Impact of metabolic and weight components on incident asthma using a real-world cohort.

ABSTRACT

BACKGROUND: Obesity and metabolic dysregulation (MetD) have increasing prevalence and adversely affect asthma morbidity and therapeutic response. OBJECTIVE: To determine the role of weight and MetD on incident asthma in adulthood. METHODS: In a retrospective, longitudinal cohort of patients, we performed a time-to-asthma diagnosis analysis after a 3-year landmark period (t0-t3) during which weight and MetD components were evaluated. We assessed incident asthma risk with MetD components and weight. RESULTS: In total, 90,081 patients met the inclusion criteria, with 836 cases (0.93%) of incident asthma in our primary cohort. Diabetes present at t0, but no other MetD components, was associated with increased risk of asthma (adjusted hazard ratio = 1.85, 95% CI 1.27-2.71, P = .0002). The effect of weight on asthma risk, independent of other MetD components, identified individuals with overweight or obesity as having a 10-year attributable risk of 15.4%. Metformin was prescribed more frequently, and hemoglobin A1c levels were lower in patients with diabetes in whom asthma did not develop (P < .0001). CONCLUSION: Weight and diabetes prevention and management represent modifiable risk factors for adult asthma development.