Improvement in pulmonary function in asthmatic patients after bariatric surgery: a systematic review and meta-analysis
•The effect of bariatric surgery on pulmonary function in asthmatic patients is inconclusive. This systematic review and meta-analysis investigated the effect of bariatric surgery on pulmonary function (forced expiratory volume in one second (FEV1), forced vital capacity (FVC), and FEV1/FVC) in pati...
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| Published in | Surgery for obesity and related diseases Vol. 15; no. 5; pp. 794 - 803 |
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| Main Authors | , , |
| Format | Journal Article |
| Language | English |
| Published |
United States
Elsevier Inc
01.05.2019
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| Subjects | |
| Online Access | Get full text |
| ISSN | 1550-7289 1878-7533 1878-7533 |
| DOI | 10.1016/j.soard.2018.12.018 |
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| Abstract | •The effect of bariatric surgery on pulmonary function in asthmatic patients is inconclusive. This systematic review and meta-analysis investigated the effect of bariatric surgery on pulmonary function (forced expiratory volume in one second (FEV1), forced vital capacity (FVC), and FEV1/FVC) in patients with asthma.•A statistically significant increase in FEV1 and FVC was observed after bariatric surgery.•No significant post-surgical improvement was observed for FEV1/FVC.
The association between obesity and asthma is well-established. Some evidence suggests that weight loss may improve asthma outcomes; however, the effect of bariatric surgery on pulmonary function in asthmatic patients remains inconclusive. This systematic review and meta-analysis of observational studies assessed the impact of bariatric surgery on patients with asthma.
To investigate the effect of bariatric surgery on pulmonary function in patients with asthma.
Systematic review and meta-analysis of published studies.
A comprehensive search of the MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials (CENTRAL) databases was conducted. The sole inclusion criterion was published studies that evaluated the effects of bariatric surgery on pulmonary function in asthmatic patients. The outcomes of interest were forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), and FEV1/FVC. A meta-analysis of studies comparing pre- and postsurgery spirometric measures, and of studies comparing surgery and control groups was performed.
From 25 full-text articles, 6 observational studies met the inclusion criteria and were included in this meta-analysis based on the random-effects model. A significant increase in FEV1 and FVC was observed after bariatric surgery among studies without a control group (mean difference: .21 L, 95% confidence interval: .07–.35 for FEV1, and mean difference: .34 L, 95% confidence interval: .14–.53 for FVC). There was no significant change in FEV1/FVC after bariatric surgery compared with control.
FEV1 and FVC were both found to be significantly improved after bariatric surgery; however, no significant postsurgical improvement was observed for FEV1/FVC. |
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| AbstractList | The association between obesity and asthma is well-established. Some evidence suggests that weight loss may improve asthma outcomes; however, the effect of bariatric surgery on pulmonary function in asthmatic patients remains inconclusive. This systematic review and meta-analysis of observational studies assessed the impact of bariatric surgery on patients with asthma.BACKGROUNDThe association between obesity and asthma is well-established. Some evidence suggests that weight loss may improve asthma outcomes; however, the effect of bariatric surgery on pulmonary function in asthmatic patients remains inconclusive. This systematic review and meta-analysis of observational studies assessed the impact of bariatric surgery on patients with asthma.To investigate the effect of bariatric surgery on pulmonary function in patients with asthma.OBJECTIVESTo investigate the effect of bariatric surgery on pulmonary function in patients with asthma.Systematic review and meta-analysis of published studies.SETTINGSystematic review and meta-analysis of published studies.A comprehensive search of the MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials (CENTRAL) databases was conducted. The sole inclusion criterion was published studies that evaluated the effects of bariatric surgery on pulmonary function in asthmatic patients. The outcomes of interest were forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), and FEV1/FVC. A meta-analysis of studies comparing pre- and postsurgery spirometric measures, and of studies comparing surgery and control groups was performed.METHODSA comprehensive search of the MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials (CENTRAL) databases was conducted. The sole inclusion criterion was published studies that evaluated the effects of bariatric surgery on pulmonary function in asthmatic patients. The outcomes of interest were forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), and FEV1/FVC. A meta-analysis of studies comparing pre- and postsurgery spirometric measures, and of studies comparing surgery and control groups was performed.From 25 full-text articles, 6 observational studies met the inclusion criteria and were included in this meta-analysis based on the random-effects model. A significant increase in FEV1 and FVC was observed after bariatric surgery among studies without a control group (mean difference: .21 L, 95% confidence interval: .07-.35 for FEV1, and mean difference: .34 L, 95% confidence interval: .14-.53 for FVC). There was no significant change in FEV1/FVC after bariatric surgery compared with control.RESULTSFrom 25 full-text articles, 6 observational studies met the inclusion criteria and were included in this meta-analysis based on the random-effects model. A significant increase in FEV1 and FVC was observed after bariatric surgery among studies without a control group (mean difference: .21 L, 95% confidence interval: .07-.35 for FEV1, and mean difference: .34 L, 95% confidence interval: .14-.53 for FVC). There was no significant change in FEV1/FVC after bariatric surgery compared with control.FEV1 and FVC were both found to be significantly improved after bariatric surgery; however, no significant postsurgical improvement was observed for FEV1/FVC.CONCLUSIONSFEV1 and FVC were both found to be significantly improved after bariatric surgery; however, no significant postsurgical improvement was observed for FEV1/FVC. •The effect of bariatric surgery on pulmonary function in asthmatic patients is inconclusive. This systematic review and meta-analysis investigated the effect of bariatric surgery on pulmonary function (forced expiratory volume in one second (FEV1), forced vital capacity (FVC), and FEV1/FVC) in patients with asthma.•A statistically significant increase in FEV1 and FVC was observed after bariatric surgery.•No significant post-surgical improvement was observed for FEV1/FVC. The association between obesity and asthma is well-established. Some evidence suggests that weight loss may improve asthma outcomes; however, the effect of bariatric surgery on pulmonary function in asthmatic patients remains inconclusive. This systematic review and meta-analysis of observational studies assessed the impact of bariatric surgery on patients with asthma. To investigate the effect of bariatric surgery on pulmonary function in patients with asthma. Systematic review and meta-analysis of published studies. A comprehensive search of the MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials (CENTRAL) databases was conducted. The sole inclusion criterion was published studies that evaluated the effects of bariatric surgery on pulmonary function in asthmatic patients. The outcomes of interest were forced expiratory volume in 1 second (FEV1), forced vital capacity (FVC), and FEV1/FVC. A meta-analysis of studies comparing pre- and postsurgery spirometric measures, and of studies comparing surgery and control groups was performed. From 25 full-text articles, 6 observational studies met the inclusion criteria and were included in this meta-analysis based on the random-effects model. A significant increase in FEV1 and FVC was observed after bariatric surgery among studies without a control group (mean difference: .21 L, 95% confidence interval: .07–.35 for FEV1, and mean difference: .34 L, 95% confidence interval: .14–.53 for FVC). There was no significant change in FEV1/FVC after bariatric surgery compared with control. FEV1 and FVC were both found to be significantly improved after bariatric surgery; however, no significant postsurgical improvement was observed for FEV1/FVC. The association between obesity and asthma is well-established. Some evidence suggests that weight loss may improve asthma outcomes; however, the effect of bariatric surgery on pulmonary function in asthmatic patients remains inconclusive. This systematic review and meta-analysis of observational studies assessed the impact of bariatric surgery on patients with asthma. To investigate the effect of bariatric surgery on pulmonary function in patients with asthma. Systematic review and meta-analysis of published studies. A comprehensive search of the MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials (CENTRAL) databases was conducted. The sole inclusion criterion was published studies that evaluated the effects of bariatric surgery on pulmonary function in asthmatic patients. The outcomes of interest were forced expiratory volume in 1 second (FEV ), forced vital capacity (FVC), and FEV /FVC. A meta-analysis of studies comparing pre- and postsurgery spirometric measures, and of studies comparing surgery and control groups was performed. From 25 full-text articles, 6 observational studies met the inclusion criteria and were included in this meta-analysis based on the random-effects model. A significant increase in FEV and FVC was observed after bariatric surgery among studies without a control group (mean difference: .21 L, 95% confidence interval: .07-.35 for FEV , and mean difference: .34 L, 95% confidence interval: .14-.53 for FVC). There was no significant change in FEV /FVC after bariatric surgery compared with control. FEV and FVC were both found to be significantly improved after bariatric surgery; however, no significant postsurgical improvement was observed for FEV /FVC. |
| Author | Sanguankeo, Anawin Thavaraputta, Subhanudh Upala, Sikarin |
| Author_xml | – sequence: 1 givenname: Sikarin orcidid: 0000-0002-6047-5302 surname: Upala fullname: Upala, Sikarin organization: Department of Preventive and Social Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand – sequence: 2 givenname: Subhanudh orcidid: 0000-0001-7085-1167 surname: Thavaraputta fullname: Thavaraputta, Subhanudh organization: Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, Texas – sequence: 3 givenname: Anawin orcidid: 0000-0002-3662-4136 surname: Sanguankeo fullname: Sanguankeo, Anawin email: asangua1@jhmi.edu organization: Department of Preventive and Social Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/30709751$$D View this record in MEDLINE/PubMed |
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| Copyright | 2018 American Society for Bariatric Surgery Copyright © 2018 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved. |
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| Keywords | Systematic review Patients with asthma Effect Pulmonary function Bariatric surgery Meta-analysis |
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| SubjectTerms | Asthma - physiopathology Asthma - prevention & control Bariatric Surgery Effect Humans Meta-analysis Obesity, Morbid - complications Obesity, Morbid - surgery Patients with asthma Pulmonary function Respiratory Function Tests Systematic review Weight Loss |
| Title | Improvement in pulmonary function in asthmatic patients after bariatric surgery: a systematic review and meta-analysis |
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