The Association Between Obesity and Asthma Is Stronger in Nonallergic Than Allergic Adults

Chen, Yue; Dales, Robert; Jiang, Ying

doi:10.1378/chest.130.3.890

Cited by 116 publications

(115 citation statements)

References 31 publications

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“…The prevalence of asthma was higher in females than in males (p=0.64). The mean age (29.35 ± 8.64 years) of subjects reported in the present study is in consistent with Chen et al [23], who found that prevalence of asthma was higher in 20-29 years age group.…”

Section: Discussionsupporting

confidence: 93%

Assessment of Nutritional Status of Patients Suffering from Asthma

Jain¹,

Kant²,

Mishra³

2017

J Clin Nutr Diet

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Background and aim: Several studies have suggested that increasing prevalence of asthma could be associated with nutrients intake. These nutrients can play beneficial as well as detrimental role in asthma and may affect the nutritional status of asthma patients. This case-control study was undertaken to assess the nutritional status and differences in dietary intake between a population with and without asthma.

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Section: Discussionsupporting

confidence: 93%

Assessment of Nutritional Status of Patients Suffering from Asthma

Jain¹,

Kant²,

Mishra³

2017

J Clin Nutr Diet

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“…There is an increased risk of developing asthma in individuals who are overweight and obese (subsequently referred to as overweight/obese) (1)(2)(3)(4)(5). The risk of asthma increases steadily with increasing body mass index (BMI) and is higher in women (1,6).…”

mentioning

confidence: 99%

Alveolar Macrophages from Overweight/Obese Subjects with Asthma Demonstrate a Proinflammatory Phenotype

Lugogo¹,

Hollingsworth

Howell³

et al. 2012

Am J Respir Crit Care Med

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Rationale: Obesity is associated with increased prevalence and severity of asthma. Adipose tissue macrophages can contribute to the systemic proinflammatory state associated with obesity. However, it remains unknown whether alveolar macrophages have a unique phenotype in overweight/obese patients with asthma. Objectives: We hypothesized that leptin levels would be increased in the bronchoalveolar lavage fluid from overweight/obese subjects and, furthermore, that leptin would alter the response of alveolar macrophages to bacterial LPS. Methods: Forty-two subjects with asthma and 46 healthy control subjects underwent research bronchoscopy. Bronchoalveolar lavage fluid from 66 was analyzed for the level of cellular inflammation, cytokines, and soluble leptin. Cultured primary macrophages from 22 subjects were exposed to LPS, leptin, or leptin plus LPS. Cytokines were measured in the supernatants. Measurements and Main Results: Leptin levels were increased in overweight/obese subjects, regardless of asthma status (P ¼ 0.013), but were significantly higher in overweight/obese subjects with asthma. Observed levels of tumor necrosis factor-a were highest in overweight/obese subjects with asthma. Ex vivo studies of primary alveolar macrophages indicated that the response to LPS was most robust in alveolar macrophages from overweight/obese subjects with asthma and that preexposure to high-dose leptin enhanced the proinflammatory response. Leptin alone was sufficient to induce production of proinflammatory cytokines from macrophages derived from overweight/obese subjects with asthma. Conclusions: Ex vivo studies indicate that alveolar macrophages derived from overweight/obese subjects with asthma are uniquely sensitive to leptin. This macrophage phenotype, in the context of higher levels of soluble leptin, may contribute to the pathogenesis of airway disease associated with obesity.Keywords: tumor necrosis factor-a; leptin; innate immunity; lipopolysaccharide; environmental lung disease There is an increased risk of developing asthma in individuals who are overweight and obese (subsequently referred to as overweight/obese) (1-5). The risk of asthma increases steadily with increasing body mass index (BMI) and is higher in women (1, 6). Furthermore, BMI negatively impacts asthma quality of life scores, asthma control scores, severity of exacerbations, and asthma-related hospitalizations (6-9). Together, these studies suggest a role of obesity in the pathogenesis of asthma. However, the mechanisms by which obesity may contribute to airway disease remain poorly understood.Evidence suggests that adipose tissue is metabolically active, participating not only in energy homeostasis but also in inflammation (12). Adipose tissue secretes biologically active cytokines, including tumor necrosis factor (TNF)-a and IL-6, as well as adipokines, including leptin, adiponectin, plasminogen activator inhibitor (PAI)-1, and resistin (10, 11). Obesity is associated with systemic inflammation, which is characterized by elevated serum levels of...

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“…This could can be explained theoretically by the higher prevalence of obesity and asthma in females, (7,11) as well as by the fact that women seek medical treatment more frequently than do men and by the influence of hormones in women. However, further studies are needed in order to fully define and clarify the role of estrogen in influencing airway inflammation, as well as the interaction between estrogen and leptin in the brain, adipose tissue, and airways.…”

Section: Discussionmentioning

confidence: 99%

“…(3)(4)(5)(6)(7)(8)(9) Asthma and obesity have both become more prevalent in recent years, and obesity has reached epidemic proportions in developed countries. (7,10,11) In Brazil, these two pathologies have become a public health problem, increasing health care costs in the public and private sectors. (1,8) Most studies of asthma prevalence have involved populations of children and adolescents and have been mainly based on the use of questionnaires, such as the International Study of Asthma and Allergies in Childhood (ISAAC) and the European Community Respiratory Health Survey (ECRHS).…”

Section: Introductionmentioning

confidence: 99%

“…Essa prevalência nas mulheres e nos homens foi de 20,4% (IC95%: 16,2-24,5) e 13,7% (IC95%: 10,1-17,2), respectivamente. Havia sintomas de asma nos últimos doze meses em 8,0% (IC95%: 5,2-10,7), e houve manifestação inicial dos sintomas de asma na infância/adolescência em 17, 4% (IC95%: 13,[5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21]3). No grupo asma, asma intermitente estava presente em 29 pacientes (43,3%); asma persistente leve, em 7 (10,4%); asma moderada, em 25 (37,3%); e asma persistente grave, em 6 (9,0%).…”

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Prevalência e gravidade de asma brônquica em adultos obesos com indicação de cirurgia bariátrica

Melo

Filho

et al. 2011

J. bras. pneumol.

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Objective: To determine the prevalence of asthma in a group of obese adult candidates for bariatric surgery and to evaluate the severity of asthma in this group of patients. Methods: This was a cross-sectional study involving 363 obese adults (body mass index ≥ 35 kg/m 2 ) evaluated by a pulmonologist, using clinical evaluation as a diagnostic tool for asthma. All patients underwent clinical evaluation and spirometry and were divided into two groups (asthma and control). The patients with asthma were stratified by the severity of asthma. Results: The prevalence of asthma in the obese population studied was 18.5% (95% CI: 14.5-22.4). That prevalence was 20.4% (95% CI: 16.2-24.5) and 13.7% (95% CI: 10.1-17.2) in the women and the men, respectively. Asthma symptoms in the last twelve months were present in 8.0% (95% CI: 5.2-10.7), and the initial manifestation of asthma symptoms occurred during childhood/adolescence in 17.4% (95% CI: 13.5-21.3). In the asthma group, intermittent asthma was present in 29 patients (43.3%), mild persistent asthma in 7 (10.4%), moderate asthma in 25 patients (37.3%), and severe persistent asthma in 6 (9.0%). Conclusions: Using clinical evaluation as the diagnostic criterion, we found the prevalence of asthma to be high in this group of obese adults. Asthma was more common in females, and the initial manifestation of asthma symptoms more commonly occurred during childhood/adolescence. The severity of asthma in this group of obese adults was within the range of mean values predicted for the general population. Intermittent asthma, mild persistent asthma, and moderate persistent asthma predominated.Keywords: Asthma; Cross-sectional studies; Spirometry; Respiratory function tests; Obesity, morbid. ResumoObjetivo: Determinar a prevalência de asma em um grupo de adultos obesos, candidatos a cirurgia bariátrica e avaliar a gravidade da asma neste grupo de pacientes. Métodos: Estudo transversal, envolvendo 363 pacientes obesos adultos (índice de massa corpórea ≥ 35 kg/m 2 ) avaliados por um médico pneumologista, utilizando a avaliação clínica como instrumento diagnóstico de asma. Todos os pacientes foram submetidos à avaliação clínica e espirometria e foram divididos em dois grupos (asma e controle). Os pacientes com asma foram classificados conforme a gravidade da doença. Resultados: A prevalência de asma na população de obesos estudada foi de 18,5% (IC95%: 14,5-22,4). Essa prevalência nas mulheres e nos homens foi de 20,4% (IC95%: 16,2-24,5) e 13,7% (IC95%: 10,1-17,2), respectivamente. Havia sintomas de asma nos últimos doze meses em 8,0% (IC95%: 5,2-10,7), e houve manifestação inicial dos sintomas de asma na infância/adolescência em 17, 4% (IC95%: 13,[5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21]3). No grupo asma, asma intermitente estava presente em 29 pacientes (43,3%); asma persistente leve, em 7 (10,4%); asma moderada, em 25 (37,3%); e asma persistente grave, em 6 (9,0%). Conclusões: A prevalência de asma neste grupo de adultos obesos, utilizando-se a avaliação ...

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The Association Between Obesity and Asthma Is Stronger in Nonallergic Than Allergic Adults

Cited by 116 publications

References 31 publications

Assessment of Nutritional Status of Patients Suffering from Asthma

Assessment of Nutritional Status of Patients Suffering from Asthma

Alveolar Macrophages from Overweight/Obese Subjects with Asthma Demonstrate a Proinflammatory Phenotype

Prevalência e gravidade de asma brônquica em adultos obesos com indicação de cirurgia bariátrica

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