Abstract
Background: Few studies have examined how developing obesity in early adulthood affects the course of asthma. Objective: We analyzed lung function and asthma impairment and risk among nonobese children with asthma, comparing those who were obese in young adulthood with those who remained nonobese. Methods: We carried out the post hoc analysis of 771 subjects with mild to moderate asthma who were not obese (pediatric definition, body mass index [BMI] < 95th percentile) when enrolled in the Childhood Asthma Management Program at ages 5-12 years. The subjects were then followed to age 20 years or more. For visits at ages 20 years or more, spirometry values as percent predicted and recent asthma symptom scores and prednisone exposure were compared between 579 subjects who were nonobese at all visits and 151 who were obese (adult definition of BMI ≥ 30 kg/m2) on at least 1 visit (median number of visits when obese = 4, IQR 2-7). Results: Compared with participants who were nonobese (BMI 23.4 ± 2.6 kg/m2), those who became obese (BMI 31.5 ± 3.8 kg/m2) had significant decreases in forced expiratory volume in the first second (FEV1)/forced vital capacity (FVC) (P < .0003) and FEV1 (P = .001), without differences in FVC (P = .15) during visits at ages 20 years or more. For each unit increase of BMI, FEV1 percent predicted decreased by 0.29 (P = .0009). The relationship between BMI and lung function was not confounded by sex or BMI at baseline. Asthma impairment (symptom scores) and risk (prednisone use) did not differ between the 2 groups. Conclusion: Becoming obese in early adulthood was associated with increased airway obstruction, without impact on asthma impairment or risk.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 765-771.e2 |
| Journal | Journal of Allergy and Clinical Immunology: In Practice |
| Volume | 3 |
| Issue number | 5 |
| DOIs | |
| State | Published - Sep 1 2015 |
Bibliographical note
Funding Information:The Childhood Asthma Management Program trial and CAMP Continuation Study were supported by contracts NO1-HR-16044, 16045, 16046, 16047, 16048, 16049, 16050, 16051, and 16052 with the National Heart, Lung, and Blood Institute and General Clinical Research Center grants M01RR00051 , M01RR0099718-24 , M01RR02719-14 , and RR00036 from the National Center for Research Resources . The CAMP Continuation Study/Phases 2 and 3 were supported by grants U01HL075232 , U01HL075407 , U01HL075408 , U01HL075409 , U01HL075415 , U01HL075416 , U01HL075417 , U01HL075419 , U01HL075420 , and U01HL075408 from the National Heart, Lung, and Blood Institute . The National Jewish Health site was also supported in part by Colorado CTSA grant UL1RR025780 from NCRR/NIH and UL1TR000154 from NCATS/NIH .
Keywords
- Childhood asthma
- Childhood obesity
- Obese asthma
- Pulmonary function
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Airway Obstruction Worsens in Young Adults with Asthma Who Become Obese. / Strunk, Robert C.; Colvin, Ryan; Bacharier, Leonard B.; Fuhlbrigge, Anne; Forno, Erick; Arbelaez, Ana Maria; Tantisira, Kelan G.; Williams, Paul; Lasley, Mary V.; Chinn, Tamara; Hinatsu, Michele; Furukawa, Clifton T.; Altman, Leonard C.; Virant, Frank S.; Kennedy, Michael S.; Tilles, Stephen; Becker, Jonathan W.; Bierman, C. Warren; Crawford, Dan; DuHamel, Thomas; Eliassen, Heather; Hammond, Babi; MacLaren, Miranda; Minotti, Dominick A.; Reagan, Chris; Shapiro, Gail; Sharpe, Marian; Tatum, Ashley; White, Grace; Wighton, Timothy G.; Plunkett, Anne; Madden, Nancy; Anderson, Susan; Boehnert, Mark; Feins, Anita; Gentile, Amanda; Kandror, Natalia; MacAulay, Kelly; Sampong, Ernestina; Weiss, Scott; Torda, Walter; Tata, Martha; Babigian, Sally; Barrant, Peter; Benson, Linda; Caicedo, Jose; Calder, Tatum; Darcy, Christine; DeFilippo, Anthony; Dorsainvil, Cindy; Erickson, Julie; Fulton, Phoebe; Grace, Mary; Gilbert, Jennifer; Greineder, Dirk; Haynes, Stephanie; Higham, Margaret; Jakubowski, Deborah; Kelleher, Susan; Koslof, Jay; Mandel, Dana; Martin, Patricia; Martinez, Agnes; McAuliffe, Jean; Nakamoto, Erika; Pacella, Paola; Parks, Paula; Sagarin, Johanna; Seligsohn, Kay; Swords, Susan; Syring, Meghan; Traylor, June; Van Horn, Melissa; Wells, Carolyn; Whitman, Ann; Grasemann, Hartmut; Miki, Melody; Solomon, Melinda; Subbarao, Padmaja; MacLusky, Ian; Reisman, Joe; Levison, Henry; Hall, Anita; Carpenter, Susan; Chay, Jennifer; Collinson, Michelle; Finlayson-Kulchin, Jane; Gore, Kenneth; Hipolito, Nina; Holmes, Noreen; Hoorntje, Erica; Klassen, Sharon; Quenneville, Joseé; Sananes, Renée; Wasson, Christine; Wilson, Margaret; Adkinson, N. Franklin; Bull, Deborah; Philips, Stephanie; Eggleston, Peyton; Huss, Karen; Plotnick, Leslie; Pulsifer, Margaret; Rand, Cynthia; Bollers, Nancy; Pessaro, Kathy; Wheeler, Barbara; Szefler, Stanley; Covar, Ronina; Nelson, Harold S.; Bender, Bruce; Liu, Andrew; Sundström, D.; Phillips, Melanie; White, Michael P.; Gleason, Melanie; Brelsford, Kristin; Bridges, Jessyca; Ciacco, Jody; Eltz, Michael; Feeley, Jeryl; Flynn, Michael; Junk-Blanchard, Tara; Hassell, Joseph; Hefner, Marcia; Hendrickson, Caroline; Hettleman, Daniel; Irvin, Charles G.; Kamada, Alan; Krawiec, Marzena; Larsen, Gary; Nimmagadda, Sai; Sandoval, Kendra; Sheridan, Jessica; Spahn, Joseph; Spears, Gayle; Washington, Trella; Willcutt, Eric; Cardona, Ivan; Carel, Kirstin; Doshi, Jayna; Hendershot, Rich; Jacobs, Jeffrey; Jain, Neal; Kang, June ku Brian; Kruzick, Tracy; Leo, Harvey; Macomber, Beth; Malka, Jonathan; Mjaanes, Chris; Prpich, John; Stewart, Lora; Song, Ben; Tamesis, Grace; Zeiger, Robert S.; Friedman, Noah; Mellon, Michael H.; Schatz, Michael; Long, Terrie; Easton, James G.; Feinberg, M.; Galbreath, Linda L.; Gulczynski, Jennifer; Harden, Kathleen; Hansen, Ellen; Jalowayski, Al; Jenson, Elaine; Lincoln, Alan; Kaufman, Jennie; King, Shirley; Lopez, Brian; Magiari-Ene, Michaela; Mostafa, Kathleen; Moscona, Avraham; Nelle, Catherine A.; Powers, Jennifer; Rodriguez, Elsa; Rodriguez, Eva; Sandoval, Karen; Wilson, Nevin W.; Raissy, Hengameh H.; Jacobs, Aaron; Kelly, H. William; Spicher, Mary; Batson, Christina; Harkings, Michelle; McCallum, Katie; Annett, Robert; Archibeque, Teresa; Bashir, Naim; Bereket, H. Selda; Braun, Marisa; Bush, Carrie; Bush, Shannon C.; Clayton, Michael; Colon-Semidey, Angel; Devault, Sara; Esparham, Anna; Grad, Roni; Hunt, David; Larsson, Jeanne; McClelland, Sandra; McWilliams, Bennie; Montoya, Elisha; Moreshead, Margaret; Murphy, Shirley; Ortega, Barbara; Weers, David; Zayas, Jose; Bacharier, Leonard; Rodgers, Denise; Belle, Gregg; Bloomberg, Gordon R.; Buchanan, W. Patrick; Caesar, Mary; Corry, James M.; DeMuth, Karen; Dolinsky, Marisa; Fisher, Edwin B.; Gaioni, Stephen J.; Glynn, Emily; Heckman, Bernadette D.; Kemp, Debra; Kertz, Lila; Lawhon, Claire; Morgan, Valerie; Moseid, Cynthia; Oliver-Welker, Tina; Richardson, Diana; Ryan, Elizabeth; Sagal, Sharon; Smith, Thomas F.; Sylvia, Susan; Turner, Carl; White, Deborah K.; Tonascia, James; Belt, Patricia; Collins, Karen; Collison, Betty; Dodge, John; Donithan, Michele; Ewing, Cathleen; Jackson, Rosetta; May, Patrick; Meinert, Jill; Reyes, Girlie; Smith, Michael; Sternberg, Alice L.; Van Natta, Mark L.; Wagoner, Annette; Wilson, Laura; Wise, Robert; Yates, Katherine; Taggart, Virginia; Eggers, Lois; Kiley, James; Moore, Howard; Zheng, Gang; Albert, Paul; Hurd, Suzanne; Parker, Sydney; Randall, Pamela; Wu, Margaret; Cloutier, Michelle; Connett, John; Cuttler, Leona; Gilliland, Frank; Davis, Clarence E.; Eigen, Howard; Evans, David; Kattan, Meyer; Menendez, Rogelio; Estelle, F.; Simons, R.; Leikin, Sanford; Strunk, Robert; Cherniack, Reuben; DuHamel, Thomas R.; Meinert, Curtis L.; Shapiro, Gail G.; Sundström, D.; Zeiger, Robert.
In: Journal of Allergy and Clinical Immunology: In Practice, Vol. 3, No. 5, 01.09.2015, p. 765-771.e2.Research output: Contribution to journal › Article › peer-review
}
TY - JOUR
T1 - Airway Obstruction Worsens in Young Adults with Asthma Who Become Obese
AU - Strunk, Robert C.
AU - Colvin, Ryan
AU - Bacharier, Leonard B.
AU - Fuhlbrigge, Anne
AU - Forno, Erick
AU - Arbelaez, Ana Maria
AU - Tantisira, Kelan G.
AU - Williams, Paul
AU - Lasley, Mary V.
AU - Chinn, Tamara
AU - Hinatsu, Michele
AU - Furukawa, Clifton T.
AU - Altman, Leonard C.
AU - Virant, Frank S.
AU - Kennedy, Michael S.
AU - Tilles, Stephen
AU - Becker, Jonathan W.
AU - Bierman, C. Warren
AU - Crawford, Dan
AU - DuHamel, Thomas
AU - Eliassen, Heather
AU - Hammond, Babi
AU - MacLaren, Miranda
AU - Minotti, Dominick A.
AU - Reagan, Chris
AU - Shapiro, Gail
AU - Sharpe, Marian
AU - Tatum, Ashley
AU - White, Grace
AU - Wighton, Timothy G.
AU - Plunkett, Anne
AU - Madden, Nancy
AU - Anderson, Susan
AU - Boehnert, Mark
AU - Feins, Anita
AU - Gentile, Amanda
AU - Kandror, Natalia
AU - MacAulay, Kelly
AU - Sampong, Ernestina
AU - Weiss, Scott
AU - Torda, Walter
AU - Tata, Martha
AU - Babigian, Sally
AU - Barrant, Peter
AU - Benson, Linda
AU - Caicedo, Jose
AU - Calder, Tatum
AU - Darcy, Christine
AU - DeFilippo, Anthony
AU - Dorsainvil, Cindy
AU - Erickson, Julie
AU - Fulton, Phoebe
AU - Grace, Mary
AU - Gilbert, Jennifer
AU - Greineder, Dirk
AU - Haynes, Stephanie
AU - Higham, Margaret
AU - Jakubowski, Deborah
AU - Kelleher, Susan
AU - Koslof, Jay
AU - Mandel, Dana
AU - Martin, Patricia
AU - Martinez, Agnes
AU - McAuliffe, Jean
AU - Nakamoto, Erika
AU - Pacella, Paola
AU - Parks, Paula
AU - Sagarin, Johanna
AU - Seligsohn, Kay
AU - Swords, Susan
AU - Syring, Meghan
AU - Traylor, June
AU - Van Horn, Melissa
AU - Wells, Carolyn
AU - Whitman, Ann
AU - Grasemann, Hartmut
AU - Miki, Melody
AU - Solomon, Melinda
AU - Subbarao, Padmaja
AU - MacLusky, Ian
AU - Reisman, Joe
AU - Levison, Henry
AU - Hall, Anita
AU - Carpenter, Susan
AU - Chay, Jennifer
AU - Collinson, Michelle
AU - Finlayson-Kulchin, Jane
AU - Gore, Kenneth
AU - Hipolito, Nina
AU - Holmes, Noreen
AU - Hoorntje, Erica
AU - Klassen, Sharon
AU - Quenneville, Joseé
AU - Sananes, Renée
AU - Wasson, Christine
AU - Wilson, Margaret
AU - Adkinson, N. Franklin
AU - Bull, Deborah
AU - Philips, Stephanie
AU - Eggleston, Peyton
AU - Huss, Karen
AU - Plotnick, Leslie
AU - Pulsifer, Margaret
AU - Rand, Cynthia
AU - Bollers, Nancy
AU - Pessaro, Kathy
AU - Wheeler, Barbara
AU - Szefler, Stanley
AU - Covar, Ronina
AU - Nelson, Harold S.
AU - Bender, Bruce
AU - Liu, Andrew
AU - Sundström, D.
AU - Phillips, Melanie
AU - White, Michael P.
AU - Gleason, Melanie
AU - Brelsford, Kristin
AU - Bridges, Jessyca
AU - Ciacco, Jody
AU - Eltz, Michael
AU - Feeley, Jeryl
AU - Flynn, Michael
AU - Junk-Blanchard, Tara
AU - Hassell, Joseph
AU - Hefner, Marcia
AU - Hendrickson, Caroline
AU - Hettleman, Daniel
AU - Irvin, Charles G.
AU - Kamada, Alan
AU - Krawiec, Marzena
AU - Larsen, Gary
AU - Nimmagadda, Sai
AU - Sandoval, Kendra
AU - Sheridan, Jessica
AU - Spahn, Joseph
AU - Spears, Gayle
AU - Washington, Trella
AU - Willcutt, Eric
AU - Cardona, Ivan
AU - Carel, Kirstin
AU - Doshi, Jayna
AU - Hendershot, Rich
AU - Jacobs, Jeffrey
AU - Jain, Neal
AU - Kang, June ku Brian
AU - Kruzick, Tracy
AU - Leo, Harvey
AU - Macomber, Beth
AU - Malka, Jonathan
AU - Mjaanes, Chris
AU - Prpich, John
AU - Stewart, Lora
AU - Song, Ben
AU - Tamesis, Grace
AU - Zeiger, Robert S.
AU - Friedman, Noah
AU - Mellon, Michael H.
AU - Schatz, Michael
AU - Long, Terrie
AU - Easton, James G.
AU - Feinberg, M.
AU - Galbreath, Linda L.
AU - Gulczynski, Jennifer
AU - Harden, Kathleen
AU - Hansen, Ellen
AU - Jalowayski, Al
AU - Jenson, Elaine
AU - Lincoln, Alan
AU - Kaufman, Jennie
AU - King, Shirley
AU - Lopez, Brian
AU - Magiari-Ene, Michaela
AU - Mostafa, Kathleen
AU - Moscona, Avraham
AU - Nelle, Catherine A.
AU - Powers, Jennifer
AU - Rodriguez, Elsa
AU - Rodriguez, Eva
AU - Sandoval, Karen
AU - Wilson, Nevin W.
AU - Raissy, Hengameh H.
AU - Jacobs, Aaron
AU - Kelly, H. William
AU - Spicher, Mary
AU - Batson, Christina
AU - Harkings, Michelle
AU - McCallum, Katie
AU - Annett, Robert
AU - Archibeque, Teresa
AU - Bashir, Naim
AU - Bereket, H. Selda
AU - Braun, Marisa
AU - Bush, Carrie
AU - Bush, Shannon C.
AU - Clayton, Michael
AU - Colon-Semidey, Angel
AU - Devault, Sara
AU - Esparham, Anna
AU - Grad, Roni
AU - Hunt, David
AU - Larsson, Jeanne
AU - McClelland, Sandra
AU - McWilliams, Bennie
AU - Montoya, Elisha
AU - Moreshead, Margaret
AU - Murphy, Shirley
AU - Ortega, Barbara
AU - Weers, David
AU - Zayas, Jose
AU - Bacharier, Leonard
AU - Rodgers, Denise
AU - Belle, Gregg
AU - Bloomberg, Gordon R.
AU - Buchanan, W. Patrick
AU - Caesar, Mary
AU - Corry, James M.
AU - DeMuth, Karen
AU - Dolinsky, Marisa
AU - Fisher, Edwin B.
AU - Gaioni, Stephen J.
AU - Glynn, Emily
AU - Heckman, Bernadette D.
AU - Kemp, Debra
AU - Kertz, Lila
AU - Lawhon, Claire
AU - Morgan, Valerie
AU - Moseid, Cynthia
AU - Oliver-Welker, Tina
AU - Richardson, Diana
AU - Ryan, Elizabeth
AU - Sagal, Sharon
AU - Smith, Thomas F.
AU - Sylvia, Susan
AU - Turner, Carl
AU - White, Deborah K.
AU - Tonascia, James
AU - Belt, Patricia
AU - Collins, Karen
AU - Collison, Betty
AU - Dodge, John
AU - Donithan, Michele
AU - Ewing, Cathleen
AU - Jackson, Rosetta
AU - May, Patrick
AU - Meinert, Jill
AU - Reyes, Girlie
AU - Smith, Michael
AU - Sternberg, Alice L.
AU - Van Natta, Mark L.
AU - Wagoner, Annette
AU - Wilson, Laura
AU - Wise, Robert
AU - Yates, Katherine
AU - Taggart, Virginia
AU - Eggers, Lois
AU - Kiley, James
AU - Moore, Howard
AU - Zheng, Gang
AU - Albert, Paul
AU - Hurd, Suzanne
AU - Parker, Sydney
AU - Randall, Pamela
AU - Wu, Margaret
AU - Cloutier, Michelle
AU - Connett, John
AU - Cuttler, Leona
AU - Gilliland, Frank
AU - Davis, Clarence E.
AU - Eigen, Howard
AU - Evans, David
AU - Kattan, Meyer
AU - Menendez, Rogelio
AU - Estelle, F.
AU - Simons, R.
AU - Leikin, Sanford
AU - Strunk, Robert
AU - Cherniack, Reuben
AU - DuHamel, Thomas R.
AU - Meinert, Curtis L.
AU - Shapiro, Gail G.
AU - Sundström, D.
AU - Zeiger, Robert
N1 - Funding Information: The Childhood Asthma Management Program trial and CAMP Continuation Study were supported by contracts NO1-HR-16044, 16045, 16046, 16047, 16048, 16049, 16050, 16051, and 16052 with the National Heart, Lung, and Blood Institute and General Clinical Research Center grants M01RR00051 , M01RR0099718-24 , M01RR02719-14 , and RR00036 from the National Center for Research Resources . The CAMP Continuation Study/Phases 2 and 3 were supported by grants U01HL075232 , U01HL075407 , U01HL075408 , U01HL075409 , U01HL075415 , U01HL075416 , U01HL075417 , U01HL075419 , U01HL075420 , and U01HL075408 from the National Heart, Lung, and Blood Institute . The National Jewish Health site was also supported in part by Colorado CTSA grant UL1RR025780 from NCRR/NIH and UL1TR000154 from NCATS/NIH .
PY - 2015/9/1
Y1 - 2015/9/1
N2 - Background: Few studies have examined how developing obesity in early adulthood affects the course of asthma. Objective: We analyzed lung function and asthma impairment and risk among nonobese children with asthma, comparing those who were obese in young adulthood with those who remained nonobese. Methods: We carried out the post hoc analysis of 771 subjects with mild to moderate asthma who were not obese (pediatric definition, body mass index [BMI] < 95th percentile) when enrolled in the Childhood Asthma Management Program at ages 5-12 years. The subjects were then followed to age 20 years or more. For visits at ages 20 years or more, spirometry values as percent predicted and recent asthma symptom scores and prednisone exposure were compared between 579 subjects who were nonobese at all visits and 151 who were obese (adult definition of BMI ≥ 30 kg/m2) on at least 1 visit (median number of visits when obese = 4, IQR 2-7). Results: Compared with participants who were nonobese (BMI 23.4 ± 2.6 kg/m2), those who became obese (BMI 31.5 ± 3.8 kg/m2) had significant decreases in forced expiratory volume in the first second (FEV1)/forced vital capacity (FVC) (P < .0003) and FEV1 (P = .001), without differences in FVC (P = .15) during visits at ages 20 years or more. For each unit increase of BMI, FEV1 percent predicted decreased by 0.29 (P = .0009). The relationship between BMI and lung function was not confounded by sex or BMI at baseline. Asthma impairment (symptom scores) and risk (prednisone use) did not differ between the 2 groups. Conclusion: Becoming obese in early adulthood was associated with increased airway obstruction, without impact on asthma impairment or risk.
AB - Background: Few studies have examined how developing obesity in early adulthood affects the course of asthma. Objective: We analyzed lung function and asthma impairment and risk among nonobese children with asthma, comparing those who were obese in young adulthood with those who remained nonobese. Methods: We carried out the post hoc analysis of 771 subjects with mild to moderate asthma who were not obese (pediatric definition, body mass index [BMI] < 95th percentile) when enrolled in the Childhood Asthma Management Program at ages 5-12 years. The subjects were then followed to age 20 years or more. For visits at ages 20 years or more, spirometry values as percent predicted and recent asthma symptom scores and prednisone exposure were compared between 579 subjects who were nonobese at all visits and 151 who were obese (adult definition of BMI ≥ 30 kg/m2) on at least 1 visit (median number of visits when obese = 4, IQR 2-7). Results: Compared with participants who were nonobese (BMI 23.4 ± 2.6 kg/m2), those who became obese (BMI 31.5 ± 3.8 kg/m2) had significant decreases in forced expiratory volume in the first second (FEV1)/forced vital capacity (FVC) (P < .0003) and FEV1 (P = .001), without differences in FVC (P = .15) during visits at ages 20 years or more. For each unit increase of BMI, FEV1 percent predicted decreased by 0.29 (P = .0009). The relationship between BMI and lung function was not confounded by sex or BMI at baseline. Asthma impairment (symptom scores) and risk (prednisone use) did not differ between the 2 groups. Conclusion: Becoming obese in early adulthood was associated with increased airway obstruction, without impact on asthma impairment or risk.
KW - Childhood asthma
KW - Childhood obesity
KW - Obese asthma
KW - Pulmonary function
UR - http://www.scopus.com/inward/record.url?scp=84941260396&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84941260396&partnerID=8YFLogxK
U2 - 10.1016/j.jaip.2015.05.009
DO - 10.1016/j.jaip.2015.05.009
M3 - Article
C2 - 26164807
AN - SCOPUS:84941260396
VL - 3
SP - 765-771.e2
JO - Journal of Allergy and Clinical Immunology: In Practice
JF - Journal of Allergy and Clinical Immunology: In Practice
SN - 2213-2198
IS - 5
ER -