Article

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: 11.99). 03/2005; 171(4):334-9. DOI: 10.1164/rccm.200405-674OC
Source: PubMed

ABSTRACT 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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    • "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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    • "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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    • "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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