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

doi:10.1016/j.jaci.2009.01.040

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 journal › Article › peer-review

38 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 language	English
Pages (from-to)	1069-1074.e4
Journal	Journal of Allergy and Clinical Immunology
Volume	123
Issue number	5
DOIs	https://doi.org/10.1016/j.jaci.2009.01.040
Publication status	Published - May 2009
Externally published	Yes

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

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

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1016/j.jaci.2009.01.040

Cite this

Marcon, A., Corsico, A., Cazzoletti, L., Bugiani, M., Accordini, S., Almar, E., Cerveri, I., Gislason, D., Gulsvik, A., Janson, C., Jarvis, D., Martínez-Moratalla, J., Pin, I., & de Marco, R. (2009). Body mass index, weight gain, and other determinants of lung function decline in adult asthma. Journal of Allergy and Clinical Immunology, 123(5), 1069-1074.e4. https://doi.org/10.1016/j.jaci.2009.01.040

@article{904a406fd71345f8a00143862b011a88,

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

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.",

keywords = "Asthma, airflow obstruction, allergen sensitization, body mass index, lung function decline, obesity, predictors, prospective cohort study, weight gain",

author = "Alessandro Marcon and Angelo Corsico and Lucia Cazzoletti and Massimiliano Bugiani and Simone Accordini and Enrique Almar and Isa Cerveri and David Gislason and Amund Gulsvik and Christer Janson and Deborah Jarvis and Jes{\'u}s Mart{\'i}nez-Moratalla and Isabelle Pin and {de Marco}, Roberto",

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 Espa{\~n}ola de Patolog{\'i}a 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 Innovaci{\'o} Tecnol{\`o}gica (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 R{\'e}gionale 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'Universit{\`a} e della Ricerca Scientifica (Italy), Glaxo Wellcome spa (Verona, Italy); Ume{\aa}: 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; Minist{\`e}re de la Sant{\'e}, Glaxo France, Insitut Pneumologique d'Aquitaine, Contrat de Plan Etat-R{\'e}gion Languedoc-Rousillon, Caisse Nationale de l'Assurance Maladie des Travailleurs Salari{\'e}s, Comit{\'e} National Contre les Maladies Respiratoires et la Tuberculose (90MR/10, 91AF/6), Ministre delegu{\'e} de la sant{\'e}, R{\'e}seau National de Sant{\'e} Publique, France; GSF, and the Bundesminister f{\"u}r Forschung und Technologie, Bonn, Germany; Ministero dell'Universit{\`a} 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 Ram{\'o}n Jim{\'e}nenz, 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. ",

year = "2009",

month = may,

doi = "10.1016/j.jaci.2009.01.040",

language = "English",

volume = "123",

pages = "1069--1074.e4",

journal = "Journal of Allergy and Clinical Immunology",

issn = "0091-6749",

publisher = "Elsevier Inc.",

number = "5",

}

Marcon, A, Corsico, A, Cazzoletti, L, Bugiani, M, Accordini, S, Almar, E, Cerveri, I, Gislason, D, Gulsvik, A, Janson, C, Jarvis, D, Martínez-Moratalla, J, Pin, I & de Marco, R 2009, 'Body mass index, weight gain, and other determinants of lung function decline in adult asthma', Journal of Allergy and Clinical Immunology, vol. 123, no. 5, pp. 1069-1074.e4. https://doi.org/10.1016/j.jaci.2009.01.040

TY - JOUR

T1 - Body mass index, weight gain, and other determinants of lung function decline in adult asthma

AU - Marcon, Alessandro

AU - Corsico, Angelo

AU - Cazzoletti, Lucia

AU - Bugiani, Massimiliano

AU - Accordini, Simone

AU - Almar, Enrique

AU - Cerveri, Isa

AU - Gislason, David

AU - Gulsvik, Amund

AU - Janson, Christer

AU - Jarvis, Deborah

AU - Martínez-Moratalla, Jesús

AU - Pin, Isabelle

AU - de Marco, Roberto

N1 - 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.

PY - 2009/5

Y1 - 2009/5

N2 - 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.

AB - 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.

KW - Asthma

KW - airflow obstruction

KW - allergen sensitization

KW - body mass index

KW - lung function decline

KW - obesity

KW - predictors

KW - prospective cohort study

KW - weight gain

UR - http://www.scopus.com/inward/record.url?scp=65349185796&partnerID=8YFLogxK

U2 - 10.1016/j.jaci.2009.01.040

DO - 10.1016/j.jaci.2009.01.040

M3 - Article

C2 - 19321196

AN - SCOPUS:65349185796

SN - 0091-6749

VL - 123

SP - 1069-1074.e4

JO - Journal of Allergy and Clinical Immunology

JF - Journal of Allergy and Clinical Immunology

IS - 5

ER -

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

Abstract

Bibliographical note

Keywords

UN SDGs

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