Does Obesity Increase Respiratory Tract Infections in Patients with Asthma?

Monica Tang, Robert J. Henderson, Janet Teresa Holbrook, Loretta G. Que, Anne M. Mathews, Robert A Wise, Anne E. Dixon, Stephen P. Peters, Linda Rogers, Lewis J. Smith, W. Gerald Teague, Jason E. Lang

Research output: Contribution to journalArticle

Abstract

Background: Because respiratory tract infections (RTIs) precede most exacerbations, a better understanding of the risk factors of RTIs and RTI-associated exacerbations in patients with asthma is a pressing public health need. Obesity in patients with asthma is associated with worse asthma control and higher asthma-associated health care utilization, but its effect on RTI risk is unknown. Objective: We aimed to study the association of body mass index (BMI) classification on the risk of self-reported RTIs and related asthma morbidity among adults and children with asthma. Methods: This post hoc analysis of 5 large asthma trials involving 747 children and 1287 adults compared BMI classification, defined as lean, overweight, and obese based on age-appropriate BMI and BMI-percentile conventions. The primary outcome was rate of visits with RTIs. Secondary asthma outcomes included upper respiratory infection (URI) severity, systemic steroid use, and health care contact. Results: Children had 1.4 times the rate of RTI compared with adults (95% confidence interval 1.27-1.56). In all participants, BMI classification did not affect the rate of visits with RTI. In children, BMI classification did not affect URI severity, all-cause asthma events, or RTI-associated asthma events. However, in adults, higher BMI classification was associated with an increase in moderate/severe URI (P =.02). Adults with higher BMI classification also had increased rates of all-cause and RTI-associated asthma exacerbations requiring systemic steroids and health care contact. Conclusions: BMI classification was not associated with an increased risk of RTIs in children or adults. In adults only, obesity was associated with increased URI severity and all-cause and RTI-associated asthma morbidity.

Original languageEnglish (US)
JournalJournal of Allergy and Clinical Immunology: In Practice
DOIs
StateAccepted/In press - Jan 1 2018

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Respiratory Tract Infections
Asthma
Obesity
Body Mass Index
Steroids
Patient Acceptance of Health Care
Morbidity
Delivery of Health Care
Public Health

Keywords

  • Asthma
  • Obesity
  • Respiratory tract infections

ASJC Scopus subject areas

  • Immunology and Allergy

Cite this

Does Obesity Increase Respiratory Tract Infections in Patients with Asthma? / Tang, Monica; Henderson, Robert J.; Holbrook, Janet Teresa; Que, Loretta G.; Mathews, Anne M.; Wise, Robert A; Dixon, Anne E.; Peters, Stephen P.; Rogers, Linda; Smith, Lewis J.; Teague, W. Gerald; Lang, Jason E.

In: Journal of Allergy and Clinical Immunology: In Practice, 01.01.2018.

Research output: Contribution to journalArticle

Tang, Monica ; Henderson, Robert J. ; Holbrook, Janet Teresa ; Que, Loretta G. ; Mathews, Anne M. ; Wise, Robert A ; Dixon, Anne E. ; Peters, Stephen P. ; Rogers, Linda ; Smith, Lewis J. ; Teague, W. Gerald ; Lang, Jason E. / Does Obesity Increase Respiratory Tract Infections in Patients with Asthma?. In: Journal of Allergy and Clinical Immunology: In Practice. 2018.
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title = "Does Obesity Increase Respiratory Tract Infections in Patients with Asthma?",
abstract = "Background: Because respiratory tract infections (RTIs) precede most exacerbations, a better understanding of the risk factors of RTIs and RTI-associated exacerbations in patients with asthma is a pressing public health need. Obesity in patients with asthma is associated with worse asthma control and higher asthma-associated health care utilization, but its effect on RTI risk is unknown. Objective: We aimed to study the association of body mass index (BMI) classification on the risk of self-reported RTIs and related asthma morbidity among adults and children with asthma. Methods: This post hoc analysis of 5 large asthma trials involving 747 children and 1287 adults compared BMI classification, defined as lean, overweight, and obese based on age-appropriate BMI and BMI-percentile conventions. The primary outcome was rate of visits with RTIs. Secondary asthma outcomes included upper respiratory infection (URI) severity, systemic steroid use, and health care contact. Results: Children had 1.4 times the rate of RTI compared with adults (95{\%} confidence interval 1.27-1.56). In all participants, BMI classification did not affect the rate of visits with RTI. In children, BMI classification did not affect URI severity, all-cause asthma events, or RTI-associated asthma events. However, in adults, higher BMI classification was associated with an increase in moderate/severe URI (P =.02). Adults with higher BMI classification also had increased rates of all-cause and RTI-associated asthma exacerbations requiring systemic steroids and health care contact. Conclusions: BMI classification was not associated with an increased risk of RTIs in children or adults. In adults only, obesity was associated with increased URI severity and all-cause and RTI-associated asthma morbidity.",
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AU - Holbrook, Janet Teresa

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AU - Mathews, Anne M.

AU - Wise, Robert A

AU - Dixon, Anne E.

AU - Peters, Stephen P.

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AB - Background: Because respiratory tract infections (RTIs) precede most exacerbations, a better understanding of the risk factors of RTIs and RTI-associated exacerbations in patients with asthma is a pressing public health need. Obesity in patients with asthma is associated with worse asthma control and higher asthma-associated health care utilization, but its effect on RTI risk is unknown. Objective: We aimed to study the association of body mass index (BMI) classification on the risk of self-reported RTIs and related asthma morbidity among adults and children with asthma. Methods: This post hoc analysis of 5 large asthma trials involving 747 children and 1287 adults compared BMI classification, defined as lean, overweight, and obese based on age-appropriate BMI and BMI-percentile conventions. The primary outcome was rate of visits with RTIs. Secondary asthma outcomes included upper respiratory infection (URI) severity, systemic steroid use, and health care contact. Results: Children had 1.4 times the rate of RTI compared with adults (95% confidence interval 1.27-1.56). In all participants, BMI classification did not affect the rate of visits with RTI. In children, BMI classification did not affect URI severity, all-cause asthma events, or RTI-associated asthma events. However, in adults, higher BMI classification was associated with an increase in moderate/severe URI (P =.02). Adults with higher BMI classification also had increased rates of all-cause and RTI-associated asthma exacerbations requiring systemic steroids and health care contact. Conclusions: BMI classification was not associated with an increased risk of RTIs in children or adults. In adults only, obesity was associated with increased URI severity and all-cause and RTI-associated asthma morbidity.

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