Asthma Severity Is Associated with Body Mass Index and Early Menarche in Women

INSERM U472, Epidemiology and Biostatistics, 16 avenue Paul Vaillant Couturier, 94807 Villejuif cedex, France.
American Journal of Respiratory and Critical Care Medicine (Impact Factor: 13). 03/2005; 171(4):334-9. DOI: 10.1164/rccm.200405-674OC
Source: PubMed


Asthma severity in relation to body mass index (BMI) has rarely been studied. The relation between BMI and asthma severity was studied by sex in 366 adults with asthma from the Epidemiological Study on the Genetics and Environment of Asthma, a case-control and family study on asthma. Factors related to asthma severity and BMI such as smoking, FEV(1), bronchial hyperresponsiveness, and dyspnea were taken into account. The influence of early menarche was studied to assess the potential role of hormonal factors. Clinical asthma severity in the last 12 months was assessed by a score (0-7) based on the frequency of asthma attacks, persisting symptoms between attacks, and hospitalization. Asthma severity, which was unrelated to sex, increased with BMI in women (p = 0.0001) but not in men (p = 0.3). In women, the association remained after adjustment for age, FEV(1), smoking habits, and BMI-adjusted dyspnea and taking into account familial dependence (p = 0.0001). The association between BMI and severity was stronger in women with early menarche than in women without early menarche (p interaction = 0.02). Findings support the hypothesis of hormonal factors involved in the severity of asthma.

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Available from: Jean Maccario, Apr 23, 2015
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    • "It has also been reported that BMI is positively correlated with the severity of bronchial asthma in women. No such correlation was found in men [7]. In the present study, body height, BMI and skin-fold thicknesses were not significantly correlated with either the severity of the disease or the duration of the disease. "
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    ABSTRACT: Background: The excess of adipose tissue and the pattern of adipose tissue distribution in the body seem to play an important role in the complicated dependencies between obesity and risk of developing asthma. The aim of the present study was to determine nutritional status in children and adolescents with bronchial asthma with special emphasis on adipose tissue distribution evaluated on the basis of skin-fold thicknesses, and to determine the relationships between patterns of adipose tissue distribution and the course of the disease. Methods: Anthropometric data on height, weight, circumferences and skin-fold thicknesses were extracted from the medical histories of 261 children diagnosed with asthma bronchitis. Values for children with asthma were compared to Polish national growth reference charts. Distribution of subcutaneous adipose tissue was evaluated using principal components analysis (PCA). Multivariate linear regression analyses tested the effect of three factors on subcutaneous adipose tissue distribution: type of asthma, the severity of the disease and the duration of the disease. Results: Mean body height in the children examined in this study was lower than in their healthy peers. Mean BMI and skin-fold thicknesses were significantly higher and lean body mass was lower in the study group. Excess body fat was noted, especially in girls. Adipose tissue was preferentially deposited in the trunk in girls with severe asthma, as well as in those who had been suffering from asthma for a longer time. The type of asthma, atopic or non-atopic, had no observable effect on subcutaneous adipose tissue distribution in children examined. Conclusions: The data suggest that long-treated subjects and those with severe bronchial asthma accumulate more adipose tissue on the trunk. It is important to regularly monitor nutritional status in children with asthma, especially in those receiving high doses of systemic or inhaled glucocorticosteroids, and long-term treatment as well.
    Respiratory Medicine 12/2014; 109(2). DOI:10.1016/j.rmed.2014.11.006 · 3.09 Impact Factor
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    • "Pubertal timing and stage are risk factors for a number of physical health and functional somatic syndromes. To illustrate, individuals with asthma who enter puberty early are at greater risk of their condition persisting into adolescence and having increased severity in adulthood [35]. Pubertal development has also been found to be a better predictor than age of functional somatic syndromes in adolescents [36]. "
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    ABSTRACT: Puberty is a multifaceted developmental process that begins in late-childhood with a cascade of endocrine changes that ultimately lead to sexual maturation and reproductive capability. The transition through puberty is marked by an increased risk for the onset of a range of health problems, particularly those related to the control of behaviour and emotion. Early onset puberty is associated with a greater risk of cancers of the reproductive tract and cardiovascular disease. Previous studies have had methodological limitations and have tended to view puberty as a unitary process, with little distinction between adrenarche, gonadarche and linear growth. The Childhood to Adolescence Transition Study (CATS) aims to prospectively examine associations between the timing and stage of the different hormonally-mediated changes, as well as the onset and course of common health and behavioural problems that emerge in the transition from childhood to adolescence. The initial focus of CATS is on adrenarche, the first hormonal process in the pubertal cascade, which begins for most children at around 8 years of age.Methods/design: CATS is a longitudinal population-based cohort study. All Grade 3 students (8--9 years of age) from a stratified cluster sample of schools in Melbourne, Australia were invited to take part. In total, 1239 students and a parent/guardian were recruited to participate in the study. Measures are repeated annually and comprise student, parent and teacher questionnaires, and student anthropometric measurements. A saliva sample was collected from students at baseline and will be repeated at later waves, with the primary purpose of measuring hormonal indices of adrenarche and gonadarche. CATS is uniquely placed to capture biological and phenotypic indices of the pubertal process from its earliest manifestations, together with anthropometric measures and assessment of child health and development. The cohort will provide rich detail of the development, lifestyle, external circumstances and health of children during the transition from childhood through to adolescence. Baseline associations between the hormonal measures and measures of mental health and behaviour will initially be examined cross-sectionally, and then in later waves longitudinally. CATS will make a unique contribution to the understanding of adrenarche and puberty in children's health and development.
    BMC Pediatrics 10/2013; 13(1):160. DOI:10.1186/1471-2431-13-160 · 1.93 Impact Factor
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    • "In fact, the estrogens level increases with obesity favouring an early menarche in women and a delay in the onset of puberty in men [23]. It was found that the prevalence of asthma and the association between BMI with the severity of the disease were greater in women with an early menarche [27,28]. Furthermore, it seems that estrogens and progesterone may modify the inflammatory response to favour a Th2 response [23]. "
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    Multidisciplinary respiratory medicine 09/2013; 8(1):60. DOI:10.1186/2049-6958-8-60 · 0.15 Impact Factor
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