• J Allergy Clin Immunol Pract · Jul 2015

    Prospective Study on the Relationship of Obesity to Asthma Impairment and Risk.

    • Michael Schatz, Robert S Zeiger, Su-Jau Yang, Wansu Chen, Shiva Sajjan, Felicia Allen-Ramey, and Carlos A Camargo.
    • Department of Allergy, Kaiser Permanente Medical Center, San Diego and Los Angeles, Calif. Electronic address: michael.x.schatz@kp.org.
    • J Allergy Clin Immunol Pract. 2015 Jul 1; 3 (4): 560-5.e1.

    BackgroundAlthough studies consistently show an association between obesity and increased asthma incidence, the role of obesity in asthma control is less clear.ObjectiveThe objective of this study was to evaluate the association between baseline body mass index (BMI) and measures of subsequent asthma control in a large real-world cohort of adults with persistent asthma.MethodsIn Kaiser Permanente Southern California (KPSC), a large managed care organization, we identified adults with persistent asthma in 2006, continuous health plan enrollment in 2007 and 2008, and a BMI measurement in 2006 or 2007. Each patient's last BMI measure in 2006 or 2007 was categorized into a BMI group: normal (<25 kg/m(2)), overweight (25-29.9 kg/m(2)), or obese (≥30 kg/m(2)). Asthma control outcomes in 2008 included asthma hospitalizations or emergency department visits (EDHO), oral corticosteroid dispensings linked to an asthma encounter (OCS), and dispensing of ≥7 short-acting beta-agonist canisters (SABA7). Multivariable analyses were conducted to assess the relationships of BMI categories with the risk of the asthma control outcomes after controlling for potential confounders.ResultsIn the 10,233 eligible adults-after adjusting for potential demographic, comorbidity, and prior utilization confounders-we found an increased relative risk (RR) of EDHO in overweight and obese (RR 1.40, 95% CI 1.10-1.78) individuals. Only obesity was associated in adjusted analyses with a significant increased relative risk of SABA7 (RR 1.27, 95% CI 1.15-1.40).ConclusionsElevated BMI, particularly obesity, is associated with subsequent poor asthma control, especially in the risk domain (exacerbations). These findings further support the importance of facilitating weight loss in overweight and obese adults with asthma.Copyright © 2015 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

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