Potential mechanisms connecting asthma, esophageal reflux, and obesity/sleep apnea complex—A hypothetical review

Kasasbeh, Aiman; Kasasbeh, Ehab; Krishnaswamy, Guha

doi:10.1016/j.smrv.2006.05.001

Cited by 63 publications

(36 citation statements)

References 76 publications

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“…Obesity has also been suggested to increase the risk of asthma through comorbidities [32], for example, GORD and SDB are important risk factors for asthma in obese people. We did not have measures of GORD and SDB in our data but previous studies suggested that GORD and SDB may be on the causative pathway between obesity and asthma [31,37]. In addition, because of the age limit (,65 yrs) set in our study, we need to be cautious when generalising these results.…”

Section: Discussionmentioning

confidence: 95%

General and abdominal obesity and incident asthma in adults: the HUNT study

et al. 2012

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Measures of body mass index (BMI) and waist circumference define general obesity and abdominal obesity respectively. While high BMI has been established as a risk factor for asthma in adults, waist circumference has seldom been investigated.To determine the association between BMI, waist circumference and incident asthma in adults, we conducted a prospective study (n523,245) in a population living in Nord-Trøndelag, Norway in 1995 Baseline BMI and waist circumference were measured and categorised as general obesity (BMI o30.0 kg?m 2 ) and abdominal obesity (waist circumference o88 cm in females and o102 cm in males). Incident asthma was self-reported new-onset cases during an 11-yr follow-up period. Odds ratios for asthma associated with obesity were calculated using multivariable logistic regression.General obesity was a risk factor for asthma in females (OR 1.96, 95% CI 1.52-2.52) and males (OR 1.84, 95% CI 1.30-2.59). In females, after additional adjustment for BMI, abdominal obesity remained a risk factor for asthma development (OR 1.46, 95% CI 1.04-2.05). Abdominal obesity seems to increase the risk of incident asthma in females in addition to BMI, indicating that using both measures of BMI and waist circumference in females may be a superior clinical assessment for asthma risk than any measure alone.

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Section: Discussionmentioning

confidence: 95%

General and abdominal obesity and incident asthma in adults: the HUNT study

et al. 2012

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“…There has been a parallel increase in prevalence of obesity, OSA and asthma in the past years. The possible causal association of asthma and OSA has not, however, been systematically studied [98].…”

Section: Hormonal Disordersmentioning

confidence: 99%

Influence of comorbid conditions on asthma

Lp¹

2009

Eur Respir J

222

169

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Various conditions such as rhinosinusitis, gastro-oesophageal reflux disease, psychological disturbances, chronic infections and obstructive sleep apnoea are often observed in asthmatic patients and may affect asthma control and outcomes. These comorbidities may change the asthma phenotype, be part of the same pathophysiological process, act as confounding factors in the diagnosis or assessment of control of asthma, and/or result from specific environmental exposures. The influences of these conditions on asthma are variable and for many of them still uncertain; nevertheless, they may alter asthma responses to current therapy. A systematic evaluation and an appropriate treatment of asthma-associated comorbid conditions should be part of asthma management, particularly for severe disease. With regard to clinical research, associated conditions may influence the results of trials and should be taken into account in the subjects' inclusion criteria and analysis of data.

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“…In a recent study, it was found that binge eating disorder was associated with the experience of both upper and lower GI symptoms, independently of the level of obesity [34]. On the other hand, the presence of comorbidities, like asthma, diabetes, or OSAHS, has been associated with the presence of motility disorders [35][36][37][38][39]. The high prevalence of functional bowel disorders in the morbid obesity population (84%) was not described in the previous studies; it requires further studies to explore the underlying factors suggestive of a common pathway that may trigger both diseases.…”

Section: Functional Bowel Disorders and Functional Abdominal Painmentioning

confidence: 99%