Article

Effect of Obesity on Clinical Presentation and Response to Treatment in Asthma

University of Vermont, Burlington, VT 05401, USA.
Journal of Asthma (Impact Factor: 1.83). 10/2006; 43(7):553-8. DOI: 10.1080/02770900600859123
Source: PubMed

ABSTRACT Obesity is a risk factor for being diagnosed with asthma, but there is conflicting evidence on whether obesity is a risk factor for lung function abnormalities characteristic of asthma. We studied a cohort of 488 subjects, 47% of whom were obese. Obese and non-obese subjects with asthma had similar airflow limitation and bronchodilator responsiveness, but obese participants had increased sleep disturbance and gastroesophageal reflux disease, higher cytokine levels, and a trend towards increased exacerbations when treated with theophylline. Obese and non-obese asthmatics have similar lung function abnormalities, but comorbidities and altered responses to medications may significantly affect asthma control in obese people.

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    • "Indeed, OCS are not used clinically in patients with inflammatory conditions to cause weight gain. Lean tissue weight gain can be beneficial in terminally ill or cachectic patients [6], but gains in fat mass are undesirable and can be detrimental especially in conditions such as asthma, osteoarthritis, and diabetes [9]. Furthermore, the perceived association of OCS with obesity and weight gain can influence patients' compliance with their prescribed medications [1]. "
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    • "They found that obese patients who took theophylline had a trend towards an increased rate of exacerbations compared to placebo (8.1 versus 4.8 events per year, í µí±ƒ = 0.06) and the relative risk for exacerbation associated with obesity among patients on theophylline was 3.7 (í µí±ƒ < 0.001). There were no significant differences in response to treatment with montelukast [38] "
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    • "A similar inverse correlation between IL-6 in sputum and FEV1 was found in a cohort of severe asthmatic patients 32, while in a cohort of allergic asthmatic patients elevation of IL-6 in sputum associates with loss of central airway function 19. In obese asthmatic patients, the increased levels of IL-6 in serum also correlated with impaired lung function 33. Together, these studies indicate that the presence of IL-6 in the lung airways correlates with an impaired lung function in different subsets of asthmatic patients, and suggests that IL-6 is likely to be directly involved in the pathogenesis of asthma and the progressive loss of lung function observed in patients who remain untreated. "
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