Objective To explore the correlation between pulmonary ventilation function and glycated hemoglobin (HbA1c) in obese children, in order to provide a new perspective for the comprehensive management of obese children. Methods A total of 255 obese children who visited the pediatric outpatient clinic of Beijing Jishuitan Hospital from January 2019 to December 2022 were included. Height, weight, serum HbA1c levels, and pulmonary ventilation function were measured. HbA1c levels were divided into three groups (Q1, Q2, Q3) based on tertiles. Pulmonary function indicators were compared among the different HbA1c groups. Multiple linear regression analysis was used to construct a model for the relationship between HbA1c and pulmonary function indicators. Receiver operating characteristic (ROC) curves were plotted to evaluate the predictive value of the model for changes in pulmonary function. Results Among the participants, 142 cases (55.69%) were in the mild-to-moderate obesity group, and 113 cases (44.31%) were in the severe obesity group. The forced vital capacity (FVC) in the mild-to-moderate obesity group was significantly lower than that in the severe obesity group (t=2.541, P=0.012), while the FEV1/FVC ratio, FEV1/FVC%, and expiratory flow at 50% of vital capacity (FEF50) were higher in the mild-to-moderate obesity group (t=2.277, 2.215, 2.075, P＜0.05). HbA1c levels were lower in the mild-to-moderate obesity group compared to the severe obesity group (t=3.097, P<0.05). Significant differences were observed in FEV1/FVC, FEV1/FVC%, FEF25, FEF50, FEF75, and maximal mid-expiratory flow (MMEF) among the different HbA1c groups (F=7.813, 7.804, 6.493, 8.209, 6.193, 6.855, P<0.01). All pulmonary function indicators in the Q1 group were superior to those in the Q2 and Q3 groups (P<0.05). Multiple linear regression analysis showed that HbA1c in obese children was negatively correlated with pulmonary function indicators FEF25, FEF50, FEF75, and MMEF (β=-0.186,-0.201,-0.148,-0.182, P<0.05). ROC curve analysis indicated that when HbA1c levels in obese children were ≥5.8%, pulmonary function indicators might be significantly affected. Conclusions Severe obesity in children is associated with higher serum HbA1c levels. HbA1c in obese children is linearly and negatively correlated with multiple pulmonary function indicators, and elevated HbA1c levels may lead to impaired small airway function. The multiple regression model of HbA1c and pulmonary function indicators demonstrates good predictive performance for assessing changes in pulmonary function in obese children.
Key words
obesity /
pulmonary function /
glycosylated hemoglobin /
children
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