Body mass index and phenotype in subjects with mild-to-moderate persistent asthma

被引:108
|
作者
Sutherland, E. Rand [1 ,2 ]
Lehman, Erik B. [3 ]
Teodorescu, Mihaela [4 ]
Wechsler, Michael E. [5 ,6 ]
机构
[1] Natl Jewish Hlth, Denver, CO 80206 USA
[2] Univ Colorado, Denver, CO 80202 USA
[3] Penn State Univ, Dept Hlth Evaluat Sci, Hershey, PA USA
[4] Univ Wisconsin, Sch Med & Publ Hlth, Wisconsin Sleep Inst, Sect Allergy Pulm & Crit Care Med,Dept Med, Madison, WI 53706 USA
[5] Brigham & Womens Hosp, Boston, MA 02115 USA
[6] Harvard Univ, Sch Med, Boston, MA USA
基金
美国国家卫生研究院;
关键词
Asthma; obesity; treatment; severity; RANDOMIZED CONTROLLED TRIAL; CLINICAL-RESEARCH NETWORK; OBSTRUCTIVE SLEEP-APNEA; INHALED CORTICOSTEROIDS; PULMONARY-FUNCTION; NOCTURNAL ASTHMA; OBESITY; WOMEN; EPIDEMIOLOGY; ASSOCIATION;
D O I
10.1016/j.jaci.2009.04.005
中图分类号
R392 [医学免疫学];
学科分类号
100102 ;
摘要
Background: Although obesity has been hypothesized to worsen asthma, data from studies of subjects with well-characterized asthma are lacking. Objective: We sought to evaluate the relationship between body mass index (BMI), asthma impairment, and response to therapy. Methods: BMI (in kilograms per meter squared) and asthma phenotypic and treatment response data were extracted from Asthma Clinical Research Network studies. The cross-sectional relationship between BMI and asthma impairment was analyzed, as was the longitudinal relationship between BMI and response to asthma controller therapies. Results: One thousand two hundred sixty-five subjects with mild-to-moderate persistent asthma were evaluated. Analyses of lean versus overweight/obese asthmatic subjects demonstrated small differences in FEV(1) (3.05 vs 2.91 L, P = .001), FEV(1)/forced vital capacity ratio (mean, 83.5% vs 82.4%; P = .01), rescue albuterol use (1.1 vs 1.2 puffs per day, P = .03), and asthma-related quality of life (5.77 vs 5.59, P = .0004). Overweight/obese asthmatic subjects demonstrated a smaller improvement in exhaled nitric oxide levels with inhaled corticosteroid (ICS) treatment than did lean asthmatic subjects (3.6 vs 6.5 ppb, P = .04). With ICS/long-acting beta-agonist treatment, overweight/obese asthmatic subjects demonstrated smaller improvements in lung function than lean asthmatic subjects, with an 80 mL (P = .04) and 1.7% (P = .02) lesser improvement in FEV(1) and FEV(1)/forced vital capacity ratio, respectively. Significant differences in therapeutic response to leukotriene modifiers between BMI categories were not observed. Conclusions: Increased BMI is not associated with clinically significant worsening of impairment in subjects with mild-to-moderate persistent asthma. There is a modest association between increased BMI and reduced therapeutic effect of ICS-containing regimens in this patient population. Prospective studies evaluating the effect of being overweight or obese on treatment response in asthma are warranted. (J Allergy Clin Immunol 2009;123:1328-34.)
引用
收藏
页码:1328 / 1334
页数:7
相关论文
共 50 条
  • [31] Ciclesonide improves health-related quality of life in adults and adolescents with mild-to-moderate persistent asthma
    Nathan, Robert A.
    Kanter, Lewis
    Ostrom, Nancy K.
    [J]. ALLERGY AND ASTHMA PROCEEDINGS, 2008, 29 (05) : 521 - 527
  • [32] An Evaluation Of Asthma Control And Pulmonary Function Following Treatment With Ciclesonide 80 G Twice Daily In Subjects With Mild-To-Moderate Persistent Asthma Previously Receiving Fluticasone Propionate
    Prenner, B. M.
    Meltzer, E. O.
    Desai, S. Y.
    Wang, B.
    Karafilidis, J.
    Walsh, J.
    [J]. AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 2011, 183
  • [33] Body mass index and asthma in adults in families of subjects with asthma in Anqing, China
    Celedón, JC
    Palmer, LJ
    Litonjua, AA
    Weiss, ST
    Wang, BY
    Fang, Z
    Xu, XP
    [J]. AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 2001, 164 (10) : 1835 - 1840
  • [34] Aeroallergen sensitization correlates with PC20 and exhaled nitric oxide in subjects with mild-to-moderate asthma
    Craig, Timothy J.
    King, Tonya S.
    Lemanske, Robert F., Jr.
    Wechsler, Michael E.
    Icitovic, Nikolina
    Zimmerman, Ronald R., Jr.
    Wasserman, Stephen
    [J]. JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY, 2008, 121 (03) : 671 - 677
  • [35] Does Body Mass Index Influence the Pelvic Floor Muscle Strength of Elderly Women with Mild-to-moderate Stress Urinary Incontinence?
    Zhang, D.
    Wang, S.
    Sun, X.
    Wang, J.
    [J]. INTERNATIONAL UROGYNECOLOGY JOURNAL, 2022, 33 (SUPPL 2) : S415 - S416
  • [36] Bronchodilator effects of exercise hyperpnea and albuterol in mild-to-moderate asthma
    Milanese, Manlio
    Saporiti, Riccardo
    Bartolini, Stefano
    Pellegrino, Riccardo
    Baroffio, Michele
    Brusasco, Vito
    Crimi, Emanuele
    [J]. JOURNAL OF APPLIED PHYSIOLOGY, 2009, 107 (02) : 494 - 499
  • [37] Cost-effectiveness analysis of fluticasone versus montelukast in children with mild-to-moderate persistent asthma in the Pediatric Asthma Controller Trial
    Wang, Li
    Hollenbeak, Christopher S.
    Mauger, David T.
    Zeiger, Robert S.
    Paul, Ian M.
    Sorkness, Christine A.
    Lemanske, Robert F., Jr.
    Martinez, Fernando D.
    Strunk, Robert C.
    Szefler, Stanley J.
    Taussig, Lynn M.
    [J]. JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY, 2011, 127 (01) : 161 - U258
  • [38] Prevention of asthma exacerbation by HFA flunisolide in adults and adolescents with mild-to-moderate asthma
    Nelson, H
    Newman, K
    [J]. JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY, 2001, 107 (02) : S105 - S105
  • [39] Yoga intervention for adults with mild-to-moderate asthma: a pilot study
    Sabina, AB
    Williams, AL
    Wall, HK
    Bansal, S
    Chupp, G
    Katz, DL
    [J]. ANNALS OF ALLERGY ASTHMA & IMMUNOLOGY, 2005, 94 (05) : 543 - 548
  • [40] FLUTICASONE PROPIONATE AEROSOL FOR THE TREATMENT OF ADULTS WITH MILD-TO-MODERATE ASTHMA
    CHERVINSKY, P
    VANAS, A
    BRONSKY, EA
    DOCKHORN, R
    NOONAN, M
    LAFORCE, C
    PLESKOW, W
    [J]. JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY, 1994, 94 (04) : 676 - 683