Obesity in aspirin-tolerant and aspirin-intolerant asthmatics.

Division of Allergy and Respiratory Diseases, Asthma and Allergy Research Group, Soonchunhyang University, Bucheon, Korea.
Respirology (Impact Factor: 3.5). 09/2008; 13(7):1034-8. DOI: 10.1111/j.1440-1843.2008.01358.x
Source: PubMed

ABSTRACT Obesity is an important factor in the development of asthma. Aspirin hypersensitivity affects 5-10% of asthmatics. The association between obesity and aspirin hypersensitivity in asthma is unclear. This study evaluated the association of BMI and asthma in patients with aspirin-tolerant asthma (ATA) and aspirin-intolerant asthma (AIA).
Aspirin provocation tests were performed in 667 asthmatic patients and changes in FEV(1) were used to categorize patients as ATA or AIA. The BMI of asthmatics was graded using the percentile BMI of 406 normal controls.
Aspirin-induced changes in FEV(1)% ranged from 15% to 68%. Compared with the controls, the ATA group had a higher BMI (24.5 +/- 0.1 vs 23.8 +/- 0.2 kg/m(2), P = 0.001). The AIA group had a lower BMI. The aspirin-induced percentage fall in FEV(1) was inversely correlated with BMI in asthmatic patients (r = -0.094, P = 0.016). BMI was correlated with age and PC20, but not with FEV(1) in asthmatic patients. In a logistic regression adjusted for age, gender, and smoking status, FEV(1) and PC20 were associated with AIA with odds ratios of 0.986 and 0.586, respectively. BMI was associated with AIA with an odds ratio of 0.916.
Aspirin intolerance in asthmatics explains the lesser association with obesity. Obesity is not a risk factor in the development of asthma in patients with AIA.

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    ABSTRACT: Background Population-based studies on aspirin-intolerant asthma are very few and no previous population study has investigated risk factors for the condition.Objective To investigate the prevalence and risk factors of aspirin-intolerant asthma in the general population.MethodsA questionnaire on respiratory health was mailed to 30 000 randomly selected subjects aged 16-75 years in West Sweden, 29 218 could be traced and 18 087 (62%) responded. The questionnaire included questions on asthma, respiratory symptoms, aspirin-induced dyspnea and possible determinants.ResultsThe prevalence of aspirin-intolerant asthma was 0.5%, 0.3% in men and 0.6% in women (p=0.014). Sick leave, emergency visits due to asthma and all investigated lower respiratory symptoms were more common in aspirin-intolerant asthma than in aspirin-tolerant asthma. Obesity was a strong risk factor for aspirin-intolerant asthma (BMI>35: OR 12.1; 95% CI 2.49-58.5) and there was a dose-response relationship between increasing body mass index and risk of aspirin-intolerant asthma. Obesity, airborne occupational exposure and visible mold at home were considerably stronger risk factors for aspirin-intolerant asthma than for aspirin-tolerant asthma. Current smoking was a risk factor for aspirin-intolerant asthma (OR 2.55; 95% CI 1.47-4.42), but not aspirin-tolerant asthma.Conclusion Aspirin-intolerant asthma identified in the general population was associated with a high burden of symptoms, uncontrolled disease and a high morbidity. Increasing body mass index increased the risk of aspirin-intolerant asthma in a dose-response manner. A number of risk factors, including obesity and current smoking, were considerably stronger for aspirin-intolerant asthma than for aspirin-tolerant asthma.This article is protected by copyright. All rights reserved.
    Clinical & Experimental Allergy 06/2014; · 4.32 Impact Factor
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    ABSTRACT: The prevalence of rhinitis and asthma has increased considerably over the past century. The cause of this increase remains unknown. Furthermore, rhinitis and asthma are now considered heterogeneous syndromes encompassing several clinical phenotypes. The overall aim of this thesis was to investigate the prevalence, risk factors and comorbidity of rhinitis and asthma phenotypes with a particular focus on aspirin-intolerant asthma. This thesis is mainly based on a postal questionnaire with 18 087 responders (62%) living in West Sweden. The prevalence of allergic rhinitis (AR) was 20% in those raised on a farm compared to 28% in subjects raised elsewhere. A lower prevalence of AR in subjects raised on a farm was found in all age groups. The prevalence of chronic rhinitis (CR) was 20%. Both AR and CR were more common in urban than in rural areas. Cigarette smoking was associated with a high prevalence of CR and a low prevalence of AR. Both associations were dose-dependent and were found also in two large population surveys conducted in the city of Stockholm. Skin prick testing was performed on a randomly selected subsample of the West Sweden cohort. Prevalence of skin prick test positivity was significantly lower in smokers (34%) than in non-smokers (46%). Considerable overlap was found between asthma and nasal comorbidities and different nasal comorbidities were associated with different symptom expression of asthma. Prevalence of aspirin-intolerant asthma (AIA) was 0.5%. The risk of AIA increased linearly with increasing body mass index. CR was commonly found in AIA. We conclude that AR and CR are common in the general population of West Sweden. The two rhinitis phenotypes share some, but not all, risk factors. Both conditions are associated with asthma and lower respiratory symptoms, indicating a strong relationship between the upper and lower airways. Aspirin-intolerant asthma was found in the general population as was associated with obesity and chronic rhinitis.
    06/2013, Degree: PhD, Supervisor: Bo Lundbäck


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