Sex Differences in the Relation between Body Mass Index and Asthma and Atopy in a Birth Cohort

Hancox, Robert J.; Milne, Barry; Poulton, Richie; Taylor, D. Robin; Greene, Justina M.; McLachlan, Christene R.; Cowan, Jan O.; Flannery, Erin M.; Herbison, Peter; Sears, Malcolm R.

doi:10.1164/rccm.200405-623oc

Cited by 227 publications

(231 citation statements)

References 43 publications

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“…4 Another longitudinal study reporting on data collected between 9 and 26 years of age found that the BMI only predicted the incidence of asthma in females, and this relationship only appeared in late adolescence. 31 Neither of these studies reported data on the incidence of asthma after weight gain. The observation that important increases in fat mass emerge later in men than in women 13,31 may explain some inconsistent gender differences in the asthma-obesity association.…”

Section: Discussionmentioning

confidence: 99%

“…31 Neither of these studies reported data on the incidence of asthma after weight gain. The observation that important increases in fat mass emerge later in men than in women 13,31 may explain some inconsistent gender differences in the asthma-obesity association.…”

Section: Discussionmentioning

confidence: 99%

“…31,32 Obesity is associated with lung changes (e.g., decreased lung volumes, decreased CO diffusion, and bronchodilation after Ventolin challenge 33 ). These lung changes, which may manifest as the symptoms diagnosed as asthma, probably are the result of mechanical changes from obesity.…”

Section: Discussionmentioning

confidence: 99%

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Asthma and body weight change: a 20-year prospective community study of young adults

Hasler

Gergen

Ajdacic³

et al. 2006

Int J Obes

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Objective: There is increasing evidence for an association between asthma and body weight change. The objectives of these analyses were to examine the temporal relationships of this association and to explore the role of childhood depression as an explanatory factor. Methods: Data were derived from six subsequent semistructured interviews on health habits and health conditions from a single-age community study of 591 young adults followed up between ages 20 and 40 years. Results: Cross-sectionally (over the whole study period), asthma was significantly associated with obesity (odds ratio ¼ 3.9 [95% confidence interval 1.2, 12.2]). Multivariate longitudinal analyses revealed that asthma was associated with increased later weight gain and later obesity among women after controlling for potentially confounding variables, whereas weight gain and obesity were not associated with later asthma. A secondary analysis showed that depressive symptoms during childhood were associated with adult obesity and asthma, partially explaining the asthma-obesity comorbidity. Conclusion: This study encourages further research on mechanisms underlying the asthma-obesity comorbidity, particularly on shared psychosocial factors operating during critical periods in childhood and adolescence that may influence the development and persistence of both obesity and asthma during adulthood.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Asthma and body weight change: a 20-year prospective community study of young adults

Hasler

Gergen

Ajdacic³

et al. 2006

Int J Obes

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“…2 In the majority of these studies, the presence of asthma was detected by questionnaire, using self-reported symptoms or self-reported asthma to define the condition. However, there is little evidence from population studies that obesity is associated with objective markers of asthma such as airway hyperresponsiveness (AHR), [3][4][5][6][7] airway obstruction 8 or airway inflammation. 9 Asthma is defined by both episodic symptoms and variable airway obstruction.…”

Section: Introductionmentioning

confidence: 99%

“…10,11 Previous studies of the association between obesity and AHR have measured effects on sensitivity. [3][4][5][6][7] However, obesity is more likely to affect the maximal response, because obesity reduces operating lung volume 12 and breathing at low operating lung volumes is known to induce increased maximal airway narrowing in non-asthmatic subjects. 13,14 The effect of low lung volume on maximal airway narrowing in obese, non-asthmatic subjects has not been reported.…”

Section: Introductionmentioning

confidence: 99%

Effect of obesity on breathlessness and airway responsiveness to methacholine in non-asthmatic subjects

et al. 2007

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Background: Obesity is associated with increased prevalence and incidence of asthma, but the mechanism is unknown. Obesity reduces lung volumes, which can increase airway responsiveness, and increases resistive and elastic work of breathing, which can increase dyspnea. Objective: To determine if the intensity of dyspnea due to airway narrowing or if airway responsiveness is increased in obese, non-asthmatic subjects. Subjects: Twenty-three obese (BMI (body mass index) X30 kg m À2 ) and 26 non-obese (BMI o30 kg m À2 ) non-asthmatic subjects, aged between 18 and 70 years. Methods: High-dose methacholine challenge was used to determine the sensitivity and the maximal response to methacholine. Respiratory system resistance (Rrs) and reactance were measured, using the forced oscillation technique, as indicators of resistive and elastic loads during challenge. Perception of dyspnea was measured by the Borg score during challenge. Static lung volumes were measured by body plethysmography. Results: Static lung volumes were reduced in the obese subjects. There were no significant differences in the sensitivity or maximal response to methacholine between obese and non-obese subjects. The magnitude of change in Rrs was similar in both groups, but obese subjects had more negative reactance after challenge (P ¼ 0.002) indicating a greater elastic load. The intensity of dyspnea was greater in obese subjects (P ¼ 0.03). Conclusions: Obesity reduces lung volumes, but does not alter the sensitivity or maximal response to methacholine. However, obese subjects have enhanced perception of dyspnea, associated with greater apparent stiffness of the respiratory system, and may therefore be at greater risk of symptoms.

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Associations of body fat percent and body mass index with childhood asthma by age and gender

Yiallouros

Lamnisos

Kolokotroni

et al. 2013

Obesity

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Objective: High body mass index (BMI) has been shown to be associated with asthma, but the pattern of this association is still unclear and may differ by gender or stage of puberty. BMI is only a proxy of adiposity, whereas estimation of body fat percent (BF%) by the bioimpedance technique is considered an accurate measure of adiposity. We investigated whether BMI and BF% behave differently in their association with asthma between genders, before and during adolescence. Design and Methods: In this cross-sectional study of 10,981 schoolchildren, we used logistic regression models to examine the pattern of association of BMI and BF% with asthma. Results: In the case of BF%, both the highest (odds ratio [OR]: 1.68, 95% confidence interval [95% CI]: 1.21-2.30) and lowest (OR: 1.59, 95% CI: 1.13-2.23) z-score categories conferred an increased adjusted risk for active asthma. The likelihood ratio test (LRT) of nonlinearity yielded significant results (P < 0.01) for BF%. In contrast, the LRT for BMI yielded a nonsignificant result (P ¼ 0.45) indicating a linear association of asthma with BMI. A unit increase in BMI z-score conferred an increase in the adjusted odds of active asthma (OR: 1.14, 95% CI: 1.02-1.27). In the case of BF%, the adjusted ORs for active asthma at the highest and lowest z-score categories in both genders, before and during adolescence, were similarly elevated, exhibiting a U-shape pattern. Conclusions: In contrast to the linear association observed with BMI, BF% displayed a U-shaped association with asthma and may be the preferred measure of adiposity in epidemiological studies of asthma in children.

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Sex Differences in the Relation between Body Mass Index and Asthma and Atopy in a Birth Cohort

Abstract: A raised body mass index is associated with asthma and atopy in women but not men. Population attributable fraction calculations estimate that 28% (95% confidence interval 7-45) of asthma developing in women after age 9 is due to overweight.

Cited by 227 publications

References 43 publications

Asthma and body weight change: a 20-year prospective community study of young adults

Asthma and body weight change: a 20-year prospective community study of young adults

Effect of obesity on breathlessness and airway responsiveness to methacholine in non-asthmatic subjects

Associations of body fat percent and body mass index with childhood asthma by age and gender

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