Obesity – a risk factor for asthma, but not for atopic dermatitis, allergic rhinitis and sensitization

Abstract

Objective: To analyse the relationship between obesity and overweight and the prevalence of allergic diseases and sensitization, and the impact of gender and place of residence. Design: Questionnaire based on those used in ISAAC (International Study of Asthma and Allergies in Childhood) and ECRHS (European Community Respiratory Health Survey). Setting: Our study involved populations of the eight largest cities and one rural region in Poland (each with over 150 000 inhabitants). Subjects: The study included 18 617 participants (24·2 % aged 6-7 years, 25·4 % aged 13-14 years, 50·4 % adults aged 20-44 years) in eight cities and one rural area. The out-patient study involved 4783 patients (25·7 %); we performed skin prick testing with fifteen aeroallergens. Results: Overweight was found in 16·13 % of participants (9·11 % of 6-7-year-olds, 4·90 % of 13-14-year-olds and 25·61 % of adults), obesity in 6·41 % (7·16 %, 2·45 % and 8·36 %, respectively). In adults, overweight (OR = 1·34) and obesity (OR = 1·80) increased the prevalence of asthma, especially in women (OR = 1·53, OR = 2·01). Among 13-14-year-olds the prevalence was higher only in the obese (OR = 1·76). Overweight (OR = 1·99) and obesity (OR = 2·17) affected the incidence of doctordiagnosed asthma in 6-7-year-olds. Overweight (OR = 0·81) and obesity (OR = 0·76) reduced the prevalence of allergic rhinitis in men. There was no relationship between BMI and asthma in people from rural areas. Obesity and overweight did not affect the frequency of sensitization to aeroallergens. Conclusions: Overweight and obesity increased the prevalence of symptomatic asthma in adults, especially in women. In 13-14-year-olds, only obesity increased the prevalence of asthma. In children, overweight was associated with increased prevalence of clinically diagnosed and declared asthma and a trend towards atopy. Higher BMI was negatively associated with the prevalence of allergic rhinitis in overweight and obese man. There was no correlation between BMI and sensitization to aeroallergens.

An Italian multicentre study on adult atopic dermatitis: persistent versus adult-onset disease

“…Conversely, obesity was very uncommon, being found in only 4/253 (1.6%) of subjects. This finding did not confirm the previous studies which showed that obesity was associated with AD in adults [25,37], supporting the results of Sybilski et al which reported obesity as a risk factor for asthma but not for AD in a cohort of 18,617 subjects [30]. Further studies are needed to deeply clarify this relationship, since obesity was related to AD in adult women, but not in men [15].…”

Association of atopic dermatitis with being overweight and obese: A systematic review and metaanalysis

“…86 Future studies are needed to better elucidate the role of these factors in the association between obesity and AD. Finally, only 4 of 28 studies analyzed did not rely on self-or parent-reported AD/ eczema; 3 used the Hanifin and Rajka criteria and 1 required at least 1 positive allergen-specific immunoglobulin E. 26,55,64,68 The use of questionnaires introduces potential recall and misclassification bias, because AD may clinically mimic other eczematous processes, such as contact and nummular dermatitis. Nevertheless, the ISAAC questionnaire used in most of the self-reported studies has been validated and used widely in epidemiologic studies regarding allergy in children.…”

“…After review of the titles and abstracts, 536 articles did not meet our inclusion criteria, and 12 were excluded 31-42 for a lack of data for the frequency of AD/eczema or BMI classification. In total, 30 studies 26,33, were included in the review, of which 20 had valid data that could be pooled to assess for the effects of overweight, 26,43,47,50,[53][54][55][56][57][59][60][61][62][63][64][65][66][67][68][69] 23 for obesity, 26,33,43,45,47,50,[52][53][54][55][56][57][59][60][61][62][63][64][65][66][67][68][69] and 26 for overweight/obesity. 26,43,44,[46]…”

Obesity and rhinitis in a nationwide study of children and adults in the United States

“…Studies of overweight or obesity and allergic rhinitis have predominantly included children and have yielded conflicting results 14–22 . Whereas some studies reported that neither overweight nor obesity was associated with symptoms suggestive of allergic rhinitis in children 19 , others have shown a positive association between obesity and allergic rhinitis in children and young adults 20–22 , with yet a few others showing an negative (inverse) association in school-aged children 14 and adult men 17 . Of interest, some studies have shown that obesity is only associated with an increased risk of allergic rhinitis in female subjects, raising the question of whether hormonal surges around puberty predispose adolescent girls to allergic sensitization and allergic rhinitis 20, 23 .…”