Body Mass Index and Asthma Severity Among Adults Presenting to the Emergency Department

Thomson, Carey C.; Clark, Sunday; Camargo, Carlos A.

doi:10.1378/chest.124.3.795

Cited by 112 publications

(88 citation statements)

References 30 publications

(23 reference statements)

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“…This finding is consistent with observations in a large study of asthmatics attending an emergency department, 28 where obese subjects reported more severe symptoms than normal weight subjects, despite having higher peak expiratory flow values on admission, suggesting they had a heightened awareness of airway narrowing. The increased intensity of dyspnea in the obese subjects in the present study was not explained by absolute differences in respiratory system resistance at baseline and throughout the challenge.…”

Section: Perception Of Dyspneasupporting

confidence: 91%

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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Section: Perception Of Dyspneasupporting

confidence: 91%

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

et al. 2007

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“…9 However, contrary results can also be found. 10,11 BMI, despite being the most frequent, is not the most precise measure of the fat excess. This index describes only the relation of the total body mass to height, not taking into consideration the actual proportion of the fat versus lean mass or the fat distribution.…”

Section: Introductionmentioning

confidence: 99%

Leptin and resistin in overweight patients with and without asthma

Muc

Todo-Bom

Mota-Pinto

et al. 2014

Allergologia et Immunopathologia

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Background: Excess body mass increases the risk of development of asthmatic symptoms and their severity and decreases the treatment effectiveness. One of the hypotheses explaining the link between the two diseases concerns the adipokines, hormones produced by adipose tissue with a proinflammatory character. The aim of this study was to compare the levels of the adipokines (leptin and resistin) between overweight asthmatic patients, asthmatic patients with normal weight and overweight patients without asthma. Methods: 80 peripheral blood samples were collected from patients and blood serum extracted. Three groups were selected: overweight asthmatic patients (BMI ≥ 25), overweight patients without asthma and asthmatic patients with normal weight (BMI < 25). Waist circumference of the patients was measured (cut-off points were 80 cm for women and over 94 cm for men) and a skin prick test performed. Comparison of adipokine concentration between the 3 groups was made and association between these concentrations and the measurements was performed. Results: Although the concentrations of both adipokines were slightly higher for overweight asthmatic patients compared to overweight healthy patients, these differences were not significant. A significant association was found between leptin concentration and both BMI (p < 0.01) and waist circumference (p < 0.01). A difference for this cytokine was also found between asthmatic and non-asthmatic female patients (p < 0.05). Conclusions: As expected overweight patients with BMI ≥ 25 and patients with increased waist circumference showed higher leptin levels. We suggest that the studied cytokines, with a stronger indication for leptin, can elicit asthmatic inflammation in obese phenotype of asthma that affects more frequently women.

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“…They found there to be no strong evidence to suggest such a relationship in men or women [23]. Several researchers have explored the obesity-asthma phenomenon and identified this relationship as a sex-specific one, where women with increased BMI's are at greater risk for asthma than women with lower BMIs [9,12,24,25]. For example, a study conducted by Beckett et al concluded that weight gain disposes young females to new asthma diagnoses, independent of physical activity [24].…”

Section: Discussionmentioning

confidence: 99%

“…These increases have a profound impact on the prevalence of a wide variety of chronic diseases [7], including asthma. Numerous studies have revealed an association between asthma and obesity [8][9][10][11][12], though the mechanistic link between the two [13,14] and their temporal association remain hotly debated. As such, it is important to examine whether ICS's could possibly be associated with weight gain in an asthmatic population.…”

Section: Introductionmentioning

confidence: 99%

Sex Differences in the Effects of Inhaled Corticosteroids on Weight Gain among Patients with Asthma

et al. 2012

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Background. Studies have shown that asthma and asthma exacerbations are related to body weight and that this relationship might be sex-specific. While oral corticosteroids have been associated with weight gain, little is known about the effect of inhaled corticosteroid (ICS) use on short-term weight gain. The purpose of the present study was to examine whether ICSs would be associated with weight gain among asthmatic patients. Methods. A total of 180 adult patients with physician-diagnosed asthma provided details of their medical history and demographic information, along with height and weight at baseline and at one year. Weight change was defined as follow-up minus baseline weight. General linear models were used to assess the relationship between ICS dose (fluticasone propionate equivalent) and sex. Results. Significant main effects of sex (P = .005) and ICS dose (P = .036) and an interaction effect of sex and ICS dose (P = .003) on weight change were observed. Further analysis of the interaction indicated that women had greater weight gain, while men had decreased weight with increased ICS dose. Conclusions. Findings suggest that ICSs may trigger weight gain in females and highlight the need for studies to confirm this relationship and examine the potential underlying mechanisms.

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Body Mass Index and Asthma Severity Among Adults Presenting to the Emergency Department

Cited by 112 publications

References 30 publications

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

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

Leptin and resistin in overweight patients with and without asthma

Sex Differences in the Effects of Inhaled Corticosteroids on Weight Gain among Patients with Asthma

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