Influence of Body Mass Indexes on Response to Treatment in Acute Asthma
Abstract
Increases in body mass index (BMI) are reported to influence asthma response to treatment. The aim of this study was to investigate the relationship between BMI and response to treatment in a group of patients that were referred for asthma control. Effectiveness measurements in this analysis included percentage of changes in forced volume in 1 second (FEV1), forced volume capacity (FVC), FEV1/FVC, and forced expiratory flow between 25% and 75% of FVC (FEF25-75%). A total of 293 subjects with asthma of both genders and above 18 years of age were divided into the following BMI categories: 107 (36.5%) non-obese (BMI < 25), 186 (63.5%) overweight and obese (BMI ≥ 25). Percentage of change was defined as change in variable between baseline and end-of-treatment. Analyses of non-obese vs. overweight/obese asthmatics demonstrated non-significant differences in baseline FEV1 (1.62 ± 0.56 Lit vs. 1.63 ± 0.56 Lit L, P = 0.89); FVC (2.58 ± 0.73 Lit vs. 2.47 ± 0.82 Lit, P = 0.25); and FEF25-75% (1.04 ± 0.55 ml/sec vs. 1.05 ± 0.50 ml/sec, P = 0.47) respectively. Compared with non-obese subjects, in overweight/obese subjects with asthma were less responded to treatment. Percentage changes of FEV1, FVC, FEF25-75%, and FEV1/FVC in non-obese versus obese/overweight patients were: 79.57 ± 55.14 % vs. 62.13 ± 41.72%, P = 0.005; 47.71 ± 33.76% vs. 39.93 ± 28.30%, P = 0.036; 151.98 ± 127.82% vs. 123 ± 91.12%, P = 0.041; 20.54 ± 15.63% vs. 15.63 ± 11.32%, P = 0.005; respectively. Percentage changes of spirometric values to treatment in over weight/obese asthmatic patient were lesser in compared with non-obese subjects.
Hedley AA, Ogden CL, Johnson CL, et al. Prevalence of overweight and obesity among US children, adolescents,and adults, 1999-2002. JAMA 2004;291(23):2847-50.
Mannino DM, Homa DM, Akinbami LJ, et al. Surveillance for asthma--United States, 1980-1999. MMWR Surveill Summ 2002;51(1):1-13.
Camargo CA Jr, Weiss ST, Zhang S, et al. Prospective study of body mass index, weight change, and risk of adult-onset asthma in women. Arch Intern Med 1999;159(21):2582-8.
Ford ES, Mannino DM, Redd SC, et al. Body mass index and asthma incidence among USA adults. Eur Respir J 2004;24(5):740-4.
Nystad W, Meyer HE, Nafstad P, et al. Body mass index in relation to adult asthma among 135,000 Norwegian men and women. Am J Epidemiol 2004;160(10):969-76.
Taylor B, Mannino D, Brown C, et al. Body mass index and asthma severity in the national asthma survey. Thorax 2008;63(1):14-20.
Mosen DM, Schatz M, Magid DJ, et al. The relationship between obesity and asthma severity and control in adults. J Allergy Clin Immunol 2008;122(3):507-11.
Sutherland ER, Lehman EB, Teodorescu M, et al. Body mass index and phenotype in subjects with mild-tomoderate persistent asthma. J Allergy Clin Immunol 2009;123(6):1328-34.
Boulet LP, Franssen E. Influence of obesity on response to fluticasone with or without salmeterol in moderate asthma. Respir Med 2007;101(11):2240-7.
Dixon AE, Shade DM, Cohen RI, et al. Effect of obesityon clinical presentation and response to treatment in asthma. J Asthma 2006;43(7):553-8.
Camargo CA Jr, Sutherland ER, Bailey W, et al. Effect of increased body mass index on asthma risk, impairment and response to asthma controller therapy in African Americans. Curr Med Res Opin 2010;26(7):1629-35.
Sutherland ER, Goleva E, Strand M, et al. Body mass and glucocorticoid response in asthma. Am J Respir Crit Care Med 2008;178(7):682-7.
Camargo CA Jr, Boulet LP, Sutherland ER, et al. Body mass index and response to asthma therapy:fluticasone propionate/salmeterol versus montelukast. J Asthma 2010;47(1):76-82.
Peters-Golden M, Swern A, Bird SS, et al. Influence of body mass index on the response to asthma controller agents. Eur Respir J 2006;27(3):495-503.
Forno E, Lescher R, Strunk R, et al. Decreased response to inhaled steroids in overweight and obese asthmatic children. J Allergy Clin Immunol 2011;127(3):741-9.
Standardization of Spirometry, 1994 Update. American Thoracic Society. Am J Respir Crit Care Med 1995;152(3):1107-36.
Carroll CL, Bhandari A, Zucker AR, et al. Childhood obesity increases duration of therapy during severe asthma exacerbations. Pediatr Crit Care Med 2006;7(6):527-31.
Rodrigo GJ, Plaza V. Body mass index and response to emergency department treatment in adults with severe asthma exacerbations:a prospective cohort study. Chest 2007;132(5):1513-9.
Lessard A, Turcotte H, Cormier Y, et al. Obesity and asthma:a specific phenotype? Chest 2008;134(2):317-23.
Tantisira KG, Litonjua AA, Weiss ST, et al. Association of body mass with pulmonary function in the Childhood Asthma Management Program (CAMP). Thorax 2003;58(12):1036-41.
Lavoie KL, Bacon SL, Labrecque M, et al. Higher BMI is associated with worse asthma control and quality of life but not asthma severity. Respir Med 2006;100(4):648-57.
Shore SA, Fredberg JJ. Obesity, smooth muscle, and airway hyperresponsiveness. J Allergy Clin Immunol 2005;115(5):925-7.
Beuther DA, Weiss ST, Sutherland ER. Obesity and asthma. Am J Respir Crit Care Med 2006;174(2):112-9.
Clark AR. MAP kinase phosphatase 1: a novel mediator of biological effects of glucocorticoids? J Endocrinol 2003;178(1):5-12.
Farah CS, Kermode JA, Downie SR, et al. Obesity is a determinant of asthma control independent of inflammation and lung mechanics. Chest 2011;140(3):659-66.
Sutherland ER, Goleva E, Jackson LP, et al. Vitamin D levels, lung function, and steroid response in adult asthma. Am J Respir Crit Care Med 2010;181(7):699-704.
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Issue | Vol 52, No 3 (2014) | |
Section | Original Article(s) | |
Keywords | ||
Body mass index Obesity Overweight Pulmonary disease Drug resistance |
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