Body mass index, weight gain, and other determinants of lung function decline in adult asthma

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• 作者：Aless ; ro Marcon ; Angelo Corsico ; Lucia Cazzoletti ; Massimiliano Bugiani ; Simone Accordini ; Enrique Almar ; Isa Cerveri ; David Gislason ; Amund Gulsvik ; Christer Janson ; Deborah Jarvis ; Jesú ; s Martí ; nez-Moratalla ; Isabelle Pin ; Roberto de Marco ; Therapy ; Health Economics Group of the European
• 关键词：Asthma ; lung function decline ; airflow obstruction ; body mass index ; weight gain ; obesity ; FEV₁ ; allergen sensitization ; prospective cohort study ; predictors
• 刊名：Journal of Allergy and Clinical Immunology
• 出版年：2009
• 出版时间：May 2009
• 年：2009
• 卷：123
• 期：5
• 页码：1069-1074.e4
• 全文大小：231 K

文摘

Background

Little is known about factors associated with lung function decline in asthma.

Objective

To identify the determinants of FEV₁ decline in adults with asthma with and without airflow obstruction at baseline.

Methods

An international cohort of 638 subjects with asthma (20-44 years old) was identified in the European Community Respiratory Health Survey (1991-1993) and followed up from 1998 to 2002. Spirometry was performed on both occasions. FEV₁ decline was related to potential determinants evaluated at baseline and during the follow-up by random intercept linear regression models. The analyses were stratified by the presence of airflow obstruction (FEV₁/forced vital capacity < 0.70) at baseline.

Results

In the group of individuals without airflow obstruction (n = 544), a faster FEV₁ decline was observed for subjects with intermediate body mass index (BMI) than for lean and obese subjects. FEV₁ decline was associated with weight gain independently of baseline BMI, and this association was stronger in men (20; 95 % CI, 10-30, mL/y/kg gained) than in women (6; 95 % CI, 1-11, mL/y). In the group of individuals with airflow obstruction (n = 94), the absence of allergen sensitization and a low BMI at baseline were associated with a faster FEV₁ decline, whereas weight gain was not associated with decline.

Conclusions

The detrimental effect of weight gain on FEV₁ decline is particularly relevant in subjects with asthma who still do not have an established airflow obstruction. Our findings support the importance of weight management in asthma and recommend weight loss in overweight or obese individuals with asthma.