Obesity and nocturnal gastro-oesophageal reflux are related to onset of asthma and respiratory symptoms

Gunnbjörnsdóttir, Mari­a; Omenaas, Ernst; Gíslason, Þórarinn; Norrman, Eva; Olin, Anna Carin; Jõgi, Rain; Jensen, E J; Lindberg, Eva; Björnsson, E.; Franklin, Karl A.; Janson, Christer; Gulsvik, Amund; Lærum, Birger Norderud; Svanes, Cecilie; Torén, Kjell; Tunsäter, Alf; Lillienberg, Linnéa; Gíslason, Davíð; Blöndal, Þorsteinn; Björnsdóttir, Unnur Steina; Jörundsdóttir, Kristín Bára; Talvik, R.; Forsberg, Bertil; Lundbäck, Bo; Söderberg, Monica; Ledin, M C; Boman, Gunnar; Norbäck, Dan; Wieslander, Gundula; Spetz-Nyström, Ulrike; Cashelunge, K Stenudd; Ryden, Eva B.

doi:10.1183/09031936.04.00042603

Cited by 151 publications

(122 citation statements)

References 39 publications

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“…Our results on the BMI-derived obesity and asthma association are consistent with previous prospective studies, which found that BMI had a strong dose-response relationship with asthma development [6,17,[25][26][27][28][29][30]. In a meta-analysis study, BEUTHER and SUTHERLAND [6] analysed seven prospective studies (n5333,102) evaluating BMI and incident asthma.…”

Section: Discussionsupporting

confidence: 79%

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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Section: Discussionsupporting

confidence: 79%

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

et al. 2012

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“…The association between asthma and CRP is by no means clear, however, and could at least in part reflect the role of obesity in CRP production [22,23], as asthma in young adults is significantly more common in subjects with a raised body mass index (BMI) [24][25][26]. Whether there is a difference in the association between CRP level and asthma severity is unknown.…”

Section: Discussionmentioning

confidence: 99%

Association Between C Reactive Protein and Asthma

Obaidi¹,

Samarai²,

Jawad³

2010

Tur Toraks Der

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Amaç: Yapılan çalışmalar sistemik inflamasyon belirteçleri ve akciğer fonksiyonları arasında ters bir orantı olduğunu göstermekte-dir. Bu çalışmada C-reaktif proteinin (CRP) serum düzeyi, vücut kitle indeksi ve astım arasındaki ilişkiyi belirlemeyi hedefledik. Gereç ve Yöntem:Bu çalışmada 178 astım hastasında ve 50 sağlıklı kontrol grubunda CRP düzeyi belirlendi. Astım hastaları-nın 126'sı stabil evrede ve 52'si ise atak dönemindeydi. Bulgular:Astım hastalarında kontrol grubuna göre CRP düzeyi-nin istatistiksel düzeyde anlamlı derecede (p<0.05) daha yüksek olduğu görüldü. Atak dönemindeki astım hastalarında ise serum CRP düzeylerinin stabil devredeki astım hastalarından anlamlı derecede daha yüksek olduğu görüldü (p<0.05). Astım hastalarında FEV1 değeri serum CRP düzeyi ile ters bir orantı gösteri-yordu. Astım hastalarında, serum CRP düzeyi ve vücut kitle indeksi arasında istatistiksel düzeyde anlamlı bir ilişki vardı (p<0.0001). Ayrıca ortalama vücut kitle indeksinin astım hastalarında kontrol gruba göre daha yüksek olduğu görüldü. Material and Method:In the present study, CRP was determined in 178 patients with asthma and 50 healthy control subjects. Of all asthmatics, 126 had stable asthma and 52 had asthma during exacerbation.Results: CRP was significantly higher (p<0.05) in asthmatic patients as compared to the control group. In asthmatics with exacerbation, serum CRP was significantly higher than in stable asthmatic patients and control subjects. FEV1 was significantly inversely correlated with serum CRP in asthmatic patients. In asthmatic patients there was a significant (p<0.0001) association between serum level of CRP and body mass index. Furthermore, the mean BMI was significantly higher in asthmatic patients than that in control subjects. Conclusion:Serum CRP may be a non specific marker of asthma and its exacerbation. In addition, obesity could be a risk factor for asthma. (Tur Toraks Der 2010; 11: 98-104)

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“…Furthermore, several diseases that coexist with obesity have also been linked to asthma prevalence or severity. These diseases include gastroesophageal reflux disease (23), obstructive sleep apnea (24,25), and depression (26,27). Obesity-associated insulin resistance has also been shown to be associated with asthma (28)(29)(30).…”

Section: Discussionmentioning

confidence: 99%

Body Mass Index Is a Stronger Predictor than the Metabolic Syndrome for Future Asthma in Women. The Longitudinal CARDIA Study

Assad

Qualls

Smith

et al. 2013

Am J Respir Crit Care Med

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Rationale: It is hypothesized that the metabolic syndrome explains the association between body mass index (BMI) and asthma in adults. Objectives: Our objective was to longitudinally compare the relative strengths of the associations of the metabolic syndrome and BMI with incident asthma in adults. Methods: We included 4,619 eligible participants in the Coronary Artery Risk Development in Young Adults (CARDIA) cohort followed over 25 years. Incident asthma was defined by a new self-reported provider asthma diagnosis plus either the presence of asthma symptoms and/or use of asthma medications. Cox proportional hazard analyses were performed. Measurements and Main Results: Six hundred two subjects (417 women and 185 men) developed incident asthma over 25 years of follow-up. Metabolic syndrome predicted incident asthma among women but not men (unadjusted hazard ratios, 1.50 and 0.98; P ¼ 0.01 and 0.93, respectively). BMI had a similar predictive association among women but not men (unadjusted hazard ratios, 1.19 and 1.04 per 5 units of BMI; P , 0.001 and 0.60, respectively). The association of metabolic syndrome with incident asthma in women was no longer statistically significant after adjustment for BMI (P ¼ 0.44). In contrast, the association of BMI with incident asthma in women remained statistically significant after adjusting for the metabolic syndrome (P ¼ 0.01). In a stepwise model, BMI was a stronger predictor than the metabolic syndrome (P ¼ 0.001). Conclusions: BMI is a stronger predictor of incident asthma among women than the metabolic syndrome. Other obesity-associated factors that are not a part of the metabolic syndrome may play a role in the BMI-asthma association in women.Keywords: incident asthma; metabolic syndrome; body mass index Obesity and asthma are chronic diseases that have increased in prevalence across the world over the last 2 decades (1, 2). During the period 2009 to 2010, 1 in 12 American adults had asthma, and more than one-third of American adults were obese (3, 4). Obesity, as defined by elevated body mass index (BMI) of 30 kg/m 2 or more, is a risk factor for asthma, particularly among women. The basis for this association, however, remains unclear. The metabolic syndrome, as defined by the third Adult Treatment Panel (ATP-III) criteria (5), includes the presence of any three of the following five traits: abdominal adiposity (waist circumference . 102 cm in men and . 88 cm in women), hypertriglyceridemia (>150 mg/dl or drug treatment for high triglycerides), low high-density lipoprotein (HDL) cholesterol levels (,40 mg/dl in men and ,50 mg/dl in women or drug treatment for low HDL), elevated blood pressure (>130/85 mm Hg or drug treatment for elevated blood pressure), and impaired fasting blood glucose or diabetes mellitus (>100 mg/dl or antidiabetic drug treatment) (6). Some epidemiologic studies suggest that waist circumference-defined abdominal adiposity, one of the characteristics of the metabolic syndrome, is more strongly associated with prevalent asthma than is BMI-defined...

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Obesity and nocturnal gastro-oesophageal reflux are related to onset of asthma and respiratory symptoms

Cited by 151 publications

References 39 publications

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

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

Association Between C Reactive Protein and Asthma

Body Mass Index Is a Stronger Predictor than the Metabolic Syndrome for Future Asthma in Women. The Longitudinal CARDIA Study

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