[Asthma and obesity: relationship and therapeutic implications in patients with asthma at the Department of Pneumology in Monastir, Tunisia]. / Asthme et obésité: relation et implications thérapeutiques auprès des patients asthmatiques du Service de Pneumologie de Monastir, Tunisie.

ABSTRACT

INTRODUCTION: Obesity and asthma are two chronic diseases affecting millions of people around the world. A causal relationship has been suggested. The purpose of our study is to examine the profile in obese people with asthma and to determine the relationship between the different severity parameters in asthma and the degree of obesity. METHODS: We conducted a retrospective, monocentric, analytical study involving 450 asthmatics with a body mass index (BMI) ≥ 30 kg/m2 having follow up visit at less than 6 months. The study was conducted in the Department of Pneumology and Allergology at the Fattouma Bourguiba Hospital in Monastir. RESULTS: The average age at diagnosis was 45±12.8 years. Mean BMI was 34.8±4.2 kg/m2. Asthma was well-controlled in 55.3% of patients. Severity criteria were reported in 37.4% of cases. According to GINA 2016, 24.2% of patients received treatment at step 4. Two asthma phenotypes associated with obesity were reported. The first phenotype (52.4%) was characterized by early-onset asthma associated with a higher incidence of allergic disease and manifestations of atopy. The second phenotype (47.6%) was characterized by late onset asthma, commonly occurring in female sex as well as a higher rate of comorbidities and hospitalizations. Patients with class II and III obesity had significant ventilatory deficiency (CVF p = 0.002 and FEV1 p = 0.007). CONCLUSION: Obesity is one of the key factors involved in poor asthma control. Its management, which has not yet been codified, should be multidisciplinary.