Influence of obesity in pulmonary function and exercise tolerance in obese women with obstructive sleep apnea

ABSTRACT Objective: To evaluate the influence of obesity on pulmonary function and exercise tolerance in women with obstructive sleep apnea (OSA). Subjects and methods: A descriptive analytic cross- sectional study was carried out. Thirty-nine (39) sedentary climacteric women, aged 45 to 60 years, were evaluated and submitted to polysomnography. The participants were divided into 4 groups: a) ‘eutrophic non-OSA’ (n = 13); b) ‘eutrophic OSA’ (n = 5); c) ‘obese non-OSA’ (n = 6); d) ‘obese OSA’ (n = 15). All subjects underwent clinical and anthropometric evaluation, followed by pulmonary function tests and 6-minute walk test (6MWT). Results: There was a significant difference in the predicted percentage values of FEV1/FVC when comparing ‘eutrophic OSA’ and ‘obese OSA’ (97.6% ± 6.1% vs. 105.7% ± 5.7%, respectively; p = 0.025). The other spirometric variables did not show any differences between the studied groups. There was no significant difference in the maximum distance walked when the ‘eutrophic non-OSA’, ‘eutrophic OSA’, ‘obese non-OSA’ and ‘obese OSA’ groups were compared. Conclusion: Considering the results of this study, OSA itself did not influence pulmonary function or functional capacity parameters compared to eutrophic women. However, not only isolated obesity but also obesity associated with OSA can negatively impact sleep quality and lung function.

摘要
目的：评估肥胖对阻塞性睡眠呼吸暂停（obstructive sleep apnea, OSA）女性患者肺功能与运动耐量的影响。
研究对象与方法：本研究为描述性分析性横断面研究。共纳入39名年龄45~60岁的久坐围绝经期女性，对所有受试者完成多导睡眠图（polysomnography）检测。将受试者分为4组：a）「营养正常非OSA组」（n=13）；b）「营养正常OSA组」（n=5）；c）「肥胖非OSA组」（n=6）；d）「肥胖OSA组」（n=15）。所有受试者均接受临床与人体测量学评估，随后完成肺功能检查及6分钟步行试验（6-minute walk test, 6MWT）。
结果：对比「营养正常OSA组」与「肥胖OSA组」时，FEV1/FVC预计百分比值存在显著统计学差异（分别为97.6%±6.1%与105.7%±5.7%，p=0.025）。其余肺量计检测指标在各组间均无显著差异。对「营养正常非OSA组」「营养正常OSA组」「肥胖非OSA组」与「肥胖OSA组」进行组间比较时，最大步行距离未呈现显著差异。
结论：基于本研究结果，与营养正常女性相比，OSA本身并未对肺功能或功能容量参数造成影响。然而，不仅单纯肥胖，合并OSA的肥胖状态均可对睡眠质量与肺功能产生负面影响。