Allergy Asthma Respir Dis AARD Allergy, Asthma & Respiratory Disease 2288-0402 2288-0410 The Korean Academy of Pediatric Allergy and Respiratory Disease; The Korean Academy of Asthma, Allergy and Clinical Immunology 10.4168/aard.2014.2.1.16 Original Article Association of body mass index with airway hyperresponsiveness and lung function in adult asthmatics Choi Jung-Eun 1 Shin Tae-Rim 1 2 Park Sang-Myeon 1 2 Kim Joo-Hee 1 2 Shin Sung-Ho 1 Lee Hyun-Young 3 Jang Juah 1 Lee Hun Gu 1 Kim Cheol-Hong 1 2 Hyun In-Gyu 1 2 Choi Jeong-Hee 1 2 Department of Internal Medicine, Hallym University College of Medicine, Chuncheon, Korea. Lung Research Institute, Hallym University College of Medicine, Chuncheon, Korea. Department of Allergy and Clinical Immunology, Ajou University Hospital, Suwon, Korea. Correspondence to: Jeong-Hee Choi. Department of Pulmonology and Allergy, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine, 7 Keunjaebong-gil, Hwaseong 445-907, Korea. Tel: +82-31-8086-2928, Fax: +82-31-8086-2482, mdqueen@hallym.or.kr 03 2014 31 03 2014 2 1 16 22 12 09 2013 09 12 2013 14 12 2013 © 2014 The Korean Academy of Pediatric Allergy and Respiratory Disease; The Korean Academy of Asthma, Allergy and Clinical Immunology 2014 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/). Purpose

Obesity is commonly regarded as a risk factor for asthma development, poor asthma control, and poor response to asthma therapy. However, its relationships are not always consistent. Gender difference has been reported to influence asthma severity and asthma control. We investigated the contribution of obesity to airway hyperresponsiveness (AHR) and lung function before and after treatment in adult asthmatics.

 Methods

The medical records of a total of 323 adult asthmatics were analyzed retrospectively. Asthma was diagnosed based on the positive result of methacholine bronchial provocation test (PC20≤25 mg/mL) or bronchodilator test (≥12% and 200-mL improvement in forced expiratory volume in 1 second after inhalation of a bronchodilator). Follow-up spirometry was performed in 113 patients after at least 3 months of asthma treatment with controller medication. Percent change between spirometry before and after treatment was defined as {[(value after treatment-value before treatment)/value before treatment]×100}. Body mass index (BMI, weight [kg]/height [m2]) was categorized into underweight (<18.5), normal weight (18.5-24.9), overweight (25.0-29.9), and obese (>30) according to the world health organization classification.

 Results

BMI did not show any significant correlation with PC20 value of methacholine provocation test and each lung function parameter before and after treatment. When we divided the study subjects according to gender and age, BMI was negatively correlated with PC20 value only in female adult asthmatics under 65 years old (r=-0.024, P=0.036).

 Conclusion

Obesity is positively correlated with the intensity of AHR in female adult asthmatics. Gender seems to differentially contribute to the relationship between BMI and AHR.

 Asthma Obesity Airway hyperresponsiveness Female National Research Foundation of Korea 2012R1A1A1012349

This study was supported by a grant from the Basic Science Research Program through the National Research Foundation of Korea (NRF), as funded by the Ministry of Education, Science and Technology (2012R1A1A1012349).

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Correlation between BMI and methacoline PC20 value (mg/mL) in the adult asthmatics according to gender. While BMI was not correlated with PC20 in the total adult asthmatics (<65 years, n=133) (A) and in the male group (n=59) (B), significant negative correlation was shown in the female group of adult asthmatics (n=74) (C). BMI was further significantly correlated with PC20 in young adult asthmatics (<45 years, n=59) (D) and in female young adult asthmatics (n=31) (F) while not in male young adult asthmatics (n=28) (E). P-values were analyzed by Spearman correlation tests. BMI, body mass index.

Clinical characteristics of the study subjects

Values are presented as mean±standard deviation unless otherwise indicated. F/U pulmonary function test was available only in 113 patients. There were no significant differences in clinical characteristics among groups by Kruskal-Walis test.

BMI, body mass index; ICS, inhaled corticosteroid; LABA, long-acting beta-agonist; LTRA, leukotriene receptor antagonist; FVC, forced vital capacity; FEV1, forced expiratory volume in 1 second; FEF25%-70%, forced expiratory flow during the middle half of the FVC; F/U, follow-up.

Subgroup analyses of the adult and the elderly asthma according to sex

Values are presented as mean±standard deviation unless otherwise indicated. F/U pulmonary function test was available only in 113 patients. P-values were analyzed by Mann-Whitney U test for continuous variables and by Fisher exact test for categorical variables.

BMI, body mass index; FVC, forced vital capacity; FEV1, forced expiratory volume in 1 second; FEF25%-70%, forced expiratory flow during the middle half of the FVC; F/U, follow-up.