Interacting effects of obesity, race, ethnicity and sex on the incidence and control of adult-onset asthma

Corinna Koebnick,Deborah Rohm Young,Heidi Fischer,Matthew F Daley,Beth Waitzfelder,Michael A Horberg,Michael K Gould,Assiamira Ferrara

doi:10.1186/s13223-016-0155-8

Corinna Koebnick, Deborah Rohm Young + Show 6 more

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https://doi.org/10.1186/s13223-016-0155-8

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Journal: Allergy, Asthma & Clinical Immunology	Publication Date: Oct 19, 2016
Citations: 25	License type: cc-by

Affiliation: Kaiser Permanente

Abstract

BackgroundTo improve care and control for patients with adult-onset asthma, a better understanding of determinants of their risk and outcomes is important. We investigated how associations between asthma, asthma control and obesity may be modified by patient demographic characteristics.MethodsThis retrospective study of adults enrolled in several health plans across the U.S. (n = 2,860,305) examined the interacting effects of obesity, age, race, and sex on adult-onset asthma and asthma control. Multivariable adjusted Cox and logistic regression models estimated hazard ratios (HR), and 95 % confidence intervals (CI) for the associations between body mass index (BMI) and study outcomes, and interactions of BMI with demographic characteristics.ResultsCompared with individuals who had a BMI <25 kg/m2, the hazard of adult-onset asthma progressively increased with increasing BMI, from a 12 % increase among persons with a BMI of 25.0–29.9 kg/m2 (HR 1.12, 95 % CI 1.10, 1.14) to an almost 250 % increase among persons with a BMI ≥50 kg/m2 (HR 2.49, 95 % CI 2.38, 2.60). The magnitude of the association between obesity and asthma risk was greater for women (compared with men) and lower for Blacks (compared with non-Hispanic Whites). Among individuals with asthma, obesity was associated with poorly controlled and high-risk asthma.ConclusionsThe present study demonstrates that the magnitude of the associations between obesity and adult-onset asthma incidence and control are modified by race, age, and sex. Understanding the role of obesity in the development of adult-onset asthma will help to improve asthma treatment algorithms and to develop targeted interventions.

Highlights

To improve care and control for patients with adult-onset asthma, a better understanding of determinants of their risk and outcomes is important
Koebnick et al Allergy Asthma Clin Immunol (2016) 12:50 pediatric and adult-onset asthma, little is known about the risk and outcomes of adult-onset asthma, the role of obesity in asthma development, and how the risk of asthma among the individuals who are obese may be modified by other factors such as race/ethnicity and sex
The hazard of developing adult-onset asthma progressively increased with higher body mass index (BMI) categories, from a 12 % increase among persons with a BMI of 25.0–29.9 kg/m2 (HR 1.12, 95 % confidence intervals (CI) 1.10, 1.14) to an almost 250 % increase among persons with a BMI ≥50 kg/m2 (HR 2.49, 95 % CI 2.38, 2.60) (Table 3)

Summary

Introduction

To improve care and control for patients with adult-onset asthma, a better understanding of determinants of their risk and outcomes is important. We investigated how associations between asthma, asthma control and obesity may be modified by patient demographic characteristics. While asthma often starts in early childhood, adult-onset asthma is often associated with poor control, more symptoms, and. Understanding the role of obesity in developing adultonset asthma and achieving control across heterogeneous groups of patients will help to improve asthma control algorithms and to develop targeted interventions. This knowledge will foster future patient-centered outcome studies to better understand patient barriers to asthma control among patients with asthma who are affected by obesity

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