Adults with Asthma Found at Higher Risk for Obesity in International Study

Adults with asthma are at higher risk for developing obesity than those without asthma, according to a new international study with more than 8700 participants. Investigators from the Barcelona Institute of Global Health (ISGlobal) also found that the risk is higher for patients with nonatopic disease, with asthma of longer duration, and who are treated with oral corticosteroids.

Results of the study, which was led by Subhabrata Moitra, PhD, a postdoctoral researcher in the division of pulmonary medicine at the University of Alberta in Edmonton, are the first to demonstrate this association, according to authors, and were published online in the journal Thorax.

"Several studies have shown that asthma and obesity share some common socioeconomic, behavioral and environmental risk factors that can lead to the development of both diseases,” said Moitra in a press release from ISGlobal where he conducted the research.

He added that while past studies have examined mechanisms by which obesity contributes to development of asthma, the inverse relationship has only recently become a research area of interest.

Moitra and colleagues used data from the European Community Respiratory Health Survey (ECRHS), a cohort study conducted in 3 waves between 1990 and 2014 in 11 European countries and Australia.

Data gathered from the different waves included lung function tests, body mass index (BMI), asthma status and characteristics.

The investigators conducted observations during 2 study periods: ECRHS I-II, from 1990-1999 (n=7576, mean age 34 years, 51.5% women) and ECRHS II-III, from 1999-2010 (n=4976, mean age 42 years; 51.3% women).

The team found that overall, 9% of participants during the ECRHS I-II period developed obesity and 15% developed obesity during ECRHS II-III.

When they looked at the difference in risk for obesity between participants with and without asthma, estimating relative risk (RR) using multivariable modified Possion regression, researchers observed a higher risk among adults with asthma vs those without (RR=1.22; 95% CI, 1.07-1.38). They also observed that risk was higher for developing obesity among adults with nonatopic vs atopic disease (RR = 1.47; 95% CI, 1.17-1.86), among those with longer (>20 years) disease duration (RR = 1.32; 95% CI, 1.1-1.59; ≤20 years RR = 1.12; 0.87-1.43), and also among participants with asthma prescribed oral corticosteroids (RR = 1.99; 95% CI, 1.26-3.15).

The authors state that there was no evidence to suggest physical activity as a mediator of the association.

"A potential explanation for the weight gain associated with asthma could be the reduction of physical activity in asthmatic patients, however, our results do not support this hypothesis, since the levels of physical activity in our study did not affect the observed association," said study senior author Judith Garcia-Aymerich, PhD, head of the Non-Communicable Diseases and Environment Programme at ISGlobal.

"Regardless of the mechanisms, still unknown, our results have implications for the clinical care of adults with asthma."


Reference: Moitra S, Carsin A-E, Abramson MJ, et al. Long-term effect of asthma on the development of obesity among adults: an international cohort study, ECRHS. Thorax. Published online ahead of print on April 28, 2022.