Overweight is Associated with Airflow Obstruction and Poor Disease Control but Not with Exhaled Nitric Oxide Change in an Asthmatic Population

Abstract

Background: The role of an elevated body mass index (BMI) in asthma remains controversial. Objectives: To investigate the relationship between overweight (BMI >25 and ≤30), lung function, disease control, and airway inflammation in an asthmatic population. Methods: We consecutively studied 348 patients (age 43 ± 16 years; 211 females). In all patients, BMI, spirometry, the Asthma Control Test (ACT), and fractional exhaled nitric oxide (FeNO; ppb) were measured. Results: One hundred forty-five patients were overweight and, as compared to those with normal BMI, had lower values of FVC, FEV₁, and FEV₁/FVC and of FEF_25–75 even when normalized for FVC (p < 0.05 for each comparison). The ratio between the number of patients with well-controlled asthma (ACT ≥20) and that of patients with poorly controlled asthma (ACT < 20) was significantly lower in overweight patients (1.07 vs. 1.84; χ² = 6.030, p < 0.01). In overweight patients, the odds ratio of uncontrolled asthma expressed by logistic regression analysis was 1.632 (95% CI = 1.043–2.553), independently of gender, atopy, smoking habit, and inhaled steroid therapy. No difference was observed in FeNO values between overweight and normal weight patients (27.7 ± 2.3 vs. 27.9 ± 2.2 ppb). Conclusions: Our results show that, in an asthmatic population, overweight is associated with airflow obstruction and poor disease control but not with FeNO change. The findings of the present study support the view that other factors besides airway inflammation alone may explain the relationship between asthma and an elevated BMI.

Body Mass Index and Comorbidities in Adult Severe Asthmatics

“…To reinforce this message, we also found that the ACQ score and the number of asthma exacerbation episodes during the last year are significantly higher in obese severe asthmatics in comparison to the other two studied groups, leading to the concept that the severe asthmatic patient with lower BMI is better “controlled” and has a lower frequency of exacerbations in comparison with the severe asthmatic patient with higher BMI. These results are in agreement with previous studies showing that overweight patients with asthma had worse disease control as compared with normal weight patients [25] and that obesity was associated with poorer asthma control as expressed by recurrent episodes of exercise-related respiratory symptoms [26]. In addition, in our study we found that the dose of corticosteroids required during the last year and LABA treatments are significantly higher in the group of severe obese asthmatic patients, strongly supporting the concept of the refractoriness to corticosteroids in severe asthma.…”

Body mass index, asthma and exhaled nitric oxide in U.S. Adults, 2007–2010

“…Two of them reported results for persons with asthma, with one finding no association [14] and the other a negative association [15]. Several other more recent studies have issued similarly inconsistent findings [18][19][20].…”

Relação Entre O Nível De Adiponectina Com Medidas Antropométricas E Respiratórias De Pacientes Submetidos À Cirurgia De Revascularização Miocárdica.

“…The classification of the BMI was not a determinant factor for the occurrence of changes in the values of FEV1 and PEF. However, showed that there was no significant difference between the values obtained and provided to the respiratory measures between the eutrophic and obese groups 2,8 .…”

“…Endocrine disorders in individuals with excess weight have been associated with the accumulation of adipose tissue, the latter being responsible for the production of hormones adipokines 2 . The leptin and adiponectin are two important adipokines that are influenced by the elevation of Body Mass Index (BMI) and can be changed in the presence of pulmonary disease 3 .…”

“…These changes in the balance of adipocitocin is a strategic component of the pathogenic metabolism, immune responses, and the lipid metabolism. These are related to cardiovascular diseases 2,5,6 .…”