Interacting effects of obesity, race, ethnicity and sex on the incidence and control of adult-onset asthma

Abstract

BackgroundTo improve care and control for patients with adult-onset asthma, a better understanding of determinants of their risk and outcomes is important. We investigated how associations between asthma, asthma control and obesity may be modified by patient demographic characteristics.MethodsThis retrospective study of adults enrolled in several health plans across the U.S. (n = 2,860,305) examined the interacting effects of obesity, age, race, and sex on adult-onset asthma and asthma control. Multivariable adjusted Cox and logistic regression models estimated hazard ratios (HR), and 95 % confidence intervals (CI) for the associations between body mass index (BMI) and study outcomes, and interactions of BMI with demographic characteristics.ResultsCompared with individuals who had a BMI <25 kg/m2, the hazard of adult-onset asthma progressively increased with increasing BMI, from a 12 % increase among persons with a BMI of 25.0–29.9 kg/m2 (HR 1.12, 95 % CI 1.10, 1.14) to an almost 250 % increase among persons with a BMI ≥50 kg/m2 (HR 2.49, 95 % CI 2.38, 2.60). The magnitude of the association between obesity and asthma risk was greater for women (compared with men) and lower for Blacks (compared with non-Hispanic Whites). Among individuals with asthma, obesity was associated with poorly controlled and high-risk asthma.ConclusionsThe present study demonstrates that the magnitude of the associations between obesity and adult-onset asthma incidence and control are modified by race, age, and sex. Understanding the role of obesity in the development of adult-onset asthma will help to improve asthma treatment algorithms and to develop targeted interventions.

Relationship between the Use of Parabens and Allergic Diseases in Japanese Adults—A Cross-Sectional Study

“…However, intriguingly, logistic regression analysis demonstrated a significant positive relationship. Previous studies reported that one of the important risk factors for asthma in women is being overweight or obese [21][22][23][24][25]. Furthermore, smoking contributes to the development of asthma in men and women [26,27].…”

Obesity and Asthma: Key Clinical Questions

“…Various biological and nonbiological mechanisms have been proposed to explain the relationship between obesity and poor asthma control. These include decreased response to corticosteroids, the effect of some immunomodulatory adipokines, the change in pulmonary dynamics, low levels of vitamin D, and obesity-related comorbidities such as gastroesophageal reflux and depression [46,60,61]. Gastroesophageal reflux is also a common comorbidity in obese children and is responsible for worse asthma control [36].…”

Clinical features of obesity in children with bronchial asthma

“…В отдель-ных работах та же тенденция отмечена у мальчиков, больных бронхиальной астмой [26]. У взрослых паци-ентов ожирение встречается чаще у женщин с бронхи-альной астмой, чем у мужчин [27][28][29].…”