Lung clearance index: A sensitive measure of airway function improvement in adolescents after weight loss from bariatric surgery

Patrick Stafler, Benjamin Rothschild, Yulia Gendler, Emmanuelle Seguier-Lipszyc, Simona Tyroler, Orith Waisbourd-Zinman, Meir Mei-Zahav, Dario Prais, Vered Shkalim Zemer

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Morbid obesity in adolescents impacts respiratory function, often leading to reduced lung volume and obstructive ventilatory defects. However, standard spirometric values frequently remain within normal ranges. Objectives: We hypothesized that Lung Clearance Index (LCI) is a more sensitive marker for detecting airway dysfunction in adolescents with morbid obesity than conventional lung function tests. Methods: A prospective single-center cohort study evaluated adolescents with morbid obesity undergoing laparoscopic sleeve gastrectomy (LSG). Assessments included fractional exhaled nitric oxide, multiple breath washout, spirometry, plethysmography, diffusion capacity, and a 6-min walk test, conducted pre- and post-surgery. Results: Seventeen adolescents (mean age 17.1 years, BMI 45.5 kg/m2) were studied. Pre-surgery, LCI was slightly elevated (mean 7, SD ± 0.7), other lung function measures were normal. LCI correlated with BMI (r = 0.637, p = 0.014), no correlation was found between FEV1 and BMI (r = −0.083, p = 0.752). Post-surgery, mean LCI fell from 7 (±0.7) to 6.5 (±0.7), p = 0.009. The pre-operatively observed correlation between LCI and BMI was no longer present post-operatively (r = 0.362, p = 0.225). LCI changes (r = 0.676, p = 0.011) correlated with BMI changes, whilst FEV1 did not (r = 0.160, p = 0.540). Conclusions: LCI appeared to be a more sensitive marker than conventional spirometry for detecting airway dysfunction in adolescents with morbid obesity. Significant post-surgery improvements suggested enhanced ventilation homogeneity. LCI may detect subtle airway changes in this population, and be potentially valuable for both clinical assessment and research.

Original languageEnglish
Article number107950
JournalRespiratory Medicine
Volume237
DOIs
StatePublished - Feb 2025

Keywords

  • Laparoscopic sleeve gastrectomy
  • Lung clearance index
  • Lung function
  • Morbid obesity
  • Multiple breath washout
  • adolescents
  • bariatric surgery

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