7 7 - 1 4 8 1 . We b . 3 0 S e p t e m b e r . 2 0 11 . <h tt p: // arch in t e. am a assn.org/cgi/content/full/162/13/1477>. [ 5 ] B e u t h e r , D a v i d A . , S c o t t T. We i s s , a n d E . R a n d S u t h e r l a n d . "Pulmonary Perspective Obesity and Asthma." American Journal of Respiratory and Critical Medicine . 174. ( 2 0 0 6 ) : 11 2 - 11 9 . P r i n t . <h t tp :/ / aj rccm. atsj o u rn al s. o rg/ cgi / co n t ent/ fu ll/ 1 74 / 2/11 2? m a x t o s h o w = & h i t s = 1 0 & R E S U LT F O R M AT = & t i t l e a b s t r a c t = O besity Asthma&searchid=1&FIRSTINDEX=0& resourcetype=HWC IT>.

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