DOSE-RESPONSE RELATIONSHIP AND IRREVERSIBLE OBSTRUCTIVE VENTILATORY DEFECT IN PATIENTS WITH CONSUMPTION OF SAUROPUS-ANDROGYNUS

Study objectives: To determine the dose-response aspect of pulmonary f unction impairment in patients with consumption of Sauropus androgynus for weight reduction. Methods: A questionnaire and pulmonary function tests were performed in 194 patients with a history of consumption of S androgynus with or without chest symptoms. Patients with obstructiv e ventilatory defect received follow-up spirometry 22 to 24 months aft er beginning consumption of the vegetable. Results: Data from 178 pati ents were analysed. Patients generally consumed 150 g of S androgynus daily as raw juice (60.7%), sauteed (16.9%), mixed preparation (20.8%) , or boiled (1.7%) for various periods of time. We divided patients in to five groups according to the total dose consumed (group A, 0 to 1,7 99 g; group B, 1,800 to 3,599 g; group C, 3,600 to 5,399 g; group D, 5 ,400 to 7,199 g; and group E, greater than or equal to 7,200 g). The f requency of obstructive ventilatory defect was higher in the high-dose group than in the low-dose group (A, 4/43=9.3%; B, 13/64=20.3%; C, 14 /32=43.8%; D, 5/12=41.7%; and E, 13/27=48.1%; p<0.01). In total, 49 pa tients (27.5%) had moderate to severe obstructive ventilatory defects without bronchodilator response. The FEV1 and FEV1 percent predicted i n these 49 patients were 0.96+/-0.38 L (mean+/-SD) and 41.8+/-16.9%, r espectively. Sixty-five percent of these 49 patients began to suffer f rom dyspnea in the third, fourth, or fifth month after taking the vege table and no patient began to develop dyspnea later than 7 months afte r beginning consumption of the vegetable. Using stepwise multiple regr ession, we found that the FEV1 percent predicted was negatively associ ated with the total dose ingested (r=0.24, p<0.01). Follow-up spiromet ry showed that the obstructive ventilatory defect was irreversible in all patients. Conclusions: Consumption of S androgynus can result in m oderate to severe obstructive ventilatory defect within 7 months, and the disorder was irreversible in the observation period for 22 months.