The effects of obesity on lung volumes and oxygenation
Open accessAbstract
Introduction Obesity can cause hypoxemia by decreasing lung volumes to where there is closure of lung units during normal breathing. Studies describing this phenomenon are difficult to translate into clinical practice. We wanted to determine the lung volume measurements that are associated with hypoxemia in obese patients, and explore how we could use these measurements to identify them.Methods We collected pulmonary function test results and arterial blood gas data on 118 patients without obstruction on pulmonary function testing. We included only patients with normal chest imaging and cardiac testing within one year of the pulmonary function test, to exclude other causes of hypoxemia.Results We found that as BMI increases, the mean paO 2, ERV % predicted, and ERV/TLC decrease (BMI 20-30 kg/m 2: paO 2=90±8 mmHg, ERV% predicted 112±50, ERV/TLC (%) 19.7±6.5; BMI 30-40 kg/m 2: paO 2=84±10 mmHg, ERV% predicted 84±40 ERV/TLC(%) 13.6±7.6; BMI>40 kg/m 2: paO 2 78 ±12 mmHg, ERV% predicted 64±27 ERV/TLC(%) 11.4±5.8, ANOVA p<0.001). The A-a gradient increases as BMI increases (r=0.42, p<0.001). This correlation was stronger in men (r=0.54) than in women (r=0.35). The paO 2 is lower in patients with a low ERV than in those with a normal ERV (p<0.001). In a multivariate linear regression, only the ERV/TLC predicted (%), age, and BMI were associated with oxygenation (r 2 for A-a gradient =0.28, p=0.036).Conclusions In obese patients without cardiopulmonary disease, oxygen levels decrease as BMI increases. This effect is associated with the obesity-related reduction in ERV and is independent of hypoventilation.
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Oxygen saturation of hemoglobin has consistently been shown to be inversely associated with BMI across various populations.
“Lastly, oxygen saturation of hemoglobin has consistently been shown to be inversely associated with BMI across various populations [66,67,73].”
From Sources of inaccuracy in photoplethysmography for continuous cardiovascular monitoring (2021) · cites this paper as [73]
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- Authors
- Littleton, S. W., & Tulaimat, A.
- Affiliations
- Loyola University Medical Center (US)
- Cook County Health and Hospitals System (US)
- Corresponding author
- Littleton, Stephen W.
- Venue
- Respiratory Medicine
- Publisher
- Elsevier BV
- Published
- 2017-03
- Volume
- 124
- Pages
- 15-20
- ISSN
- 0954-6111 (ISSN-L)
- OpenAlex
- W2576059063
- Semantic Scholar
- a3f6ec1b0162625bd07c745e9e341d4511e6e1b8
- Cited by
- 150
- References
- 35
- Citations by year
- 2026: 12 · 2025: 18 · 2024: 23 · 2023: 17 · 2022: 24 · 2021: 20 · 2020: 21 · 2019: 10 · 2018: 4 · 2013: 1
- FWCI
- 7.91
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Respiratory Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Chronic Obstructive Pulmonary Disease (COPD) Research
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Respiratory Support and Mechanisms
- Health Sciences › Medicine › Physiology › Obstructive Sleep Apnea Research
- Keywords
- obesity, hypoxemia, lung volume, expiratory reserve volume, oxygenation, arterial-arterial oxygen gradient, body mass index, lung function, arterial oxygen tension, sex differences
- MeSH terms
- Adult, Hypoxia, Blood Gas Analysis, Expiratory Reserve Volume, Female, Functional Residual Capacity, Humans, Lung, Lung Volume Measurements, Male, Middle Aged, Obesity, Oxygen, Pulmonary Gas Exchange, Respiration, Respiratory Function Tests, Spirometry, Tidal Volume, Body Mass Index
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