{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T14:28:12Z","timestamp":1785421692282,"version":"3.56.0"},"reference-count":24,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T00:00:00Z","timestamp":1781049600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Inonu University","award":["4911"],"award-info":[{"award-number":["4911"]}]},{"award":["4911"],"award-info":[{"award-number":["4911"]}],"id":[{"id":"https:\/\/ror.org\/04asck240","id-type":"ROR","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Childhood obesity can cause changes in respiratory mechanics, particularly in the peripheral airways. This study aimed to evaluate impulse oscillometry (IOS) parameters in obese children and to investigate the relationship between small airway function and metabolic indicators. Methods: A total of 135 children and adolescents (56.3% female) were included in the study. Seventy participants were obese, and 65 were in the normal-weight control group. IOS parameters (R5, R20, R5\u2013R20, X5, X20, AX, Fres) were compared between the two groups. Obese participants were further divided into subgroups based on HOMA-IR levels, with and without metabolic disorders. The relationships between IOS parameters and body mass index z-score, HOMA-IR, and HbA1c were evaluated using correlation analysis. Results: The R5 value was significantly higher in the obese group compared to the control group (p = 0.01). The R20 parameter and R5\u2013R20 parameter were markedly increased in the obese group (p = 0.03 and p &lt; 0.001, respectively). The AX value was also significantly higher in the obese group (p = 0.02). No significant differences were found between the groups in terms of X5, X20, and Fres (p &gt; 0.05). In the metabolic sub-analysis of the obese group, IOS parameters did not differ according to metabolic status. However, a weak positive correlation was found between HOMA-IR and R5\u2013R20 (r = 0.257, p = 0.031) and AX (r = 0.290, p = 0.015). A moderate positive relationship was found between BMI z-score and R5\u2013R20 (r = 0.424, p &lt; 0.001) and AX (r = 0.383, p = 0.01). Conclusions: Small airway dysfunction was detected in obese children. The findings suggest that mechanical factors may be more dominant than metabolic factors in peripheral airway involvement.<\/jats:p>","DOI":"10.3390\/jcm15124480","type":"journal-article","created":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T06:33:44Z","timestamp":1781073224000},"page":"4480","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Impulse Oscillometry Reveals Predominantly Mechanical Drivers of Small Airway Dysfunction in Obese Children"],"prefix":"10.3390","volume":"15","author":[{"given":"Ercan","family":"Y\u0131lmaz","sequence":"first","affiliation":[{"name":"Department of Pediatric Allergy and Immunology, Faculty of Medicine, Inonu University, 44000 Malatya, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6910-5463","authenticated-orcid":false,"given":"Zeynep","family":"Yamancan Y\u0131lmaz","sequence":"additional","affiliation":[{"name":"Department of Pediatric Endocrinology, Faculty of Medicine, Inonu University, 44000 Malatya, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1468-6405","authenticated-orcid":false,"given":"\u0130smail","family":"D\u00fcndar","sequence":"additional","affiliation":[{"name":"Department of Pediatric Endocrinology, Faculty of Medicine, Inonu University, 44000 Malatya, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8144-4409","authenticated-orcid":false,"given":"Emine","family":"\u00c7amtosun","sequence":"additional","affiliation":[{"name":"Department of Pediatric Endocrinology, Faculty of Medicine, Inonu University, 44000 Malatya, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4439-2689","authenticated-orcid":false,"given":"Erdem","family":"Topal","sequence":"additional","affiliation":[{"name":"Department of Pediatric Allergy and Immunology, Faculty of Medicine, Inonu University, 44000 Malatya, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,6,10]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (2026, April 02). Obesity and Overweight. Available online: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/obesity-and-overweight."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1080\/17446651.2019.1635007","article-title":"Association of pediatric obesity and asthma, pulmonary physiology, metabolic dysregulation, and atopy; and the role of weight management","volume":"14","author":"De","year":"2019","journal-title":"Expert Rev. Endocrinol. Metab."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"494","DOI":"10.1016\/j.anai.2022.12.034","article-title":"In young children with asthma, obesity and uncontrolled disease are highly associated with peripheral airway impairment","volume":"130","author":"Galant","year":"2023","journal-title":"Ann. Allergy Asthma Immunol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1261","DOI":"10.1080\/17476348.2020.1813573","article-title":"Impulse oscillometry: Pulmonary function assessment in preschool children","volume":"14","author":"Medeiros","year":"2020","journal-title":"Expert Rev. Respir. Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1596","DOI":"10.1016\/j.jaip.2017.12.028","article-title":"Spirometry and Impulse Oscillometry in Preschool Children: Acceptability and Relationship to Maternal Smoking in Pregnancy","volume":"6","author":"Kattan","year":"2018","journal-title":"J. Allergy Clin. Immunol. Pract."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"206","DOI":"10.1152\/japplphysiol.00694.2009","article-title":"Physiology of obesity and effects on lung function","volume":"108","author":"Salome","year":"2010","journal-title":"J. Appl. Physiol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1038\/nri2921","article-title":"Adipokines in inflammation and metabolic disease","volume":"11","author":"Ouchi","year":"2011","journal-title":"Nat. Rev. Immunol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"319","DOI":"10.3345\/cep.2024.01053","article-title":"Impact of obesity on pulmonary function of preschool children: An impulse oscillometry study","volume":"68","author":"Klubdaeng","year":"2025","journal-title":"Clin. Exp. Pediatr."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"509","DOI":"10.1165\/rcmb.2011-0449OC","article-title":"High glucose enhances responsiveness of human airways smooth muscle via the Rho\/ROCK pathway","volume":"47","author":"Cazzola","year":"2012","journal-title":"Am. J. Respir. Cell Mol. Biol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1038\/sj.bjp.0706985","article-title":"Insulin induces airway smooth muscle contraction","volume":"150","author":"Schaafsma","year":"2007","journal-title":"Br. J. Pharmacol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"bnaa004","DOI":"10.1210\/endrev\/bnaa004","article-title":"Metabolically Healthy Obesity","volume":"41","year":"2020","journal-title":"Endocr. Rev."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1900753","DOI":"10.1183\/13993003.00753-2019","article-title":"Technical standards for respiratory oscillometry","volume":"55","author":"King","year":"2020","journal-title":"Eur. Respir. J."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"412","DOI":"10.1007\/BF00280883","article-title":"Homeostasis model assessment: Insulin resistance and beta-cell function from fasting plasma glucose and insulin concentrations in man","volume":"28","author":"Matthews","year":"1985","journal-title":"Diabetologia"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"S68","DOI":"10.2337\/dc23-S005","article-title":"5. Facilitating Positive Health Behaviors and Well-being to Improve Health Outcomes: Standards of Care in Diabetes-2023","volume":"46","author":"ElSayed","year":"2023","journal-title":"Diabetes Care"},{"key":"ref_15","first-page":"716","article-title":"Roles of circadian rhythmicity and sleep in human glucose regulation","volume":"18","author":"Polonsky","year":"1997","journal-title":"Endocr. Rev."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1111\/j.1440-1843.2011.02096.x","article-title":"Impact of obesity on respiratory function","volume":"17","author":"Littleton","year":"2012","journal-title":"Respirology"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1169","DOI":"10.1016\/j.jaci.2018.02.004","article-title":"Obesity and asthma","volume":"141","author":"Peters","year":"2018","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1097\/ACI.0000000000000339","article-title":"The effect of obesity, weight gain, and weight loss on asthma inception and control","volume":"17","author":"Forno","year":"2017","journal-title":"Curr. Opin. Allergy Clin. Immunol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"755","DOI":"10.1080\/17476348.2018.1506331","article-title":"The effect of obesity on lung function","volume":"12","author":"Dixon","year":"2018","journal-title":"Expert Rev. Respir. Med."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"570","DOI":"10.1016\/j.jaip.2017.07.010","article-title":"Overweight, Obesity, and Lung Function in Children and Adults-A Meta-analysis","volume":"6","author":"Forno","year":"2018","journal-title":"J. Allergy Clin. Immunol. Pract."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"671","DOI":"10.1016\/j.jaci.2011.11.002","article-title":"Relating small airways to asthma control by using impulse oscillometry in children","volume":"129","author":"Shi","year":"2012","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1087","DOI":"10.1016\/j.jaci.2008.03.004","article-title":"Obesity and asthma: Possible mechanisms","volume":"121","author":"Shore","year":"2008","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1111\/nyas.12357","article-title":"Linking obesity and asthma","volume":"1311","author":"Sutherland","year":"2014","journal-title":"Ann. N. Y. Acad. Sci."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1525","DOI":"10.1016\/j.chest.2015.12.034","article-title":"Metabolic Syndrome and the Lung","volume":"149","author":"Baffi","year":"2016","journal-title":"Chest"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/12\/4480\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,13]],"date-time":"2026-06-13T04:30:17Z","timestamp":1781325017000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/12\/4480"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,10]]},"references-count":24,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2026,6]]}},"alternative-id":["jcm15124480"],"URL":"https:\/\/doi.org\/10.3390\/jcm15124480","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,10]]}}}