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

Alessandro Marcon*, Angelo Corsico, Lucia Cazzoletti, Massimiliano Bugiani, Simone Accordini, Enrique Almar, Isa Cerveri, David Gislason, Amund Gulsvik, Christer Janson, Deborah Jarvis, Jesús Martínez-Moratalla, Isabelle Pin, Roberto de Marco

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

36 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)1069-1074.e4
JournalJournal of Allergy and Clinical Immunology
Volume123
Issue number5
DOIs
Publication statusPublished - May 2009
Externally publishedYes

Bibliographical note

Funding Information:
Albacete: Fondo de Investigaciones Santarias (grant code: 97/0035-01, 99/0034-01 and 99/0034-02), Hospital Universitario de Albacete, Consejeria de Sanidad; Antwerp: Fund for Scientific Research—Flanders, Belgium (grant code: G.0402.00), University of Antwerp, Flemish Health Ministry; Barcelona: Sociedad Española de Patología Respiratoria, Public Health Service (grant code: R01 HL62633-01), Fondo de Investigaciones Santarias (grant codes: 97/0035-01, 99/0034-01, and 99/0034-02) Consell Interdepartamental de Recerca i Innovació Tecnològica (grant code: 1999SGR 00241); Basel: Swiss National Science Foundation, Swiss Federal Office for Education and Science, Swiss National Accident Insurance Fund; Bergen: Norwegian Research Council, Norwegian Asthma and Allergy Association, Glaxo Wellcome AS, Norway Research Fund; Bordeaux: Institut Pneumologique d'Aquitaine; Erfurt: GSF-National Research Centre for Environment & Health, Deutsche Forschungsgemeinschaft (grant code: FR 1526/1-1); Galdakao: Basque Health Department; Goteborg: Swedish Heart Lung Foundation, Swedish Foundation for Health Care Sciences and Allergy Research, Swedish Asthma and Allergy Foundation, Swedish Cancer and Allergy Foundation; Grenoble: Programme Hospitalier de Recherche Clinique-DRC de Grenoble 2000 no. 2610, Ministry of Health, Direction de la Recherche Clinique, Ministere de l'Emploi et de la Solidarite, Direction Generale de la Sante, Centre Hospitalier Universitarie de Grenoble, Comite des Maladies Respiratoires de l'Isere; Hamburg: GSF-National Reasearch Centre for Environment and Health, Deutsche Forschungsgemeinschaft (grant code: MA 711/4-1); Ipswich and Norwich: Asthma UK (formerly known as National Asthma Campaign [United Kingdom]); Huelva: Fondo de Investigaciones Santarias (grant codes: 97/0035-01, 99/0034-01, and 99/0034-02); Montpellier: Programme Hospitalier de Recherche Clinique-DRC de Grenoble 2000 no. 2610, Ministry of Health, Direction de la Recherche Clinique, Centre Hospitalier Universitarie de Grenoble, Ministere de l'Emploi et de la Solidarite, Direction Generale de la Sante, Aventis (France), Direction Régionale des Affaires Sanitaires et Sociales Languedoc-Roussillon; Oviedo: Fondo de Investigaciones Santarias (grant codes: 97/0035-01, 99/0034-01, and 99/0034-02) ; Paris: Ministere de l'Emploi et de la Solidarite, Direction Generale de la Sante, Union Chimique Belge—Pharma (France), Aventis (France), Glaxo France, Programme Hospitalier de Recherche Clinique—DRC de Grenoble 2000 no. 2610, Ministry of Health, Direction de la Recherche Clinique, Centre Hospitalier Universitarie de Grenoble; Pavia: Glaxo-SmithKline Italy, Italian Ministry of University and Scientific and Technological Research, Local University Funding for research 1998 and 1999 (Pavia, Italy); Portland: American Lung Association of Oregon, Northwest Health Foundation, Collins Foundation, Merck Pharmaceutical; Reykjavik: Icelandic Research Council, Icelandic University Hospital Fund; Tartu: Estonian Science Foundation; Turin: Azienda Sanitaria Locale 4 Regione Piemonte (Italy), Azienda Ospedaliera Centro Traumatologico Ospedaliero/Centro Traumatologico Ortopedico—Istituto Clinico Ortopedico Regina Maria Adelaide, Regione Piemonte (Italy), Ministero dell'Università e della Ricerca Scientifica (Italy), Glaxo Wellcome spa (Verona, Italy); Umeå: Swedish Heart Lung Foundation, Swedish Foundation for Health Care Sciences and Allergy Research, Swedish Asthma and Allergy Foundation, Swedish Cancer and Allergy Foundation; Uppsala: Swedish Heart Lung Foundation, Swedish Foundation for Health Care Sciences and Allergy Research, Swedish Asthma and Allergy Foundation, Swedish Cancer and Allergy Foundation; Verona: University of Verona; Italian Ministry of University and Scientific and Technological Research; GlaxoSmithKline Italy.

Funding Information:
Belgian Science Policy Office, National Fund for Scientific Research; Ministère de la Santé, Glaxo France, Insitut Pneumologique d'Aquitaine, Contrat de Plan Etat-Région Languedoc-Rousillon, Caisse Nationale de l'Assurance Maladie des Travailleurs Salariés, Comité National Contre les Maladies Respiratoires et la Tuberculose (90MR/10, 91AF/6), Ministre delegué de la santé, Réseau National de Santé Publique, France; GSF, and the Bundesminister für Forschung und Technologie, Bonn, Germany; Ministero dell'Università e della Ricerca Scientifica e Tecnologica, Consiglio Nazionale delle Ricerche, Regione Veneto grant no. 381/05.93, Italy; Norwegian Research Council project no. 101422/310; Dutch Ministry of Wellbeing, Public Health and Culture, Netherlands; Ministero Sanidad y Consumo Fondo de Investigaciones Santarias (grants #91/0016060/00E-05E and #93/0393), and grants from Hospital General de Albacete, Hospital General Juan Ramón Jiménenz, Consejeria de Sanidad Principado de Asturias, Spain; the Swedish Medical Research Council, the Swedish Heart Lung Foundation, the Swedish Association against Asthma and Allergy; Swiss National Science Foundation grant 4026-28099; National Asthma Campaign, British Lung Foundation, Department of Health, South Thames Regional Health Authority, United Kingdom; United States Department of Health, Education and Welfare Public Health Service (grant #2 S07 RR05521-28).

Funding Information:
The coordination of the European Community Respiratory Health Survey II was supported by the European Commission as part of their Quality of Life program.

Keywords

  • airflow obstruction
  • allergen sensitization
  • Asthma
  • body mass index
  • lung function decline
  • obesity
  • predictors
  • prospective cohort study
  • weight gain

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