Effects of obesity on lung volume and capacity in children and adolescents: a systematic review

Abstract Objective: To assess the effects of obesity on lung volume and capacity in children and adolescents. Data source: This is a systematic review, carried out in Pubmed, Lilacs, Scielo and PEDro databases, using the following Keywords: Plethysmography; Whole Body OR Lung Volume Measurements OR Total Lung Capacity OR Functional Residual Capacity OR Residual Volume AND Obesity. Observational studies or clinical trials that assessed the effects of obesity on lung volume and capacity in children and adolescents (0-18 years) without any other associated disease; in English; Portuguese and Spanish languages were selected. Methodological quality was assessed by the Agency for Healthcare Research and Quality. Data synthesis: Of the 1,030 articles, only four were included in the review. The studies amounted to 548 participants, predominantly males, with sample size ranging from 45 to 327 individuals. 100% of the studies evaluated nutritional status through BMI (z-score) and 50.0% reported the data on abdominal circumference. All demonstrated that obesity causes negative effects on lung volume and capacity, causing a reduction mainly in functional residual capacity in 75.0% of the studies; in the expiratory reserve volume in 50.0% and in the residual volume in 25.0%. The methodological quality ranged from moderate to high, with 75.0% of the studies classified as having high methodological quality. Conclusions: Obesity causes deleterious effects on lung volume and capacity in children and adolescents, mainly by reducing functional residual capacity, expiratory reserve volume and residual volume.

摘要
研究目的：评估肥胖对儿童及青少年肺容积与肺容量的影响。
数据来源：本研究为一项系统综述，检索了PubMed、LILACS、SciELO及PEDro数据库，检索关键词包括：体积描记法（Plethysmography）；全身测量 OR 肺容积测量 OR 肺总量（Total Lung Capacity） OR 功能残气量（Functional Residual Capacity） OR 残气量（Residual Volume） AND 肥胖。最终纳入以英语、葡萄牙语及西班牙语发表的、评估肥胖对0~18岁无其他合并疾病的儿童及青少年肺容积与肺容量影响的观察性研究或临床试验。采用美国医疗保健研究与质量局（Agency for Healthcare Research and Quality, AHRQ）的评价工具对纳入研究的方法学质量进行评估。
数据综合：本次检索共获得1030篇文献，最终仅4篇符合纳入标准并纳入本综述。纳入研究合计包含548名受试者，以男性为主，样本量范围为45至327例。所有研究均通过身体质量指数（Body Mass Index, BMI）z评分评估营养状况，其中50.0%的研究报告了腹围相关数据。所有纳入研究均证实，肥胖会对儿童及青少年的肺容积与肺容量产生负面影响：75.0%的研究显示肥胖可导致功能残气量降低，50.0%的研究显示呼气储备量（Expiratory Reserve Volume）降低，25.0%的研究显示残气量降低。纳入研究的方法学质量从中等到高水平不等，其中75.0%的研究被评定为高质量方法学研究。
结论：肥胖会对儿童及青少年的肺容积与肺容量产生有害影响，主要表现为功能残气量、呼气储备量及残气量的降低。