Obesity is associated with increased asthma severity and exacerbations, and increased serum immunoglobulin E in inner-city adults

S. Fitzpatrick, R. Joks, J. I. Silverberg*

*Corresponding author for this work

Research output: Contribution to journalArticle

43 Scopus citations

Abstract

Background: Obesity is associated with increased asthma and atopy. Objective: To determine whether or not obesity in inner-city adults is associated with increased asthma prevalence, severity and exacerbations and IgE responses. Methods: This retrospective study involved 246 adults with asthma and other atopic disorders who were seen at an asthma clinic in New York City between 1997 and 2010. Height, weight, asthma diagnosis and symptoms, peak flow (PF), spirometry, serum IgE levels and white blood cell differentials were recorded. Results: Asthmatic patients had higher body mass index than non-asthmatics (median, interquartile range: 30.5, 10.2 vs. 27.8, 8.8; Mann-Whitney U-test, P = 0.0006). Class I and II/III obesity were associated with increased asthma (I: OR: 2.35, 95% CI: 1.04-5.34, P = 0.04; II/III: OR: 3.25, 95% CI: 1.36-7.74, P = 0.008). Class I and II/III obesity were associated with worsened asthma severity (ordinal logistic regression; I: OR: 4.23, 95% CI: 1.61-11.06, P = 0.003; II/III: OR: 2.76, 95% CI: 1.08-7.09, P = 0.03). Class II/III obesity was associated with increased asthma exacerbations requiring oral corticosteroids (repeated measures logistic regression, OR: 1.13, 95% CI: 1.03-1.25; P = 0.01) and increased requirement of inhaled corticosteroid for long-term asthma management (OR: 1.45, 95% CI: 1.29-1.62; P < 0.0001). In asthmatics, class II/III obesity was associated with decreased PF (general linear model, least squares mean ± SEM: 333.8 ± 37.4 vs. 396.2 ± 32.1 L/min; P = 0.007), forced expiratory volume in 1 s (75.2 ± 4.6 vs. 88.4 ± 5.6%; P = 0.03) and forced vital capacity (83.2 ± 4.7 vs. 109.2 ± 6.0%; P = 0.0002) and increased serum IgE (480.2 ± 88.3 vs. 269.0 ± 66.6 IU/mL; P = 0.04) and neutrophils (66.6 ± 3.7 vs. 60.1 ± 3.8%; P = 0.02). Class I obesity was also associated with increased serum IgE (458.7 ± 68.9, P = 0.03). Conclusion and clinical relevance: Obesity in inner-city adults may be both a risk and exacerbating factor for atopic asthma.

Original languageEnglish (US)
Pages (from-to)747-759
Number of pages13
JournalClinical and Experimental Allergy
Volume42
Issue number5
DOIs
StatePublished - May 1 2012

Keywords

  • Asthma
  • Asthma severity
  • Atopy
  • BMI
  • Basophil
  • Class I, II and III obesity
  • Eosinophil
  • Forced expiratory volume in 1 s (FEV1)
  • Forced vital capacity (FVC)
  • Immunoglobulin E
  • Leukocyte
  • Lymphocyte
  • Monocyte
  • Neutrophil
  • Obesity
  • Overweight
  • Peak flow
  • Pulmonary function test
  • Spirometry
  • Weight
  • Wheeze
  • White blood cell

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology

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