Does Obesity Increase Respiratory Tract Infections in Patients with Asthma?

Monica Tang*, Robert J. Henderson, Janet T. Holbrook, Loretta G. Que, Anne M. Mathews, Robert A. Wise, Anne E. Dixon, Stephen P. Peters, Linda Rogers, Lewis J Smith, W. Gerald Teague, Jason E. Lang

*Corresponding author for this work

Research output: Contribution to journalArticle

Abstract

Background: Because respiratory tract infections (RTIs) precede most exacerbations, a better understanding of the risk factors of RTIs and RTI-associated exacerbations in patients with asthma is a pressing public health need. Obesity in patients with asthma is associated with worse asthma control and higher asthma-associated health care utilization, but its effect on RTI risk is unknown. Objective: We aimed to study the association of body mass index (BMI) classification on the risk of self-reported RTIs and related asthma morbidity among adults and children with asthma. Methods: This post hoc analysis of 5 large asthma trials involving 747 children and 1287 adults compared BMI classification, defined as lean, overweight, and obese based on age-appropriate BMI and BMI-percentile conventions. The primary outcome was rate of visits with RTIs. Secondary asthma outcomes included upper respiratory infection (URI) severity, systemic steroid use, and health care contact. Results: Children had 1.4 times the rate of RTI compared with adults (95% confidence interval 1.27-1.56). In all participants, BMI classification did not affect the rate of visits with RTI. In children, BMI classification did not affect URI severity, all-cause asthma events, or RTI-associated asthma events. However, in adults, higher BMI classification was associated with an increase in moderate/severe URI (P =.02). Adults with higher BMI classification also had increased rates of all-cause and RTI-associated asthma exacerbations requiring systemic steroids and health care contact. Conclusions: BMI classification was not associated with an increased risk of RTIs in children or adults. In adults only, obesity was associated with increased URI severity and all-cause and RTI-associated asthma morbidity.

Original languageEnglish (US)
Pages (from-to)954-961.e6
JournalJournal of Allergy and Clinical Immunology: In Practice
Volume7
Issue number3
DOIs
StatePublished - Mar 1 2019

Fingerprint

Respiratory Tract Infections
Asthma
Obesity
Body Mass Index
Steroids
Patient Acceptance of Health Care
Morbidity
Delivery of Health Care
Public Health

Keywords

  • Asthma
  • Obesity
  • Respiratory tract infections

ASJC Scopus subject areas

  • Immunology and Allergy

Cite this

Tang, M., Henderson, R. J., Holbrook, J. T., Que, L. G., Mathews, A. M., Wise, R. A., ... Lang, J. E. (2019). Does Obesity Increase Respiratory Tract Infections in Patients with Asthma? Journal of Allergy and Clinical Immunology: In Practice, 7(3), 954-961.e6. https://doi.org/10.1016/j.jaip.2018.09.033
Tang, Monica ; Henderson, Robert J. ; Holbrook, Janet T. ; Que, Loretta G. ; Mathews, Anne M. ; Wise, Robert A. ; Dixon, Anne E. ; Peters, Stephen P. ; Rogers, Linda ; Smith, Lewis J ; Teague, W. Gerald ; Lang, Jason E. / Does Obesity Increase Respiratory Tract Infections in Patients with Asthma?. In: Journal of Allergy and Clinical Immunology: In Practice. 2019 ; Vol. 7, No. 3. pp. 954-961.e6.
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title = "Does Obesity Increase Respiratory Tract Infections in Patients with Asthma?",
abstract = "Background: Because respiratory tract infections (RTIs) precede most exacerbations, a better understanding of the risk factors of RTIs and RTI-associated exacerbations in patients with asthma is a pressing public health need. Obesity in patients with asthma is associated with worse asthma control and higher asthma-associated health care utilization, but its effect on RTI risk is unknown. Objective: We aimed to study the association of body mass index (BMI) classification on the risk of self-reported RTIs and related asthma morbidity among adults and children with asthma. Methods: This post hoc analysis of 5 large asthma trials involving 747 children and 1287 adults compared BMI classification, defined as lean, overweight, and obese based on age-appropriate BMI and BMI-percentile conventions. The primary outcome was rate of visits with RTIs. Secondary asthma outcomes included upper respiratory infection (URI) severity, systemic steroid use, and health care contact. Results: Children had 1.4 times the rate of RTI compared with adults (95{\%} confidence interval 1.27-1.56). In all participants, BMI classification did not affect the rate of visits with RTI. In children, BMI classification did not affect URI severity, all-cause asthma events, or RTI-associated asthma events. However, in adults, higher BMI classification was associated with an increase in moderate/severe URI (P =.02). Adults with higher BMI classification also had increased rates of all-cause and RTI-associated asthma exacerbations requiring systemic steroids and health care contact. Conclusions: BMI classification was not associated with an increased risk of RTIs in children or adults. In adults only, obesity was associated with increased URI severity and all-cause and RTI-associated asthma morbidity.",
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Tang, M, Henderson, RJ, Holbrook, JT, Que, LG, Mathews, AM, Wise, RA, Dixon, AE, Peters, SP, Rogers, L, Smith, LJ, Teague, WG & Lang, JE 2019, 'Does Obesity Increase Respiratory Tract Infections in Patients with Asthma?', Journal of Allergy and Clinical Immunology: In Practice, vol. 7, no. 3, pp. 954-961.e6. https://doi.org/10.1016/j.jaip.2018.09.033

Does Obesity Increase Respiratory Tract Infections in Patients with Asthma? / Tang, Monica; Henderson, Robert J.; Holbrook, Janet T.; Que, Loretta G.; Mathews, Anne M.; Wise, Robert A.; Dixon, Anne E.; Peters, Stephen P.; Rogers, Linda; Smith, Lewis J; Teague, W. Gerald; Lang, Jason E.

In: Journal of Allergy and Clinical Immunology: In Practice, Vol. 7, No. 3, 01.03.2019, p. 954-961.e6.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Does Obesity Increase Respiratory Tract Infections in Patients with Asthma?

AU - Tang, Monica

AU - Henderson, Robert J.

AU - Holbrook, Janet T.

AU - Que, Loretta G.

AU - Mathews, Anne M.

AU - Wise, Robert A.

AU - Dixon, Anne E.

AU - Peters, Stephen P.

AU - Rogers, Linda

AU - Smith, Lewis J

AU - Teague, W. Gerald

AU - Lang, Jason E.

PY - 2019/3/1

Y1 - 2019/3/1

N2 - Background: Because respiratory tract infections (RTIs) precede most exacerbations, a better understanding of the risk factors of RTIs and RTI-associated exacerbations in patients with asthma is a pressing public health need. Obesity in patients with asthma is associated with worse asthma control and higher asthma-associated health care utilization, but its effect on RTI risk is unknown. Objective: We aimed to study the association of body mass index (BMI) classification on the risk of self-reported RTIs and related asthma morbidity among adults and children with asthma. Methods: This post hoc analysis of 5 large asthma trials involving 747 children and 1287 adults compared BMI classification, defined as lean, overweight, and obese based on age-appropriate BMI and BMI-percentile conventions. The primary outcome was rate of visits with RTIs. Secondary asthma outcomes included upper respiratory infection (URI) severity, systemic steroid use, and health care contact. Results: Children had 1.4 times the rate of RTI compared with adults (95% confidence interval 1.27-1.56). In all participants, BMI classification did not affect the rate of visits with RTI. In children, BMI classification did not affect URI severity, all-cause asthma events, or RTI-associated asthma events. However, in adults, higher BMI classification was associated with an increase in moderate/severe URI (P =.02). Adults with higher BMI classification also had increased rates of all-cause and RTI-associated asthma exacerbations requiring systemic steroids and health care contact. Conclusions: BMI classification was not associated with an increased risk of RTIs in children or adults. In adults only, obesity was associated with increased URI severity and all-cause and RTI-associated asthma morbidity.

AB - Background: Because respiratory tract infections (RTIs) precede most exacerbations, a better understanding of the risk factors of RTIs and RTI-associated exacerbations in patients with asthma is a pressing public health need. Obesity in patients with asthma is associated with worse asthma control and higher asthma-associated health care utilization, but its effect on RTI risk is unknown. Objective: We aimed to study the association of body mass index (BMI) classification on the risk of self-reported RTIs and related asthma morbidity among adults and children with asthma. Methods: This post hoc analysis of 5 large asthma trials involving 747 children and 1287 adults compared BMI classification, defined as lean, overweight, and obese based on age-appropriate BMI and BMI-percentile conventions. The primary outcome was rate of visits with RTIs. Secondary asthma outcomes included upper respiratory infection (URI) severity, systemic steroid use, and health care contact. Results: Children had 1.4 times the rate of RTI compared with adults (95% confidence interval 1.27-1.56). In all participants, BMI classification did not affect the rate of visits with RTI. In children, BMI classification did not affect URI severity, all-cause asthma events, or RTI-associated asthma events. However, in adults, higher BMI classification was associated with an increase in moderate/severe URI (P =.02). Adults with higher BMI classification also had increased rates of all-cause and RTI-associated asthma exacerbations requiring systemic steroids and health care contact. Conclusions: BMI classification was not associated with an increased risk of RTIs in children or adults. In adults only, obesity was associated with increased URI severity and all-cause and RTI-associated asthma morbidity.

KW - Asthma

KW - Obesity

KW - Respiratory tract infections

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