Central obesity is associated with nonatopic but not atopic asthma in a representative population sample

Appleton, Sarah; Adams, Robert; Wilson, David H.; Taylor, Anne; Ruffin, Richard E.

doi:10.1016/j.jaci.2006.08.011

Cited by 107 publications

(107 citation statements)

References 55 publications

(52 reference statements)

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“…This has been commented on elsewhere [23]. A number of other mechanisms have been suggested to contribute to a rise in asthma symptoms, including weight gain and lifestyle factors, which result in reduced cardiovascular fitness and breathlessness [5,8,25,26]. However, these possibilities are not supported by the lack of change from 1981 to 2005-2007 in shortness of breath or AHR.…”

Section: Resultsmentioning

confidence: 99%

Changes in the prevalence of asthma in adults since 1966: the Busselton health study

Knuiman¹,

Divitini²,

Hui³

et al. 2009

Eur Respir J

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Asthma prevalence has increased worldwide; although less so in developed countries recently. This study assessed changes in the prevalence of asthma and related symptoms in the Busselton community since 1966.Cross-sectional respiratory health surveys of Busselton adults were conducted in 1966, 1969, 1972, 1975, 1981, 1990 and 2005-2007. Logistic regression models were used to estimate prevalence rates of asthma, respiratory symptoms, smoking, airway hyperresponsiveness (AHR) and atopy and to make comparisons in 2005-2007 and previous survey years. Asthma was defined as ever having doctor-diagnosed asthma (DDA).The prevalence of DDA was around 6% from 19666% from to 19756% from , 8% in 19816% from and rose to 19% in 20056% from -20076% from . From 19816% from to 20056% from -2007, smoking prevalence declined and obesity and atopy increased but changes in these variables explained only a small part of the increase in DDA. Wheeze and cough/ phlegm increased but AHR, breathlessness and doctor-diagnosed bronchitis remained relatively stable over the same period.These observations indicate that the increase in DDA is partly explained by increased symptoms and atopy. The lack of changes in AHR and doctor-diagnosed bronchitis suggests that factors such as diagnostic transfer and increased awareness of asthma have also contributed to the rise in prevalence of DDA.

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Section: Resultsmentioning

confidence: 99%

Changes in the prevalence of asthma in adults since 1966: the Busselton health study

Knuiman¹,

Divitini²,

Hui³

et al. 2009

Eur Respir J

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“…A few studies have investigated the association of waist circumference and asthma [11][12][13][14][15][16][17], and considerably fewer studies have taken BMI into consideration in the association [15,17]. Most of these studies are cross-sectional in nature, subject to reverse causality, and their observed association of waist circumference with asthma may be confounded by BMI [11][12][13][14][15][16]. In the Nurses' Health Study of 85,911 females, waist circumference was not found to be associated with incident asthma after adjustment for BMI [17].…”

Section: Discussionmentioning

confidence: 99%

“…Abdominal subcutaneous and visceral fat deposits as measured by waist circumference may be metabolically different from other body fat, indicating a separate risk for common medical complications from peripheral fatness measured by BMI [8]. Only a few studies have investigated the association between abdominal obesity and asthma, most of which have been cross-sectional and have not taken BMI into consideration [11][12][13][14][15][16][17]. BMI and waist circumference are highly correlated [4]; to study the association between waist circumference and asthma, BMI should be considered.…”

mentioning

confidence: 99%

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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“…The findings have been concordant in adolescents and adults [5]. One study also reported a positive relationship between hip/waist ratio and asthma incidence [6], and another found an inverse relationship between body height and asthma incidence [7]. Furthermore, one study found the body mass index (BMI)-asthma relationship only in nonatopic disease [6].…”

mentioning

confidence: 95%

“…One study also reported a positive relationship between hip/waist ratio and asthma incidence [6], and another found an inverse relationship between body height and asthma incidence [7]. Furthermore, one study found the body mass index (BMI)-asthma relationship only in nonatopic disease [6]. A recent meta-analysis of prospective studies concluded that asthma incidence increased by 50% in overweight/obese individuals [8].…”

mentioning

confidence: 99%

Body mass index as predictor for asthma: a cohort study of 118,723 males and females

Hjellvik¹,

Tverdal²,

Furu³

2010

Eur Respir J

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The objective of the present study was to quantify the relationship between body mass index (BMI; in kilogrammes per metre squared) and asthma in middle-aged males and females, and to evaluate change in BMI as a risk factor for asthma.Asthma incidence was estimated from data on redeemed prescriptions of anti-asthmatic drugs during the period 2004-2007, retrieved from the nationwide Norwegian Prescription Database. BMI was measured during health surveys in 1994-1999 in .100,000 individuals born during 1952-1959. Change in BMI was based on self-report. Relative risks were estimated using Poisson regression.The relative risk associated with a 3-unit increase in BMI ranged from 1.14 (95% confidence interval 1.10-1.18) in current smokers to 1.27 (1.22-1.32) in never-smokers after adjusting for confounders. The relative risk associated with a 3-unit increase in BMI was 1.21 (1.16-1.26) after adjusting for confounders, including sex, smoking and BMI.Asthma incidence, as measured by anti-asthmatic drug use, was positively related to both BMI and change in BMI. For BMI, the association was stronger for never-smokers than for ex-smokers and current smokers.

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Central obesity is associated with nonatopic but not atopic asthma in a representative population sample

Cited by 107 publications

References 55 publications

Changes in the prevalence of asthma in adults since 1966: the Busselton health study

Changes in the prevalence of asthma in adults since 1966: the Busselton health study

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

Body mass index as predictor for asthma: a cohort study of 118,723 males and females

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