BACKGROUND: Asthma and obesity are associated disorders, but the contribution of obesity to difficult-to-treat asthma as well as the mechanisms responsible for this relationship are unclear. The aim of this study was to investigate the relationship between obesity (body mass index >/= 30) and factors related with asthma severity in patients with difficult-to-treat asthma. METHODS: One hundred and thirty-six nonsmoking asthmatic adults with persistent symptoms despite high doses of inhaled or oral corticosteroids and long-acting bronchodilators were studied [70% female, median (range) age 44.6 (18-75) years, 32% on daily oral corticosteroids]. The association between obesity, lung function parameters [forced expiratory volume in 1 s (FEV(1)), functional residual capacity/total lung capacity (FRC/TLC)], inflammatory markers [blood eosinophils, sputum eosinophils and neutrophils, exhaled nitric oxide (FE(NO)), airway hyperresponsiveness, C-reactive protein (CRP)] and aggravating co-morbid factors (severe chronic sinus disease, gastro-esophageal reflux, recurrent respiratory infections, psychopathology and obstructive sleep apnea) was investigated. RESULTS: Obese patients (n = 29) had a higher FEV(1)%pred (P = 0.05) and a lower FRC/TLC%pred (P < 0.01) compared with nonobese patients (n = 107). Body mass index was inversely related with sputum eosinophils (r = -0.36, P < 0.01) and FE(NO) (r = -0.30, P < 0.01). Obese patients had an increased risk for gastro-esophageal reflux (OR = 2.3) and sleep apnea (OR = 3.1). CONCLUSION: Obesity in patients with difficult-to-treat asthma is inversely related with sputum eosinophils and FE(NO), and positively associated with the presence of co-morbid factors and reduced lung volumes. This suggests that other factors than airway inflammation alone explain the relationship between obesity and asthma severity.
BACKGROUND:Asthma and obesity are associated disorders, but the contribution of obesity to difficult-to-treat asthma as well as the mechanisms responsible for this relationship are unclear. The aim of this study was to investigate the relationship between obesity (body mass index >/= 30) and factors related with asthma severity in patients with difficult-to-treat asthma. METHODS: One hundred and thirty-six nonsmoking asthmatic adults with persistent symptoms despite high doses of inhaled or oral corticosteroids and long-acting bronchodilators were studied [70% female, median (range) age 44.6 (18-75) years, 32% on daily oral corticosteroids]. The association between obesity, lung function parameters [forced expiratory volume in 1 s (FEV(1)), functional residual capacity/total lung capacity (FRC/TLC)], inflammatory markers [blood eosinophils, sputum eosinophils and neutrophils, exhaled nitric oxide (FE(NO)), airway hyperresponsiveness, C-reactive protein (CRP)] and aggravating co-morbid factors (severe chronic sinus disease, gastro-esophageal reflux, recurrent respiratory infections, psychopathology and obstructive sleep apnea) was investigated. RESULTS:Obesepatients (n = 29) had a higher FEV(1)%pred (P = 0.05) and a lower FRC/TLC%pred (P < 0.01) compared with nonobese patients (n = 107). Body mass index was inversely related with sputum eosinophils (r = -0.36, P < 0.01) and FE(NO) (r = -0.30, P < 0.01). Obesepatients had an increased risk for gastro-esophageal reflux (OR = 2.3) and sleep apnea (OR = 3.1). CONCLUSION:Obesity in patients with difficult-to-treat asthma is inversely related with sputum eosinophils and FE(NO), and positively associated with the presence of co-morbid factors and reduced lung volumes. This suggests that other factors than airway inflammation alone explain the relationship between obesity and asthma severity.
Authors: Mihaela Teodorescu; Oleg Broytman; Douglas Curran-Everett; Ronald L Sorkness; Gina Crisafi; Eugene R Bleecker; Serpil Erzurum; Benjamin M Gaston; Sally E Wenzel; Nizar N Jarjour Journal: J Allergy Clin Immunol Pract Date: 2015-05-21
Authors: Anne E Dixon; Scott E Johnson; Laurianne V Griffes; Danielle M Raymond; Ramona Ramdeo; Avigail Soloveichik; Benjamin T Suratt; Rubin I Cohen Journal: J Asthma Date: 2011-10 Impact factor: 2.515
Authors: Njira Lugogo; Dave Francisco; Kenneth J Addison; Akarsh Manne; William Pederson; Jennifer L Ingram; Cynthia L Green; Benjamin T Suratt; James J Lee; Mary E Sunday; Monica Kraft; Julie G Ledford Journal: J Allergy Clin Immunol Date: 2017-06-15 Impact factor: 10.793
Authors: L M Campana; A Malhotra; B Suki; L Hess; E Israel; E Smales; P Deyoung; R L Owens Journal: Respir Physiol Neurobiol Date: 2012-10-02 Impact factor: 1.931