Adiposity, asthma, and airway inflammation

doi:10.1016/j.jaci.2006.10.029

Journal of Allergy and Clinical Immunology

Volume 119, Issue 3, March 2007, Pages 634-639

https://doi.org/10.1016/j.jaci.2006.10.029 Get rights and content

Background

Several studies have found obesity to be associated with an increased prevalence of asthma. For reasons that remain unclear, this association has often been reported to be stronger in women than in men. One possible explanation might be that these studies have used body mass index to identify adiposity, which might be a less reliable measure of body fat in men than in women.

Objective

We sought to explore the association between body fat percentage measured by means of bioelectrical impedance analysis and asthma, airflow obstruction, and airway inflammation in men and women.

Methods

Respiratory questionnaires, spirometry, bronchodilator response, exhaled nitric oxide level, and percentage of body fat were measured in a population-based cohort of approximately 1000 individuals at age 32 years.

Results

There was a significant association between the percentage of body fat and asthma in women (P = .043) but not in men (P = .75). Airflow obstruction was associated with percentage of body fat in women (P = .046), but there was an inverse association in men (P = .010). Bronchodilator responsiveness was also associated with lower body fat in men (P = .004). Airway inflammation, measured by means of exhaled nitric oxide, was not associated with body fat in either women (P = .17) or men (P = .25).

Conclusion

Adiposity is associated with asthma and airflow obstruction in women. This does not appear to be mediated by airway inflammation. In men airflow obstruction and bronchodilator responsiveness are associated with a lower percentage of body fat.

Clinical implications

In women, but not in men, obesity is associated with asthma and airflow obstruction, but there was no association with airway inflammation.

Section snippets

Methods

The Dunedin Study has been described in detail elsewhere.¹⁴ Briefly, this is a longitudinal study in a birth cohort of 1037 individuals born in Dunedin in 1972-1973. The cohort represents the full range of socioeconomic status in New Zealand's South Island, and Study members are mostly of New Zealand/European ethnicity. A broad range of health, behavioral, and developmental assessments has been conducted at birth and ages 3, 5, 7, 9, 11, 13, 15, 18, 21, 26, and 32 years. At the assessment at 32

Adiposity

Body fat percentage was used to determine adiposity and was measured in 438 nonpregnant women and 487 men. Women had a higher mean body fat than men (34.2% [SD, 8.0%] vs 20.7% [SD, 6.2%], respectively; P < .001). Current smokers had lower body fat percentages than nonsmokers (women: 33.3% vs 34.7%, P = .081; men: 19.1% vs 21.6%, P < .001). Similar differences were found for percentage of trunk fat. Mean BMI was not significantly different between women (25.9 kg/m² [SD, 5.6 kg/m²]) and men (26.3

Discussion

These results confirm that there is an association between obesity and asthma in adult women. They extend earlier observations by using body fat percentage in place of BMI as the measure of adiposity. No association was found between asthma and adiposity in men by using either BMI or body fat percentage. In women, a higher body fat percentage was also associated with airflow obstruction on spirometry but not with bronchodilator responsiveness to salbutamol. By contrast, we found a lower body

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In Singapore, the prevalence of asthma is as high as 13.2% in young adults (Ministry of Health, 2009). Obesity is well documented to be associated with increased risk and severity of asthma, although the underlying biological mechanism and relationship with NPY is not well understood (McLachlan et al., 2007). In a 10-year longitudinal study of 939 Singaporean asthma patients (Tan et al., 2016), the prevalence of being overweight or obese accounts for more than half of the sample (31% obese (BMI ≥ 25 kg/m2) and 20% overweight (BMI 24–26.9 kg/m2)) and is among the main predictors of subsequent asthma costs.
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This study and the Dunedin Multidisciplinary Health and Development Research Unit are funded by the Health Research Council of New Zealand. Christene McLachlan received support from the Otago Asthma Society. Dr Sears holds the AstraZeneca Chair in Respiratory Epidemiology, McMaster University.

Disclosure of potential conflict of interest: The authors have declared that they have no conflict of interest.

View full text

Mechanisms of asthma and allergic inflammationAdiposity, asthma, and airway inflammation

Background

Objective

Methods

Results

Conclusion

Clinical implications

Section snippets

Methods

Adiposity

Discussion

J Allergy Clin Immunol

Chest

J Allergy Clin Immunol

J Allergy Clin Immunol

Am J Clin Nutr

Respir Med

Am J Clin Nutr

Am J Clin Nutr

The relation of body mass index to asthma, chronic bronchitis, and emphysema

Chest

Asthma is associated with weight gain in females but not males, independent of physical activity

Am J Respir Crit Care Med

Obesity: insight into the origins of asthma

Nat Immunol

How useful is body mass index for comparison of body fatness across age, sex, and ethnic groups?

Am J Epidemiol

Obesity is a risk for asthma and wheeze but not airway hyperresponsiveness

Thorax

Sex differences in the relation between body mass index and asthma and atopy in a birth cohort

Am J Respir Crit Care Med

Mechanisms of asthma and allergic inflammation
Adiposity, asthma, and airway inflammation