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Original Research: ASTHMA |

Decreased Fraction of Exhaled Nitric Oxide in Obese Subjects With Asthma Symptoms: Data From the Population Study INTERGENE/ADONIX

Christina M. Berg, PhD; Dag S. Thelle, MD; Annika Rosengren, MD; Lauren Lissner, PhD; Kjell Torén, MD, FCCP; Anna-Carin Olin, MD
Author and Funding Information

From the Department of Emergency and Cardiovascular Medicine (Dr Rosengren), the Department of Public Health and Community Medicine (Drs Thelle, Lissner, Torén, and Olin), Institute of Medicine, Sahlgrenska Academy, and the Department of Food and Nutrition, and Sport Science (Dr Berg), University of Gothenburg, Gothenburg, Sweden; and the Department of Biostatistics (Dr Thelle), Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway.

Correspondence to: Christina Berg, PhD, Department of Food and Nutrition, and Sport Science, University of Gothenburg, Box 300, SE 405 30 Gothenburg, Sweden; e-mail: christina.berg@ped.gu.se


Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (http://www.chestpubs.org/site/misc/reprints.xhtml).

Funding/Support: This study was supported by grants from the Västra Götaland County Council, the Swedish Council for Working Life and Social Research, the Swedish Research Council, the Swedish Heart and Lung Foundation, and the Swedish Research Council for Environment, Agricultural Sciences and Spatial Planning.


© 2011 American College of Chest Physicians


Chest. 2011;139(5):1109-1116. doi:10.1378/chest.10-1299
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Background:  Several studies have demonstrated an association between obesity and asthma. However, it is uncertain if fraction of exhaled nitric oxide (Feno), which is used as a marker of airway inflammation, and atopy are associated with BMI. The aim of this study was to examine if obese subjects with asthma symptoms have a different phenotype of asthma than nonobese subjects as indicated by Feno.

Methods:  The subjects (N = 2,187) consisted of women and men, aged 25 to 74, living in Gothenburg, Sweden, who participated in the randomly selected INTERGENE study cohort. Measurements included anthropometric measures, bioelectric impedance, Feno, pulmonary function, and blood samples for IgE; questionnaires included items on respiratory symptoms. Obesity was defined as BMI ≥ 30 kg/m2. In this cross-sectional analysis, general linear models were used to analyze how Feno was associated with anthropometry, body composition, wheezing, and atopy.

Results:  In nonobese subjects, wheezing was associated with raised Feno and atopy, whereas in contrast, obese subjects who reported wheezing had lower Feno than obese subjects without wheezing (16.1 vs 19.1 parts per billion, P < .01). The prevalence of atopy was similar in both of those subgroups (25.0% vs 20.7%, P = .4). Similarly, in 395 subjects (19%) who reported wheezing, Feno was negatively associated with BMI, waist-to-hip ratio, and percentage of body fat, whereas no significant relationships were observed in those without respiratory symptoms.

Conclusions:  Wheezing was significantly associated with reduced Feno in obese subjects, whereas there was a positive association between wheezing and Feno among the nonobese subjects, indicating a possible difference in asthma phenotype, based on body weight.

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