PREVALENCE AND ASSOCIATIONS BETWEEN METABOLICALLY UNHEALTHY OBESITY AND ASTHMA EXACERBATIONS AND EMERGENCY DEPARTMENT USAGE

Abstract

<h3>Introduction</h3> Th1 cell polarization and monocyte cell activation influence FEV1/FVC and are affected by body mass index (BMI), insulin resistance, and serum lipoproteins. No study has assessed the impact of metabolic syndrome components on asthma symptom control. We aimed to determine the prevalence of patients with metabolically unhealthy obesity (MUO) and asthma. Our secondary objective was to compare the strength of associations between asthma outcomes in obese patients measured by BMI, waist circumference, and MUO. <h3>Methods</h3> A cross-sectional analysis of the combined 2011-2016 cycles of NHANES was performed among persons with asthma. MUO was defined as a BMI ≥ 30kg/m2 and one or more of the following: increased waist circumference, insulin resistance, low physical activity, hyperlipidemia, or hypertension. Multiple logistic regression models were computed to assess asthma exacerbations and emergency department usage for asthma in patients with metabolically healthy compared to unhealthy obesity. <h3>Results</h3> Among respondents with MUO, 50.09% (n=543; N=17011880) had asthma compared to 7.91% in those with metabolically healthy obesity (n=77; N=2685858). Persons with MUO were significantly more likely to report the use of an emergency department for their asthma symptoms within the past 12 months (OR 3.53; 95%CI 1.54-8.09). Persons with elevated waist circumference were more likely to report asthma exacerbations (OR 1.58; 95%CI 1.09-2.26). No significant difference existed in reported asthma exacerbations or emergency department usage in patients measured by BMI. <h3>Conclusions</h3> Metabolically unhealthy obesity is associated with increased emergency department usage for asthma and is better at predicting exacerbations and emergency department usage than BMI alone.