BMI as a risk factor for the development of chronic rhinosinusitis: a prospective population-based study

Clarhed, Ulrika K. E.; Schiöler, Linus; Fell, Anne Kristin Møller; Hellgren, Johan

doi:10.1007/s00405-022-07320-y

Cited by 13 publications

(19 citation statements)

References 42 publications

(49 reference statements)

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“…An association between BMI or its categories and sinusitis was hereby established, which was consistent with several previous studies [9,17,18]. Although the clinical characteristics of the study populations, the types of olfactory assessment tests varied substantially by report.…”

Section: Discussionsupporting

confidence: 89%

Association of sinusitis with systemic and local adipose tissue in adults: a cross-sectional study

Cao,

Han,

Cao

et al. 2023

Preprint

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Background Obesity is associated with several nasal diseases. However, as indicated by conflicting findings from multifarious studies, the association of sinusitis with systemic and local adipose tissue remains inconclusive. Methods In this cross-sectional study, we examined the relationship between sinusitis and adipose tissue in adults using data from 3,203 participants in the 2005-2006 National Health and Nutrition Examination Survey through multivariate logistic regression models. Three indicators were utilized to assess this association: a systemic indicator of Body Mass Index (BMI), as well as two local indicators of Waist Circumference (WC) and Head Percent Fat (HPF). Results Compared to individuals with normal weight or those overweight, only those classified as obese were exposed to increased odds of sinusitis in adults (adjusted odds ratio, 1.77; 95% CI, 1.12-2.81) in this study focusing on systemic adipose tissue. Additionally, central obesity was found to be associated with elevated odds of sinusitis in adults (adjusted odds ratio, 1.57; 95% CI, 1.09-2.21) in this study emphasizing on local adipose tissue. Further analysis stratified by sex revealed that the observed association of central obesity were attenuated and became statistically insignificant among male adults while remaining significant among female adults (adjusted odds ratio, 1.69; 95% CI, 1.05-2.73). Meanwhile, WC, an indicator of abdominal fat as a continuous variable, showed a statistically significant association with sinusitis only in female adults during a sex-stratified analysis (adjusted odds ratio, 1.02; 95% CI, 1.01-1.03). Another continuous local adipose variable HPF was found to have a significant association with sinusitis in both males (adjusted odds ratio, 1.53; 95% CI, 1.22-1.91) and females (adjusted odds ratio, 1.3; 95% CI, 1.08-1.56). The optimal cutoff values for BMI and WC indicating sinusitis were determined to be 34.97 kg/m2 and 103.4 cm, respectively. Conclusions This study demonstrates that both systemic and local adipose tissue are associated with an increased risk of sinusitis in adults, especially among females. Further investigations are needed to elucidate the underlying mechanisms and explore the potential benefits of weight management for preventing and treating sinusitis.

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Section: Discussionsupporting

confidence: 89%

Association of sinusitis with systemic and local adipose tissue in adults: a cross-sectional study

Cao,

Han,

Cao

et al. 2023

Preprint

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“…A cross-sectional analysis of 229 million U.S. adults revealed the association between the increase in BMI and the increased incidence of CRS [ 9 ]. A prospective population-based study demonstrated that the incidence of new CRS was 53% higher in the obese group (BMI ≥ 30) than in the normal weight group (18.5 ≤ BMI < 25) in the Norwegian population, and higher BMI was associated with an increased risk of CRS [ 40 ]. Our study also suggested that BMI had a causal effect on CRS.…”

Section: Discussionmentioning

confidence: 99%

Causal relationships between potential risk factors and chronic rhinosinusitis: a bidirectional two-sample Mendelian randomization study

Zhang

et al. 2022

Eur Arch Otorhinolaryngol

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Purpose Smoking, alcohol consumption, allergic rhinitis (AR), asthma, and obesity are associated with chronic rhinosinusitis (CRS), albeit the causal relationships between them remain elusive. Therefore, we conducted a bidirectional two-sample Mendelian randomization (MR) study to investigate the bidirectional causal effects between these potential risk factors and CRS. Methods The data for daily cigarette consumption, age of smoking initiation, weekly alcohol consumption, AR, asthma, body mass index (BMI), and CRS were drawn from large sample size genome-wide association studies. Single-nucleotide polymorphisms associated with each exposure were considered instrumental variables in this study. We investigated causal effects by using the inverse-variance weighted (IVW) method with random effects, and weighted median and MR–Egger methods were used for sensitivity analyses. Pleiotropic effects were detected and corrected by the MR pleiotropy residual sum and outlier test and MR–Egger model. Results We found the causal effects of daily cigarette consumption (IVW, OR = 1.15, 95% CI 1.00−1.32, p = 0.046), AR (IVW, OR = 4.77, 95% CI 1.61−14.13, p = 0.005), asthma (IVW, OR = 1.45, 95% CI 1.31 − 1.60, p < 0.001), and BMI (IVW, OR = 1.05, 95% CI 1.00−1.09, p = 0.028) on CRS. Furthermore, we found a causal effect of CRS on asthma (IVW OR = 1.08, 95% CI 1.05−1.12, p < 0.001). Conclusions We confirmed the causal effects of daily cigarette consumption, AR, asthma, and BMI on CRS, and the causal effect of CRS on asthma, while no causal relationship between age of smoking initiation, weekly alcohol consumption, and CRS was found. These findings are expected to provide high-quality causal evidence for clinical practice and the pathogenesis of CRS and asthma. Supplementary Information The online version contains supplementary material available at 10.1007/s00405-022-07798-6.

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“…Third, there was variability in the definition of CRS utilized between each study. For the Meta‐analysis on the odds of having CRS in the presence of obesity, CRS was defined by the validated EPOS2012 guidelines for epidemiological studies with sinus endoscopy, ICD‐9 codes (US‐based study), the EPOS2012 guidelines for epidemiological studies only, or radiologic findings only 12,15,16,21 . The variation of the CRS definition used between the studies may limit the power of the statistical association observed in this outcome due to misclassification bias.…”

Section: Discussionmentioning

confidence: 99%

“…For the Meta-analysis on the odds of having CRS in the presence of obesity, CRS was defined by the validated EPOS2012 guidelines for epidemiological studies with sinus endoscopy, ICD-9 codes (US-based study), the EPOS2012 guidelines for epidemiological studies only, or radiologic findings only. 12,15,16,21 The variation of the CRS definition used between the studies may limit the power of the statistical association observed in this outcome due to misclassification bias. Nonetheless, nearly every article included in this review uses a validated symptomatic diagnosis of CRS, 65 ICD codes, or a combination of sinonasal symptoms and radiologic evidence for the diagnosis of CRS, potentially minimizing the risk of misclassification.…”

Section: Limitationsmentioning

confidence: 99%

Evaluating the Association of Obesity and Chronic Rhinosinusitis: A Systematic Review and Meta‐analysis

Hoying,

Miller,

Tanzo

et al. 2023

Otolaryngol.--head neck surg.

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ObjectiveThe aim of this Meta‐analysis and systematic review was to perform a comprehensive assessment of the association of chronic rhinosinusitis (CRS) with overweight/obesity, leptin hormone, and its associated metabolic dysregulation.Data SourcesOvid MEDLINE, Embase, Web of Science, and Cochrane Central Register of Controlled Trials, were searched for studies from 1946 to October 2022, using predefined syntax.Review MethodsOutcome data for the meta‐analysis were extracted on odds ratios (OR) of CRS prevalence based on the presence of overweight/obesity and mean serum leptin levels. A Meta‐analysis was performed using the DerSimonian‐Laird estimator to pool extracted data by the generalized inverse variance approach. Random effect models were utilized due to the small sample size. A qualitative synthesis was performed on articles that did not meet the inclusion criteria for the Meta‐analysis.ResultsThirty‐six studies met the systematic review inclusion criteria out of 1113 articles screened. A total of 6 studies were included in the pooled Meta‐analysis of the various outcome variables. Our pooled meta‐analysis observed a positive association between overweight/obesity and the prevalence of CRS (OR = 1.33, 95% confidence interval [CI]: 1.17‐1.51). The pooled ratio of the means analysis of the mean serum leptin levels between CRS with nasal polyposis and control patients was 2.21 (95% CI: 1.45; 3.36).ConclusionOur pooled Meta‐analysis indicates a positive association between overweight/obesity and CRS. Future prospective studies are needed to explore the association between CRS and obesity with an understanding of potential confounding comorbidities, including studies focused on assessing the underlying immunologic mechanism of this association.

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BMI as a risk factor for the development of chronic rhinosinusitis: a prospective population-based study

Cited by 13 publications

References 42 publications

Association of sinusitis with systemic and local adipose tissue in adults: a cross-sectional study

Association of sinusitis with systemic and local adipose tissue in adults: a cross-sectional study

Causal relationships between potential risk factors and chronic rhinosinusitis: a bidirectional two-sample Mendelian randomization study

Evaluating the Association of Obesity and Chronic Rhinosinusitis: A Systematic Review and Meta‐analysis

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