Obesity the Enemy of Lung Function

Obesity and Chronic Respiratory Diseases in Children: Recent Advances and Clinical Implications (D87)

1:30-3:30 p.m. Wednesday

Ballroom B (South Building, Level 3), Walter E. Washington Convention Center

Obesity is an epidemic that is tied to a variety of health conditions, but evidence is mounting that it may be linked to changes in lung function, asthma, and sleep. A conversation about obesity last year led several pediatric physicians to develop an ATS 2017 session to examine those links.

“We wanted to include how obesity affects chronic respiratory diseases in children and adolescents, and to try to get to some of the basic mechanisms of how this relationship happens. That is why we decided to strike a balance between basic science and clinical science,” says Erick Forno, MD, MPH, one of the moderators of the symposium developed as a result of that conversation.

Erick Forno, MD, MPH

A starting point for exploring the role of obesity is how it affects lung function in general because some studies show that obesity can affect non-asthmatic children and adolescents.

“We will have talks that are important for clinicians in terms of diagnosis and management of their patients. We will also have talks about the underlying mechanisms by which obesity affects lung disease,” says Dr. Forno, an assistant professor of pediatrics at the University of Pittsburgh. One presentation will examine gene expression and gene regulation that may affect cells in the airways and inside the lungs.

Two related talks at the symposium will focus on sleep disorders. One presentation will explore how obesity affects sleep and obstructive sleep apnea, and the complications it can lead to. The second talk will examine how to manage children who have obesity and sleep disorders, including their transition to adulthood.

“Oftentimes, these children don’t have many complications initially, but as they become adults they start to have metabolic and other complications,” Dr. Forno says.

The final topic of discussion will evaluate how the microbiome affects health and disease, and how it is linked to obesity.

“There are studies that show that asthma may be related to changes in the microbiome,” Dr. Forno says. “One of the theories of why obesity and asthma are related is not that asthma is always a consequence of obesity, but that both may be consequences of something that happens earlier. The final lecture is about how changes in the bacterial composition in our bodies may link obesity and lung disease.”

A concluding presentation will summarize the earlier presentations to raise questions and ask how those questions could be answered by future research.

“Within each topic, we will talk about research advances, but also about what the clinical implications are,” Dr. Forno says. “There is still much work to be done in terms of obesity and pediatric chronic lung diseases. Along with understanding the causes and mechanisms, we must focus on what it means for clinical management and how to improve our management of these patients. The implication is, if we have a patient who is obese and has lung disease, we need make sure that we pay attention to their obesity as well.”

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