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Sunday, 17 August 2014

Obesity Complication of Asthma

By Kyle J. Norton

Obesity is defined as a medical condition of excess body fat has accumulated overtime, while overweight is a condition of excess body weight relatively to the height. According to the Body Mass Index(BMI), a BMI between 25 to 29.9 is considered over weight, while a BMI of over 30 is an indication of obesity. According to the statistic, 68% of American population are either overweight or obese.

B. How to calculate your BMI index
BMI= weight (kg)/ height (m2)

C. How Obesity associates with Asthma
1. In an abstract of study of "Overweight is not a comorbidity factor during childhood asthma (GrowthOb study)?" by Mahut B, Beydon N, Delclaux C. (Source from Hôpital européen Georges-Pompidou, Service de Physiologie - Clinique de la Dyspnée, F-75015 Paris, France), posted in PubMed, researchers indicated that Compared to normal weight children, overweight plus obese children had reduced lung volume ratios (FRC/TLC and RV/TLC), no evidence of airflow limitation and similar symptoms.In conclusion, the observed functional relationships with BMI are not specific of asthma, and, being overweight is not associated with significant clinical impacts on asthma during childhood.

2. According to a study of "Urban-rural differences in asthma prevalence among young people in Canada: the roles of health behaviors and obesity" by Lawson JA, Janssen I, Bruner MW, Madani K, Pickett W. (Source from Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, SK, Canada, and the Department of Medicine, University of Saskatchewan, Saskatoon, SK, Canada), posted in PubMed, researchers found that Although asthma prevalence among youth was lower in rural areas, this association was not mediated by health behaviors or obesity. Other exposures, likely environmental, are the logical mechanisms through which rural geographic status is related to lower asthma prevalence.

3. In a study of "The association of obesity and asthma severity and control in children" by
Quinto KB, Zuraw BL, Poon KY, Chen W, Schatz M, Christiansen SC. (Source from Department of Allergy and Immunology, University of California, San Diego, La Jolla, Calif), posted in PubMed, researchers found that Even after adjusting for demographics, parental education level, asthma controller use, and gastroesophageal reflux disease and diabetes mellitus diagnoses, overweight (BMI percentile for age, 85% to 94%) and obese (BMI percentile for age, ≥95%) children were more likely to have increased β-agonists dispensed (odds ratio of 1.15 [95% CI, 1.02-1.27] and odds ratio of 1.17 [95% CI, 1.06-1.29], respectively) and increased risk for oral corticosteroids dispensed (odds ratio of 1.21 [95% CI, 1.13-1.29] and odds ratio of 1.28 [95% CI, 1.21-1.36], respectively) compared with normal-weight (BMI percentile for age, 16% to 84%) children.

4. According to the study of "The relationship between obesity and asthma severity and control in adults" by Mosen DM, Schatz M, Magid DJ, Camargo CA Jr. (Source from Center for Health Research, Kaiser Permanente, Portland, OR 92111, USA. david.m.mosen@kpchr.org), posted in PubMed, researchers found that Even after adjusting for demographics, smoking status, oral corticosteroid use, evidence of gastroesophageal reflux disease, and inhaled corticosteroid use, obese adults were more likely than those with normal BMIs (<25 kg/m(2)) to report poor asthma-specific quality of life (odds ratio [OR], 2.8; 95% CI, 1.6-4.9), poor asthma control (OR, 2.7; 95% CI, 1.7-4.3), and a history of asthma-related hospitalizations (OR, 4.6; 95% CI, 1.4-14.4).

5. In a study of "Measures of obesity associated with asthma diagnosis in ethnic minority children" by Vangeepuram N, Teitelbaum SL, Galvez MP, Brenner B, Doucette J, Wolff MS. (Source from
Department of Preventive Medicine, Mount Sinai School of Medicine, 1 Gustave L. Levy Place, Box 1512, New York, NY 10029, USA),posted in PubMed, researchers found that When comparing the highest quintile of each body fat measure to the combined lowest two quintiles, higher body mass index percentile, percent body fat, and waist circumference all were associated with a higher likelihood of physician-diagnosed asthma (PR = 1.63 (95% CI 1.12-2.39), 1.50 (95% CI 1.02-2.21), and 1.56 (95% CI 1.04-2.34), resp.). Conclusions. This study found a significant association between increased body size and asthma diagnosis, regardless of the measurement examined.

6. In an abstract of the study of "Body mass index and the risk of asthma in adults" by Luder E, Ehrlich RI, Lou WY, Melnik TA, Kattan M. (Source from Department of Pediatrics, Mount Sinai School of Medicine, One Gustave L. Levy Place, Box 1202B, New York, NY 10029, USA. elisabeth.luder@mssm.edu), posted in PubMed, researchers indicated that this cross-sectional study showed that men and women differ significantly in the association between BMI and asthma prevalence only with respect to the lowest weight category. While women had a monotonic association, men showed a U-shaped relationship, indicating that both extremes of weight are associated with a higher prevalence of asthma.

7. Etc

D. Treatments of Obesity and Asthma

1. According to the study of "Influence of obesity on control in asthmatic Japanese patients defined by the Japanese definition of obesity" by Youkou A, Hasegawa T, Suzuki K, Koya T, Sakagami T, Toyabe S, Arakawa M, Gejyo F, Narita I, Suzuki E. (Source from Division of Respiratory Medicine, Niigata University Graduate School of Medical and Dental Sciences, Japan.), posted in PubMed, researchers found that This study investigated influences of JASSO-defined obesity on asthma severity and management in a clinical setting in Japan. It is possible that there are strong interactions between asthma and obesity, such as obesity causing decreased ICS therapy efficacy and leukotriene (LT)-related inflammation, although further investigation is necessary.

2. According to a study of "Impact of bariatric surgery on pulmonary function and nitric oxide in asthmatic and non-asthmatic obese patients" by Lombardi C, Gargioni S, Gardinazzi A, Canonica GW, Passalacqua G. (Source from Allergy Unit, Department of Internal Medicine, Sant'Orsola-Poliambulanza Hospital, Brescia, Italy), posted in PubMed, researchers stated that Bariatric surgery significantly reduces the intake of inhaled corticosteroids and the levels of exhaled nitric oxide, thus bronchial inflammation, in asthmatics.

3. According to the study of "Weight loss and asthma control in severely obese asthmatic females" by Maniscalco M, Zedda A, Faraone S, Cerbone MR, Cristiano S, Giardiello C, Sofia M. (Source from Section of Respiratory Medicine, Hospital S. Maria della Pietà Casoria, Naples, Italy. mauromaniscalco@hotmail.com), posted in PubMed, researchers found that Consistent weight loss in severely obese patients with asthma is associated to improvement in respiratory symptoms and lung function. However, the mechanisms underlying the effect of large body mass changes on asthma would require further studies.
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