PURPOSE: Asthma and obesity continue to have a significant impact on public health. It is now widely accepted that obesity may be an independent risk factor for asthma and may impact asthma severity and quality of life (QOL). We examined the relationship between BMI and asthma severity, spirometry, health care utilization (HCU), and QOL.
METHODS: This 12-month prospective RCT comparing disease management to traditional care enrolled 902 subjects (473 pediatric;429 adults)representing an underserved predominately Hispanic population. Data were collected at baseline and at 6 month intervals, and included demographics, asthma severity, medication use, spirometry and health care utilization (HCU). QOL was assessed by the pediatric and adult asthma quality of life questionnaire (PAQLQ/AQLQ) and the SF-36. HCU was determined by patient interview and extensive review of medical records. Data was analyzed using negative binomial regression and ANOVA.
RESULTS: In the pediatric group (PG), 37% were overweight/obese (15% with a BMI in the 85-95%tile; 22% with a BMI >95%tile). In adults, 58% were overweight/obese (32% with a BMI > 30). There was no relationship in the PG between BMI and severity of asthma, spirometry, QOL, or HCU. In adults, BMI did have an inverse relationship with FVC but not other spirometric values. In adults, there was no relationship to BMI and asthma severity or HCU. Higher BMI had an inverse relationship to QOL as assessed by the AQLQ and SF36-PCS (p<.001).
CONCLUSION: Obesity was not associated with worse asthma severity, spirometry, quality of life, or health care utilization in the pediatric group; however, obesity was associated with a lower FVC and worse quality of life in the group of adult asthmatics.
CLINICAL IMPLICATIONS: Although obesity is a risk factor for asthma, it appeared to have little or no impact on children with asthma. Health care providers should be aware that obesity may effect spirometry and quality of life in adults with asthma. The reduced FVC in this group may necessitate evaluation of restrictive lung disease.
DISCLOSURE: Jason McKinney, None.