Journal of the Korean Society of Physical Medicine (대한물리의학회지)

The Korean Society of Physical Medicine (대한물리의학회)
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Comparison of Pulmonary Function, Respiratory Muscle Strength, and Diaphragm Thickness between Underweight and Normal Adults

  • Ho-Jeong Shin (Department of Physical Therapy, Graduate School, Catholic University of Pusan) ;
  • Ho-Hee Son (Department of Physical Therapy, College of Health Sciences, Catholic University of Pusan)
  • Received : 2023.07.19
  • Accepted : 2023.08.19
  • Published : 2023.08.31
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Abstract

PURPOSE: This study aimed to investigate the relationship between being underweight and respiratory function indicators such as pulmonary function, respiratory muscle strength, and diaphragm thickness in normal adults without lung disease. METHODS: The participants in this experiment were thirty young adults. To compare the respiratory function between the underweight and normal weight individuals, 15 participants were selected from each of the underweight and normal weight groups based on body mass index. Respiratory function tests were conducted through pulmonary function tests and respiratory muscle strength tests. Diaphragm thickness was measure with ultrasonography, and physical characteristics were obtained from grip strength and waist circumference. An independent t-test was used to compare the averages of the parameters measured in the two groups. RESULTS: In the respiratory function tests between the two groups, statistically significant differences (p < .05) emerged in the ratio of the predicted forced vital capacity (%FVC), the ratio of the predicted forced expiratory volume in one second (%FEV1), maximal expiratory pressure (MEP), and diaphragm thickness at the functional residual capacity (FRC). There was no statistically significant difference in the forced vital capacity, forced expiratory volume in one second, maximal inspiratory pressure, diaphragm thickness at the total lung capacity, and thickening ratio (p > .05). CONCLUSION: Decreases in some variables of respiratory function, such as the %FVC, %FEV1, MEP, and diaphragm thickness at the FRC were observed in underweight subjects. However, it is difficult to determine whether it affected the overall respiratory function. Future studies are needed to clearly identify the relationship between being underweight and respiratory function.

Keywords

Acknowledgement

This study was supported by grants from Catholic University of Pusan in 2023.

References

  1. Collaboration PS. Body-mass index and cause-specific mortality in 900 000 adults: collaborative analyses of 57 prospective studies. Lancet. 2009;373(9669):1083-96.  https://doi.org/10.1016/S0140-6736(09)60318-4
  2. Ni Y-N, Luo J, Yu H, et al. Can body mass index predict clinical outcomes for patients with acute lung injury/acute respiratory distress syndrome? A meta-analysis. Crit care. 2017;21(1):1-10.  https://doi.org/10.1186/s13054-016-1589-6
  3. Furukawa T, Hasegawa T, Suzuki K, et al. Influence of underweight on asthma control. Allergol Int. 2012;61(3):489-96.  https://doi.org/10.2332/allergolint.12-OA-0425
  4. Cao C, Wang R, Wang J, et al. Body mass index and mortality in chronic obstructive pulmonary disease: a meta-analysis. PLoS One. 2012;7(8). 
  5. Eriksson B, Backman H, Bossios A, et al. Only severe COPD is associated with being underweight: results from a population survey. ERJ Open research. 2016;2(3). 
  6. Sutherland TJ, Goulding A, Grant AM, et al. The effect of adiposity measured by dual-energy X-ray absorptiometry on lung function. Eur Respir J. 2008;32(1):85-91.  https://doi.org/10.1183/09031936.00112407
  7. Hakala K, Mustajoki P, Aittomaki J, et al. Effect of weight loss and body position on pulmonary function and gas exchange abnormalities in morbid obesity. Int J Obes Relat Metab Disord. 1995;19(5):343-6. 
  8. Do JG, Park C-H, Lee Y-T, et al. Association between underweight and pulmonary function in 282,135 healthy adults: A cross-sectional study in Korean population. Scientific reports. 2019;9(1):14308. 
  9. Tuinman PR, Jonkman AH, Dres M, et al. Respiratory muscle ultrasonography: methodology, basic and advanced principles and clinical applications in ICU and ED patients-a narrative review. Intensive Care Med. 2020;46:594-605.  https://doi.org/10.1007/s00134-019-05892-8
  10. Jung JH, Kim NS. The correlation between diaphragm thickness, diaphragmatic excursion, and pulmonary function in patients with chronic stroke. J Phys Ther Sci. 2017;29(12):2176-9.  https://doi.org/10.1589/jpts.29.2176
  11. Lee K. Correlation between respiratory muscle strength and pulmonary function with respiratory muscle length increase in healthy adults. Physical therapy rehabilitation science. 2021;10(4):398-405.  https://doi.org/10.14474/ptrs.2021.10.4.398
  12. World Health Organization. Obesity: preventing and managing the global epidemic: report of a WHO consultation. Switzerland. World Health Organization. 2000. 
  13. Yu R, Ong S, Cheung O, et al. Reference values of grip strength, prevalence of low grip strength, and factors affecting grip strength values in Chinese adults. J Am Med Dir Assoc. 2017;18(6):551. 
  14. World Health Organization. Waist circumference and waist-hip ratio: report of a WHO expert consultation, Geneva, 8-11 December 2008. Switzerland. World Health Organization. 2011. 
  15. American Thoracic Society. European respiratory society. ATS/ERS statement on respiratory muscle testing. Am J Respir Crit Care Med. 2002;166(4):518-624.  https://doi.org/10.1164/rccm.166.4.518
  16. Miller MR, Hankinson J, Brusasco V, et al. Standardisation of spirometry. Eur Respir J. 2005;26(2):319-38.  https://doi.org/10.1183/09031936.05.00034805
  17. Ueki J, De Bruin P, Pride N. In vivo assessment of diaphragm contraction by ultrasound in normal subjects. Thorax. 1995;50(11):1157-61.  https://doi.org/10.1136/thx.50.11.1157
  18. Lewis MI, Sieck GC, Fournier M, et al. Effect of nutritional deprivation on diaphragm contractility and muscle fiber size. J Appl Physiol. 1986;60(2):596-603.  https://doi.org/10.1152/jappl.1986.60.2.596
  19. ota T, Wada T, Miyagi M, et al. The relationship of diaphragm thickening ratio and respiratory muscle strength in young healthy adults. Physiotherapy. 2015;101:e1425-6.  https://doi.org/10.1016/j.physio.2015.03.1382
  20. Syabbalo N. Assessment of respiratory muscle function and strength. Postgrad Med J. 1998;74(870):208-15.  https://doi.org/10.1136/pgmj.74.870.208
  21. Schoser B, Fong E, Geberhiwot T, et al. Maximum inspiratory pressure as a clinically meaningful trial endpoint for neuromuscular diseases: a comprehensive review of the literature. Orphanet J Rare Dis. 2017;12:1-12. https://doi.org/10.1186/s13023-016-0551-7