Long-term prognosis of new adult-onset asthma in obese patients

Ilmarinen, Pinja; Pardo, Adrienn; Tuomisto, Leena E.; Vähätalo, Iida; Niemelä, Onni; Nieminen, Pentti; Kankaanranta, Hannu

doi:10.1183/13993003.01209-2020

Cited by 21 publications

(18 citation statements)

References 45 publications

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“…Previous studies show worse respiratory symptoms in multimorbid asthma patients. We show patients with MetS tend to experience worsened FEV1%, while asthma control and GINA classification tends to be comparable between MetS+ and MetS-patients [34]. No correlations were seen between adipose tissue derived inflammatory markers and asthma control or FEV1%.…”

Section: Discussionmentioning

confidence: 63%

Adult but not childhood onset asthma is associated with the metabolic syndrome, independent from body mass index

Boer

Tramper-Stranders

Houweling

et al. 2021

Respiratory Medicine

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Adult-onset asthma (AOA) is usually more severe compared to childhood onset asthma (CoA). Given the increasing evidence that AoA is associated with obesity, we investigated the relationship of other related metabolic comorbid conditions with AoA compared to CoA. Study design and methods: This cross-sectional study compared the metabolic syndrome and lipid derived inflammatory markers in patients with AoA, CoA and age-and sex-matched control subjects without asthma. Participants were asthma patients visiting the outpatient clinic of two teaching hospitals in Rotterdam, The Netherlands. All participants underwent lung function tests, blood tests and physical activity tracking. AoA was defined as asthma age of onset after the age of 18 years. Metabolic syndrome was defined according to the international joint interim statement criteria.Results: Eighty-one participants were included (27 AoA, 25 CoA, 29 controls). AoA was associated with the metabolic syndrome (Odds Ratio = 3.64 95% ) p = 0.03, Nagelkerke R 2 = 0.26), adjusted for age, sex, body mass index and smoking habits. AoA patients had higher median serum IL-6 and leptin-adiponectin (LA) ratio compared to controls (IL-6 (pg/mL): 3.10 [1.11-4.30] vs. 1.13 [0.72-1.58], p = 0.002 and LA ratio (pg/mL): 6.21 [2.45-14.11] vs. 2.24 [0.67-4.71], p = 0.0390). This was not observed in CoA and controls. Conclusion: AoA was associated with the metabolic syndrome and its related pro-inflammatory endocrine and cytokine status. This may suggest adipose tissue derived inflammatory markers play a role in the pathophysiology of AoA.

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Section: Discussionmentioning

confidence: 63%

Adult but not childhood onset asthma is associated with the metabolic syndrome, independent from body mass index

Boer

Tramper-Stranders

Houweling

et al. 2021

Respiratory Medicine

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“… 28 , 39 , 41 Furthermore, Ilmarinen et al reported that obese LOA patients experienced more exacerbations and respiratory-related hospital admissions compared to normal-weight patients during 12-year follow-up. 42 In the Severe Asthma Research Program, obese patients with LOA showed increased respiratory symptoms, reduced lung function, lower IgE levels, and reduced fractional exhaled nitric oxide. 43 Smoking has also been indicated to be correlated to LOA.…”

Section: Clinical Characteristics and Risk Factors Of Loamentioning

confidence: 99%

Revisiting Late-Onset Asthma: Clinical Characteristics and Association with Allergy

Quirce¹,

Heffler²,

Nenasheva³

et al. 2020

JAA

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The Global Initiative for Asthma (GINA) 2020 defines late-onset asthma (LOA) as one of the clinical phenotypes of asthma wherein patients, particularly women, present with asthma for the first time in adult life, tend to be non-allergic and often require higher doses of inhaled corticosteroids (ICS) or are relatively refractory to corticosteroid treatment. In this review, we examine the published literature improve the understanding of the following aspects of LOA: 1) the age cut-off for its diagnosis; 2) its distinct clinical phenotypes, characteristics and risk factors; and 3) its association with allergic comorbidities and conditions. Overall, our review reveals that clinicians and researchers have used multiple age cut-offs to define LOA, with cut-off ages ranging from >12 years to ≥65 years. LOA has also been classified into several distinct phenotypes, some of which drastically differ in their clinical characteristics, course and prognosis. Although LOA has traditionally been considered non-allergic in nature, our review indicates that it is commonly associated with allergic features and comorbidities. Our findings suggest that there is an urgent need for the development of more clear clinical practice guidelines that can provide more clarity on the definition and other aspects of LOA. In addition, the association of LOA and allergy needs to be re-examined to frame a more optimal treatment strategy for patients with LOA.

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“…Asthma treatment response has been shown to vary depending on the underlying asthma phenotypes and should ideally be tailored based on clinical and molecular traits 1,16 . Despite the available pharmacological therapies, obese asthma patients often remain symptomatic, with more exacerbations and hospitalizations, although these results are less clear regarding overweight asthma patients [17][18][19] . Overweight and obese subjects with asthma are more commonly resistant to the standard treatment with inhaled corticosteroids (ICS), likely related to frequent lack of the eosinophilic airway inflammation and also to dysregulation of some metabolic signaling pathways [20][21][22] .…”

Section: Introductionmentioning

confidence: 99%

Body mass index increase: a risk factor for forced expiratory volume in 1 s decline for overweight and obese adults with asthma

et al. 2022

Self Cite

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Background: With increasing prevalence of overweight and obesity, it is important to study how BMI change may affect lung function among subjects with asthma. There are few prospective studies on this topic, especially with separate analyses of those with normal and high BMI.Aim: To prospectively study the association between annual BMI change and annual lung function decline, separately among those with normal initial BMI and overweight/obesity, in an adult asthma cohort.Methods: A population-based adult asthma cohort was examined at study entry between 1986–2001 and at follow-up between 2012–2014 (n=945). Annual BMI change was analysed in association to annual decline in FEV1, FVC and FEV1/FVC separately in those with normal weight (BMI=18.5–24.9) and overweight/obesity (BMI≥25) at study entry. Regression models were used to adjust for sex, age, smoking, ICS use and occupational exposure to gas, dust, or fumes.Results: Subjects with overweight/obesity had lower FEV1 and FVC but slower annual FEV1 and FVC decline compared to those with normal weight. After adjustment through regression modelling, the association between BMI change with FEV1 and FVC decline remained significant for both BMI groups, but with stronger associations among the overweight/obese (FEV1 B[Overweight/obese]=−25 ml versus B[normal weight]=−15 ml). However, when including only those with BMI increase during follow-up, the associations remained significant among those with overweight/obesity, but not in the normal weight group. No associations were seen for FEV1/FVC.Conclusions: BMI increase is associated with faster FEV1 and FVC decline among overweight and obese adults with asthma in comparison with their normal weight counterparts.

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Long-term prognosis of new adult-onset asthma in obese patients

Cited by 21 publications

References 45 publications

Adult but not childhood onset asthma is associated with the metabolic syndrome, independent from body mass index

Adult but not childhood onset asthma is associated with the metabolic syndrome, independent from body mass index

Revisiting Late-Onset Asthma: Clinical Characteristics and Association with Allergy

Body mass index increase: a risk factor for forced expiratory volume in 1 s decline for overweight and obese adults with asthma

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