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							Marywood University Human Physiology Laboratory
Academic Research Enhancement Award (AREA) R15—Resubmission

Funder: National Institutes of Health (NIH)
PI: Dr. Gerald Zavorsky
Request: $403,555

This proposal is in response to the program announcement PA-10-070 to encourage research scientists to apply for an
Academic Research Enhancement Award (Parent R15) that have not been a major recipient of NIH support. This proposal
will include undergraduate and graduate student training as highly qualified personnel in the area of obesity, exercise and
weight loss, and its effects on lung function. This proposal specifically addresses morbidly obese individuals (Body mass
index ≥ 40 kg/m2) who are undergoing bariatric surgery to lose weight.
The short-term objective is to conduct a battery of lung function tests in morbidly obese subjects prior to bariatric (weight
loss) surgery. The long-term objective of this program is to demonstrate that one of these lung function parameters
predicts cardiorespiratory fitness, and then from that determine how will that parameter predicts post surgical
complications. Should these objectives be achieved, this program could be prescribed to obese subjects to perform pre-
surgical exercise before surgery without the need for exercise testing to determine fitness levels

The first specific aim of this study is to determine which lung function parameter best predicts cardio-respiratory fitness in
morbidly obese subjects. Based on published data obtained by the principal investigator (Zavorsky), pulmonary diffusing
capacity for nitric oxide (DLNO) is a good indicator of cardiorespiratory fitness; however, what remains to be seen is if
any other lung function parameter (spirometry, lung volumes, exhaled nitric oxide, maximal inspiratory or expiratory
pressures) could also predict cardiorespiratory fitness. The hypothesis is that DLNO will be the best parameter that
predicts cardiorespiratory fitness in the morbidly obese. Once that lung function parameter is determined, then the sub-
specific aim is see how well that parameter predicts post-surgical complications. The hypothesis is that DLNO will predict
post-surgical complications with a sensitivity of 70% (DLNO would catch 70% of the morbidly obese tested to have post
surgical complications) and a specificity of 80% (DLNO would only falsely predict 20% of the morbidly obese as getting
post-surgical complications when they in fact, they will not have any complications).

The second specific aim is to determine the extent of increase in cardiorespiratory fitness from a pre-surgical supervised 4
week aerobic interval training program given to morbidly obese subjects. The hypothesis is that interval training is
feasible, time efficient and potent such that cardiorespiratory fitness (peak oxygen uptake in L/min) will improve by 15%
(~300 ml/min) compared to a non-exercising (control) group. If cardiorespiratory fitness improves then the next
hypothesis is that the lung function parameter that best predicts fitness (i.e. DLNO) will also improve to the same extent.