Clinical and functional characteristics of patients with bronchial asthma depending on body mass index
DOI:
https://doi.org/10.14739/2310-1210.2023.6.291214Keywords:
bronchial asthma, obesity, triggers, symptoms, course, controlAbstract
The aim of the study was to investigate the relationship between body mass index (BMI) and clinical and anamnestic data in patients with bronchial asthma (BA).
Material and methods. 553 patients with BA and 95 apparently healthy individuals without medical or family history of asthma, allergy or atopy symptoms were examined. Patients were divided into three groups depending on BMI: Group I included 152 patients with normal body weight (NBW), II – 206 overweight patients, III – 195 with obesity. BA control was assessed by using the ACQ-5 questionnaire, and the AQLQ was used to assess quality of life. The study was approved by the Bioethics Commission of the Medical Institute of Sumy State University. Statistical analysis of the obtained results was carried out using the SPSS-17 program.
Results. There were no significant sex– and age-related differences (p > 0.05) between clinical groups. Complaints, medical history, clinical and instrumental indicators, disease severity, control, and quality of life of patients were analyzed to identify features of BA associated with obesity. The study has found that BA patients with obesity experienced a higher frequency of positive family history (p = 0.004), exacerbations during the cold season (p = 0.001), sensitivity to weather changes (p = 0.001), acute respiratory diseases (p = 0.001), stress (p = 0.001), and a combination of non-specific triggers (p = 0.001) which could result in exacerbations compared to patients with NBW. Exacerbations caused by flowering plants were more common in BA patients with NBW (55.3 %) compared to those with obesity (43.1 %). When comparing BA in individuals with obesity to those with NBW, there were several distinctive features. These included a higher frequency of symptoms such as cough and shortness of breath at rest or with minor physical exertion, weakness, fatigue, sleep disturbances, heartburn; night and day symptoms when using salbutamol, a severe and uncontrolled course with more pronounced obstructive disorders and lower reversibility, pneumonia, exacerbation episodes, and lower quality of life.
Conclusions. BA with obesity compared to BA with NBW is characterized by a number of differences such as non-allergic factors as triggers, more severe course, lower level of control and quality of life, pain, pronounced bronchial obstruction with lower reversibility.
References
Global Initiative for Asthma. (2016). Global strategy for asthma management and prevention. Retrieved from: https://ginasthma.org/wp-content/uploads/2019/01/2016-GINA.pdf
National Center for Environmental Health. (2021). AsthmaStats. Asthma and obesity. Retrieved from: https://www.cdc.gov/asthma/asthma_stats/percentage_people_asthma_obese.pdf
Fainardi, V., Passadore, L., Labate, M., Pisi, G., & Esposito, S. (2022). An Overview of the Obese-Asthma Phenotype in Children. International journal of environmental research and public health, 19(2), 636. https://doi.org/10.3390/ijerph19020636
Farzan, S., Coyle, T., Coscia, G., Rebaza, A., & Santiago, M. (2022). Clinical Characteristics and Management Strategies for Adult Obese Asthma Patients. Journal of asthma and allergy, 15, 673-689. https://doi.org/10.2147/JAA.S285738
Ross, M. K., Romero, T., Sim, M. S., & Szilagyi, P. G. (2019). Obese- and allergic-related asthma phenotypes among children across the United States. The Journal of asthma, 56(5), 512-521. https://doi.org/10.1080/02770903.2018.1466317
Fitzpatrick, A. M., Mutic, A. D., Mohammad, A. F., Stephenson, S. T., & Grunwell, J. R. (2022). Obesity Is Associated with Sustained Symptomatology and Unique Inflammatory Features in Children with Asthma. The journal of allergy and clinical immunology. In practice, 10(3), 815-826.e2. https://doi.org/10.1016/j.jaip.2021.10.020
Lugogo, N., Francisco, D., Addison, K. J., Manne, A., Pederson, W., Ingram, J. L., Green, C. L., Suratt, B. T., Lee, J. J., Sunday, M. E., Kraft, M., & Ledford, J. G. (2018). Obese asthmatic patients have decreased surfactant protein A levels: Mechanisms and implications. The Journal of allergy and clinical immunology, 141(3), 918-926.e3. https://doi.org/10.1016/j.jaci.2017.05.028
Forno, E., & Celedón, J. C. (2017). The effect of obesity, weight gain, and weight loss on asthma inception and control. Current opinion in allergy and clinical immunology, 17(2), 123-130. https://doi.org/10.1097/ACI.0000000000000339
Peters, U., Dixon, A. E., & Forno, E. (2018). Obesity and asthma. The Journal of allergy and clinical immunology, 141(4), 1169-1179. https://doi.org/10.1016/j.jaci.2018.02.004
Villeneuve, T., & Guilleminault, L. (2020). Asthme et obésité de l’adulte [Asthma and obesity in adults]. Revue des maladies respiratoires, 37(1), 60-74. [in French]. https://doi.org/10.1016/j.rmr.2019.03.016
Reyes-Angel, J., Kaviany, P., Rastogi, D., & Forno, E. (2022). Obesity-related asthma in children and adolescents. The Lancet. Child & adolescent health, 6(10), 713-724. https://doi.org/10.1016/S2352-4642(22)00185-7
Feshchenko, Yu. I., Gumeniuk, G. L., Gumeniuk, M. I., Zaikov, S. V., Rekalova, O. M., & Opimakh, S. H. (2019). Lung ventilation impairment in asthma patients with obesity. Zaporozhye medical journal, 21(6), 733-738. https://doi.org/10.14739/2310-1210.2019.6.186486
Khalid, F., & Holguin, F. (2018). A review of obesity and asthma across the life span. The Journal of asthma, 55(12), 1286-1300. https://doi.org/10.1080/02770903.2018.1424187
Dixon, A. E., & Poynter, M. E. (2016). Mechanisms of Asthma in Obesity. Pleiotropic Aspects of Obesity Produce Distinct Asthma Phenotypes. American journal of respiratory cell and molecular biology, 54(5), 601-608. https://doi.org/10.1165/rcmb.2016-0017PS
Kim, M., Cho, S. H., Jung, J. W., Choi, B. W., Kim, S. H., Park, H. K., Jang, A. S., Jin, H. J., Shin, Y. S., Kim, M. H., Lee, J. H., Park, J. W., Kwon, J. W., Lee, T., Kim, S., Kim, T. B., Choi, J. H., & COREA investigators (2022). Association between obesity and lung function changes by sex and age in adults with asthma. The Journal of asthma, 59(1), 59-69. https://doi.org/10.1080/02770903.2020.1839904
Çelebi Sözener, Z., Aydın, Ö., Mungan, D., & Mısırlıgil, Z. (2016). Obesity-asthma phenotype: Effect of weight gain on asthma control in adults. Allergy and asthma proceedings, 37(4), 311-317. https://doi.org/10.2500/aap.2016.37.3949
Jiang, D., Wang, L., Ding, M., Bai, C., Zhu, X., & Chen, O. (2020). Association between Body Mass Index Status and Childhood Asthma Control. Childhood obesity (Print), 16(4), 274-280. https://doi.org/10.1089/chi.2020.0029
Mohan, A., Grace, J., Wang, B. R., & Lugogo, N. (2019). The Effects of Obesity in Asthma. Current allergy and asthma reports, 19(10), 49. https://doi.org/10.1007/s11882-019-0877-z
Downloads
Published
How to Cite
Issue
Section
License
Authors who publish with this journal agree to the following terms:- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access)
