Airway inflammation in obese and nonobese patients with difficult-to-treat asthma.
Allergy
; 63(5): 570-4, 2008 May.
Article
em En
| MEDLINE
| ID: mdl-18394131
ABSTRACT
BACKGROUND:
Asthma and obesity are associated disorders, but the contribution of obesity to difficult-to-treat asthma as well as the mechanisms responsible for this relationship are unclear. The aim of this study was to investigate the relationship between obesity (body mass index >/= 30) and factors related with asthma severity in patients with difficult-to-treat asthma.METHODS:
One hundred and thirty-six nonsmoking asthmatic adults with persistent symptoms despite high doses of inhaled or oral corticosteroids and long-acting bronchodilators were studied [70% female, median (range) age 44.6 (18-75) years, 32% on daily oral corticosteroids]. The association between obesity, lung function parameters [forced expiratory volume in 1 s (FEV(1)), functional residual capacity/total lung capacity (FRC/TLC)], inflammatory markers [blood eosinophils, sputum eosinophils and neutrophils, exhaled nitric oxide (FE(NO)), airway hyperresponsiveness, C-reactive protein (CRP)] and aggravating co-morbid factors (severe chronic sinus disease, gastro-esophageal reflux, recurrent respiratory infections, psychopathology and obstructive sleep apnea) was investigated.RESULTS:
Obese patients (n = 29) had a higher FEV(1)%pred (P = 0.05) and a lower FRC/TLC%pred (P < 0.01) compared with nonobese patients (n = 107). Body mass index was inversely related with sputum eosinophils (r = -0.36, P < 0.01) and FE(NO) (r = -0.30, P < 0.01). Obese patients had an increased risk for gastro-esophageal reflux (OR = 2.3) and sleep apnea (OR = 3.1).CONCLUSION:
Obesity in patients with difficult-to-treat asthma is inversely related with sputum eosinophils and FE(NO), and positively associated with the presence of co-morbid factors and reduced lung volumes. This suggests that other factors than airway inflammation alone explain the relationship between obesity and asthma severity.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Asma
/
Índice de Gravidade de Doença
/
Pulmão
/
Obesidade
Tipo de estudo:
Etiology_studies
/
Risk_factors_studies
Limite:
Adolescent
/
Adult
/
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Allergy
Ano de publicação:
2008
Tipo de documento:
Article
País de afiliação:
Holanda