1
|
Hayashi Y, Tanabe N, Shimizu K, Maetani T, Shiraishi Y, Oguma T, Sunadome H, Sakamoto R, Sato A, Sato S, Date H, Matsumoto H, Hirai T. Lower skeletal muscle density and airway structure on computed tomography in asthma. Ann Allergy Asthma Immunol 2024:S1081-1206(24)00527-1. [PMID: 39179101 DOI: 10.1016/j.anai.2024.08.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2024] [Revised: 08/09/2024] [Accepted: 08/12/2024] [Indexed: 08/26/2024]
Abstract
BACKGROUND Lower skeletal muscle density may reflect muscle adiposity and metabolic dysregulation that potentially impair disease control and lung function independent of high body mass index (BMI) in patients with asthma. OBJECTIVE To investigate whether the lower density of pectoralis muscles (PMs) and erector spinae muscles (ESMs) on chest computed tomography was associated with airway structural changes in patients with asthma. METHODS Consecutive patients with asthma and healthy controls undergoing chest computed tomography were retrospectively analyzed. The ESM and PM density, areas of subcutaneous adipose tissue near the PM and epicardial adipose tissue, wall area percent of the airways, and airway fractal dimension (AFD) were quantified on computed tomography. RESULTS The study included 179 patients with asthma (52% women) and 88 controls (47% women). All the controls were 60 years old or younger. The PM and ESM density in female patients with asthma who were 60 years old or younger were significantly lower than those in controls after adjustment for BMI. In female patients with asthma at all ages, lower PM and ESM density (but not subcutaneous or epicardial adipose tissue area) was associated with greater wall area percent of the airways and lower AFD after adjusting for age, height, BMI, smoking status, blood eosinophil count, and oral corticosteroid use. The only association between ESM density and AFD was found in male patients with asthma. CONCLUSION Lower skeletal muscle density may be associated with airway wall thickening and less complexity of the airway luminal tree in female patients with asthma.
Collapse
Affiliation(s)
- Yusuke Hayashi
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Naoya Tanabe
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
| | - Kaoruko Shimizu
- Department of Respiratory Medicine, Faculty of Medicine, Hokkaido University, Sapporo, Japan
| | - Tomoki Maetani
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Yusuke Shiraishi
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Tsuyoshi Oguma
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan; Department of Respiratory Medicine, Kyoto City Hospital, Kyoto, Japan
| | - Hironobu Sunadome
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan; Department of Respiratory Care and Sleep Control Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Ryo Sakamoto
- Department of Diagnostic Imaging and Nuclear Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Atsuyasu Sato
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Susumu Sato
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan; Department of Respiratory Care and Sleep Control Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Hiroshi Date
- Department of Thoracic Surgery, Kyoto University, Kyoto, Japan
| | - Hisako Matsumoto
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan; Department of Respiratory Medicine and Allergology, Faculty of Medicine, Kindai University, Osakasayama, Japan
| | - Toyohiro Hirai
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| |
Collapse
|
2
|
Yin P, Tao S, Xing Z, Luo S, Yang Z, Xue Z, Yang R, Liu L, Wu S, Ge J. Association between visceral adipose tissue and asthma based on the NHANES and Mendelian randomization study. Postgrad Med J 2024; 100:642-648. [PMID: 38538571 DOI: 10.1093/postmj/qgae031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 02/24/2024] [Indexed: 08/20/2024]
Abstract
BACKGROUND Obesity is a crucial risk factor for asthma. Observational studies have examined the association between abdominal obesity and asthma symptoms. This study aimed to investigate the causal relationship between visceral adipose tissue (VAT) and asthma and its potential as an independent indicator. METHODS This study utilized data from the National Health and Nutrition Examination Survey spanning 2011-8. Multivariable logistic regression and stratified variable selection were employed to identify associations between asthma and VAT. Moreover, a two-sample Mendelian randomization analysis, using 221 genetic variants as instrumental variables, was conducted to assess this relationship further. RESULTS Our findings indicated that individuals with higher VAT levels were more likely to develop asthma. Visceral obesity remained a significant risk factor for asthma after adjusting for demographic characteristics. Genetic predictions suggest a positive association between VAT and an elevated risk of asthma (odds ratio [OR] = 1.393, 95% confidence interval [CI]: 1.266-1.534, and P = 1.43E-11). No significant polymorphisms were detected using the Mendelian randomization-Egger intercept test. CONCLUSIONS This study presents potential evidence supporting the causal role of VAT in asthma development. Furthermore, the findings from the Mendelian randomization analysis further reinforce the relationship between VAT and asthma risk.
Collapse
Affiliation(s)
- Pan Yin
- Department of Pulmonary and Critical Care Medicine, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, China
| | - Shiran Tao
- Department of Pulmonary and Critical Care Medicine, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, China
| | - Zixuan Xing
- Department of Infectious Diseases, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, China
| | - Shenglin Luo
- Department of Pulmonary and Critical Care Medicine, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, China
| | - Zhiluo Yang
- Department of Pulmonary and Critical Care Medicine, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, China
| | - Zihan Xue
- Department of Pulmonary and Critical Care Medicine, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, China
| | - Ruida Yang
- Department of Pulmonary and Critical Care Medicine, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, China
| | - Luyu Liu
- Department of Pulmonary and Critical Care Medicine, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, China
| | - Shaobo Wu
- Department of Pulmonary and Critical Care Medicine, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, China
| | - Juan Ge
- Department of Pulmonary and Critical Care Medicine, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, 710004, China
| |
Collapse
|
3
|
Shimizu K, Kimura H, Tanabe N, Tanimura K, Chubachi S, Iijima H, Sato S, Wakazono N, Nakamaru Y, Okada K, Makita H, Goudarzi H, Suzuki M, Nishimura M, Konno S. Increased adiposity-to-muscle ratio and severity of sinusitis affect quality of life in asthma: Computed tomographic analysis. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. GLOBAL 2024; 3:100277. [PMID: 38983113 PMCID: PMC11231708 DOI: 10.1016/j.jacig.2024.100277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 03/03/2024] [Accepted: 04/05/2024] [Indexed: 07/11/2024]
Abstract
Background Deteriorated sinusitis and increased adiposity relative to muscle mass may affect quality of life in patients with asthma. However, whether these effects are observed regardless of intrapulmonary pathology is unknown. Objectives We evaluated the correlation of the cross-sectional ratio of abdominal visceral fat (VF) to erector spinae muscle (ESM) and sinus findings based on Lund-Mackey scoring system (LMS) on computed tomography (CT) with the impaired score of the Asthma Quality of Life Questionnaire (AQLQ), regardless of airway and parenchymal disease, in patients with asthma. Methods We recruited participants from the Hokkaido-based severe asthma cohort who had completed AQLQ and CT examination at the entry. The participants were divided into high (highest) and low (other quartiles) groups on the bases of the extrapulmonary indices. Multivariate analysis examined the association of VF/ESM for the adiposity-to-muscle ratio and LMS with AQLQ after adjusting for the airway fractal dimension for airway index and percentage of low attenuation volume to lung volume for parenchymal index. Results No significant differences were observed in VF/ESM and LMS in terms of sex. The AQLQ score in the high VF/ESM group and high LMS group was lower than those in low VF/ESM group and low LMS group (63 male and 100 female subjects). High VF/ESM (estimate [95% confidence interval] (-0.43 [-0.61, -0.25]) and high LMS scores (-0.22 [-0.41, -0.03]) were associated with low AQLQ scores when adjusted for age, body mass index, smoking status, blood eosinophil count, and intrapulmonary CT indices. Conclusions Increased VF relative to ESM mass and high LMS may deteriorate asthma-related quality of life, regardless of presence of intrapulmonary disease.
Collapse
Affiliation(s)
- Kaoruko Shimizu
- Division of Emergent Respiratory and Cardiovascular Medicine, Hokkaido University Hospital, Sapporo, Japan
- Department of Respiratory Medicine, Faculty of Medicine, Hokkaido University, Sapporo, Japan
| | - Hirokazu Kimura
- Department of Respiratory Medicine, Faculty of Medicine, Hokkaido University, Sapporo, Japan
| | - Naoya Tanabe
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Kazuya Tanimura
- Department of Respiratory Medicine, Nara Medical University, Kashihara, Japan
| | - Shotaro Chubachi
- Department of Medicine, Division of Pulmonary Medicine, Keio University School of Medicine, Tokyo, Japan
| | - Hiroaki Iijima
- Department of Respiratory Medicine, Tsukuba Medical Center Hospital, Tsukuba, Japan
| | - Susumu Sato
- Department of Respiratory Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Nobuyasu Wakazono
- Department of Respiratory Medicine, Faculty of Medicine, Hokkaido University, Sapporo, Japan
| | - Yuji Nakamaru
- Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Hokkaido University, Sapporo, Japan
| | - Kazufumi Okada
- Data Science Center, Promotion Unit, Institute of Health Science Innovation for Medical Care, Hokkaido University Hospital, Sapporo, Japan
| | - Hironi Makita
- Department of Respiratory Medicine, Faculty of Medicine, Hokkaido University, Sapporo, Japan
- Hokkaido Medical Research Institute for Respiratory Diseases, Sapporo, Japan
| | - Houman Goudarzi
- Department of Respiratory Medicine, Faculty of Medicine, Hokkaido University, Sapporo, Japan
| | - Masaru Suzuki
- Department of Respiratory Medicine, Faculty of Medicine, Hokkaido University, Sapporo, Japan
| | - Masaharu Nishimura
- Department of Respiratory Medicine, Faculty of Medicine, Hokkaido University, Sapporo, Japan
- Hokkaido Medical Research Institute for Respiratory Diseases, Sapporo, Japan
| | - Satoshi Konno
- Department of Respiratory Medicine, Faculty of Medicine, Hokkaido University, Sapporo, Japan
| |
Collapse
|
4
|
Wang S, Li D, Sun L. Weight-adjusted waist index is an independent predictor of all-cause and cause-specific mortality in patients with asthma. Heart Lung 2024; 68:166-174. [PMID: 39003963 DOI: 10.1016/j.hrtlng.2024.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Revised: 07/03/2024] [Accepted: 07/08/2024] [Indexed: 07/16/2024]
Abstract
BACKGROUND There is a close relationship between obesity and the occurrence of asthma.The weight-adjusted waist index (WWI) is a relatively novel anthropometric parameter that reflects obesity. OBJECTIVE We aimed to explore the association between WWI and mortality in the asthma population. METHODS We included adult with asthma from NHANES 1999-2018. WWI = Waist circumference (cm)/square root of body weight (kg). Current asthma was determined by the participant's responses in standardized questionnaires. All-cause, cardiovascular disease (CVD), cancer, and respiratory disease mortality information was obtained by prospectively matching these data to the National Death Index. Multivariate-adjusted Cox proportional hazards regression analyses, Kaplan Meier survival analyses, restricted cubic spline (RCS) analyses, stratified analyses, and sensitivity analyses were used to clarify these associations. RESULTS A total of 101,316 participants were included in the study, and 3223 were diagnosed with asthma.WWI was independently and positively associated with all-cause and all factor-specific mortality in asthma. In fully adjusted models, each unit increase in WWI was associated with 43 % (hazard ratio [HR] and 95 % confidence interval [CI] = 1.43 [1.25,1.64], p < 0.0001), 58 % (1.58 [1.25, 1.99], p < 0.001), 50 % (1.50 [1.19, 1.90], p < 0.001), and 79 % (1.79 [1.34, 2.39], p < 0.0001) increased all-cause, CVD, cancer, and respiratory disease mortality, respectively. RCS analyses showed largely linear associations between WWI and all mortality risks. Stratified analyses indicated that these associations were influenced by multiple factors, and that age was consistently the effect modifier across all associations. CONCLUSIONS WWI is an independent predictor of all-cause, CVD, cancer, and respiratory-related mortality in the adult asthma population. These findings highlight that WWI may have novel prognostic value as a simple and easily accessible obesity parameter in asthma patients.
Collapse
Affiliation(s)
- Shidong Wang
- Department of Respiratory Medicine, Shaoxing Second Hospital, Zhejiang, China
| | - Dai Li
- Department of Respiratory Medicine, Shaoxing Second Hospital, Zhejiang, China
| | - Liping Sun
- Department of Nutrition, Shaoxing Second Hospital, Zhejiang, China.
| |
Collapse
|
5
|
Tashiro H, Kurihara Y, Kuwahara Y, Takahashi K. Impact of obesity in asthma: Possible future therapies. Allergol Int 2024; 73:48-57. [PMID: 37659887 DOI: 10.1016/j.alit.2023.08.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 07/10/2023] [Accepted: 07/31/2023] [Indexed: 09/04/2023] Open
Abstract
Obesity is one of the factors associated with the severity of asthma. Obesity is associated with aggravation of the pathophysiology of asthma, including exacerbations, airway inflammation, decreased pulmonary function, and airway hyperresponsiveness. The present review addresses the characteristics of asthma with obesity, focusing especially on the heterogeneity caused by the degree of type 2 inflammation, sex differences, the onset of asthma, and race differences. To understand the severity mechanisms in asthma and obesity, such as corticosteroid resistance, fatty acids, gut microbiome, and cytokines, several basic research studies are evaluated. Finally, possible future therapies, including weight reduction, microbiome-targeted therapies, and other molecular targeted therapies are addressed. We believe that the present review will contribute to better understanding of the severity mechanisms and the establishment of novel treatments for severe asthma patients with obesity.
Collapse
Affiliation(s)
- Hiroki Tashiro
- Division of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, Japan.
| | - Yuki Kurihara
- Division of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, Japan
| | - Yuki Kuwahara
- Division of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, Japan
| | - Koichiro Takahashi
- Division of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, Japan
| |
Collapse
|
6
|
Knott-Torcal C, Sebastián-Valles F, Girón Moreno RM, Martín-Adán JC, Jiménez-Díaz J, Marazuela M, Sánchez de la Blanca N, Fernández-Contreras R, Arranz-Martín A. A prospective study to assess the impact of a novel CFTR therapy combination on body composition in patients with cystic fibrosis with F508del mutation. Clin Nutr 2023; 42:2468-2474. [PMID: 38411018 DOI: 10.1016/j.clnu.2023.10.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 09/04/2023] [Accepted: 10/16/2023] [Indexed: 02/28/2024]
Abstract
BACKGROUND & AIM Malnutrition is a prevalent condition in Cystic Fibrosis (CF) and can result in worsening of pulmonary function and other comorbidities. Cystic fibrosis transmembrane regulator (CFTR) modulator therapies are improving the CF-related care and outcomes. Body Mass Index (BMI) is the most commonly used parameter to assess nutritional status, albeit it is a very unspecific indicator. Hence, current guidelines recommend body composition analysis as a part of nutritional assessment. The aim of our study was to evaluate the impact of elexacaftor-tezacaftor-ivacaftor (ELX/TEZ/IVA) treatment on body composition and respiratory function. METHODS We recruited patients with CF from University Hospital La Princesa, with follow-up in the Adult Cystic Fibrosis Unit. All patients were eligible to initiate ELX/TEZ/IVA therapy. Body composition was assessed with a Bioelectrical Impedance Analysis (BIA) and spirometry data were obtained before and after 6 months of treatment. RESULTS Our study sample was composed of 36 patients with CF. We observed a significant increase in BMI after 6 months of treatment (p < 0.001), as well as an increase in fat mass (p = 0.008) and visceral fat area (p = 0.026). The other body composition parameters did not yield significant changes. Overall, %FEV1 increased from 72.67 % (±17.39) to 84.74 % (±18.18) after 6 months of treatment. Interestingly, we found an inverse correlation between %FEV1 and fat mass (r = -0,476; p = 0,0058), %FEV1 and age (r = -0,411; p = 0,0196) and between %FEV1 and visceral fat area (r = -0,515; p = 0,0025). On the contrary, we found a direct correlation between %FEV1 and body cell mass (r = 0,367; p = 0,038). CONCLUSIONS Novel CFTR modulators are emerging for the treatment of CF. Specifically, triple combination with ELX/TEZ/IVA has shown to effectively improve both pulmonary and nutritional status in patients with CF with F508del mutation. Body composition should be a part of the routine assessment for patients with CF.
Collapse
Affiliation(s)
- Carolina Knott-Torcal
- Department of Endocrinology and Nutrition, Health Research Institute, Hospital Universitario de La Princesa, Universidad Autónoma de Madrid, 28006 Madrid, Spain.
| | - Fernando Sebastián-Valles
- Department of Endocrinology and Nutrition, Health Research Institute, Hospital Universitario de La Princesa, Universidad Autónoma de Madrid, 28006 Madrid, Spain.
| | - Rosa María Girón Moreno
- Department of Respiratory Medicine, Adult Cystic Fibrosis Unit, Health Research Institute, Hospital Universitario de La Princesa, Universidad Autónoma de Madrid, 28006 Madrid, Spain.
| | - José Carlos Martín-Adán
- Department of Endocrinology and Nutrition, Health Research Institute, Hospital Universitario de La Princesa, Universidad Autónoma de Madrid, 28006 Madrid, Spain.
| | - Jessica Jiménez-Díaz
- Department of Endocrinology and Nutrition, Hospital Universitario de Torrejón, C. Mateo Inurria, 28850 Torrejón de Ardoz, Madrid, Spain.
| | - Mónica Marazuela
- Department of Endocrinology and Nutrition, Health Research Institute, Hospital Universitario de La Princesa, Universidad Autónoma de Madrid, 28006 Madrid, Spain.
| | - Nuria Sánchez de la Blanca
- Department of Endocrinology and Nutrition, Health Research Institute, Hospital Universitario de La Princesa, Universidad Autónoma de Madrid, 28006 Madrid, Spain.
| | - Raúl Fernández-Contreras
- Department of Endocrinology and Nutrition, Health Research Institute, Hospital Universitario de La Princesa, Universidad Autónoma de Madrid, 28006 Madrid, Spain.
| | - Alfonso Arranz-Martín
- Department of Endocrinology and Nutrition, Health Research Institute, Hospital Universitario de La Princesa, Universidad Autónoma de Madrid, 28006 Madrid, Spain.
| |
Collapse
|
7
|
Bal C, Pohl W, Milger K, Skowasch D, Schulz C, Gappa M, Koerner-Rettberg C, Jandl M, Schmidt O, Zehetmayer S, Taube C, Hamelmann E, Buhl R, Korn S, Idzko M. Characterization of Obesity in Severe Asthma in the German Asthma Net. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2023; 11:3417-3424.e3. [PMID: 37406803 DOI: 10.1016/j.jaip.2023.06.049] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 06/17/2023] [Accepted: 06/20/2023] [Indexed: 07/07/2023]
Abstract
BACKGROUND Asthma is increasingly recognized as heterogeneous, characterized by different endotypes, with obesity not only a distinct phenotype but a risk factor for severe asthma. OBJECTIVE We sought to understand the associations of obesity with relevant parameters of severe asthma, including asthma control, disease burden, and lung function. METHODS The German Asthma Net registry is a multicenter international real-life registry capturing long-term follow-up data. This analysis included 2213 patients (52 ± 16 years, 58% female, 29% with obesity [body mass index ≥30 kg/m2], 4.2 ± 4.3 exacerbations/year). The primary analysis assessed relationships between BMI and variables through univariate tests, followed by a multiple regression model. Secondary outcomes regarded clinically relevant variables in relation to weight groups. RESULTS Patients with obesity were more frequently female, more likely to have depression and gastroesophageal reflux, and suffered from worse asthma control, lower quality of life, reduced static lung volumes, more pronounced hypoxemia, and higher blood neutrophil counts, all statistically significant. Blood eosinophils, exhaled nitric oxide, and total IgE were independent of obesity. In the multiple regression analysis, obesity was significantly associated with more frequent reflux and depression, reduced static lung function values, older age, poor asthma control, and long-acting muscarinic antagonist therapy, and inversely associated with bronchiectasis and nonsmoking status. CONCLUSION In this large, well-characterized cohort, we identified the association of obesity with a significantly higher disease burden and a similar portfolio of inflammation type 2 markers in patients with and without obesity; therefore, patients with obesity seem similarly eligible for the treatment with biologics targeting these disease endotypes.
Collapse
Affiliation(s)
- Christina Bal
- Department of Pneumology, University Hospital Vienna AKH, Medical University of Vienna, Vienna, Austria
| | - Wolfgang Pohl
- Karl Landsteiner Institute for Clinical and Experimental Pneumology, Vienna, Austria
| | - Katrin Milger
- Department of Medicine V, Ludwig-Maximilians-University (LMU) of Munich, Munich, Germany; Comprehensive Pneumology Center (CPC-M), German Center for Lung Research (DZL), Munich, Germany
| | - Dirk Skowasch
- Department of Internal Medicine II-Pneumology, University Hospital Bonn, Bonn, Germany
| | - Christian Schulz
- Department of Internal Medicine II, University Hospital Regensburg, Regensburg, Germany
| | - Monika Gappa
- Evangelisches Krankenhaus Düsseldorf, Children's Hospital, Düsseldorf, Germany
| | | | - Margret Jandl
- Hamburger Institut für Therapieforschung GmbH, Hamburg, Germany
| | - Olaf Schmidt
- Pneumologische Gemeinschaftspraxis und Studienzentrum KPPK, Koblenz, Germany
| | - Sonja Zehetmayer
- Section for Medical Statistics, Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Vienna, Austria
| | - Christian Taube
- Department of Pulmonary Medicine, University Hospital Essen-Ruhrlandklinik, Essen, Germany
| | - Eckard Hamelmann
- Kinderzentrum Bethel, Evangelisches Klinikum Bethel, University Bielefeld, Bielefeld, Germany
| | - Roland Buhl
- Pulmonary Department, Mainz University Hospital, Mainz, Germany
| | - Stephanie Korn
- Department of Pneumology/Respiratory Medicine, Thoraxklinik Heidelberg, Heidelberg, Germany; IKF Pneumologie Mainz, Mainz, Germany.
| | - Marco Idzko
- Department of Pneumology, University Hospital Vienna AKH, Medical University of Vienna, Vienna, Austria
| |
Collapse
|
8
|
Kontopoulou L, Kotsiou OS, Tourlakopoulos K, Karpetas G, Paraskevadaki EV, Malli F, Pantazopoulos I, Daniil Z, Gourgoulianis KI. Physical Health-Related Quality of Life in Relation to Mediterranean Diet Adherence in a Sample of Greek Asthma Patients: A Pilot Study. J Pers Med 2023; 13:1512. [PMID: 37888123 PMCID: PMC10608726 DOI: 10.3390/jpm13101512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 10/17/2023] [Accepted: 10/18/2023] [Indexed: 10/28/2023] Open
Abstract
The role of nutrition in the management of asthma in obese patients is of increasing interest due to their limited response to inhaled corticosteroids. Some studies note that through diet and lifestyle, there can be an improvement in asthma control. The aim of the present study was to investigate the adherence to the Mediterranean Diet and its association with asthma severity and quality of life in patients with bronchial asthma. This is a cross-sectional study of 85 patients (70.6% female), with a mean age of 57 years, from the General University Hospital of Larissa and, more specifically, patients of the outpatient asthma clinic. Data were collected with the use of specific questionnaires. In relation to BMI, 12.9% of participants were of a normal weight, 45.9% were overweight, 25.9% were obese level I, 5.9% were obese level II, and 9.4% were in the morbidly obese range. Based on the Med Diet Score (ranging from 21 to 35), most participants (85.9%) reported moderate adherence to the Mediterranean Diet. Further analysis examined the correlations of the PCS-12 score with the frequency of consumption of each of the 11 food categories, as well as all demographic and health behavior variables. The ranked correlations indicated a significant relationship between PCS-12 score and Med Diet adherence and the consumption of alcoholic beverages (r = 0.437, p < 0.05), in accordance with the Mediterranean Diet suggestions, as well as a negative relationship with BMI score (r = -0.454, p < 0.010). Moreover, significant correlations were also present between the physical quality of life and AQLQ score and work type, as well as gender, age, and marital status. The results of our study showed a high rate of obesity in patients with asthma at the General University Hospital of Larissa and moderate adherence to the Mediterranean Diet. Increased BMI and alcoholic beverage consumption in asthma patients were significant predictors of lower physical health-related quality of life. In conclusion, personal and society-level interventions are required to effectively address obesity and poor diet in patients with asthma.
Collapse
Affiliation(s)
- Lamprini Kontopoulou
- Respiratory Disorders Lab, Faculty of Nursing, University of Thessaly, 41500 Larissa, Greece;
| | - Ourania S. Kotsiou
- Respiratory Disorders Lab, Faculty of Nursing, University of Thessaly, 41500 Larissa, Greece;
- Department of Human Pathophysiology, Faculty of Nursing, University of Thessaly, 41500 Gaiopolis, Greece
| | - Konstantinos Tourlakopoulos
- Department of Respiratory Medicine, Faculty of Medicine, University of Thessaly, 41110 Biopolis, Greece; (K.T.); (G.K.); (I.P.); (Z.D.); (K.I.G.)
| | - Georgios Karpetas
- Department of Respiratory Medicine, Faculty of Medicine, University of Thessaly, 41110 Biopolis, Greece; (K.T.); (G.K.); (I.P.); (Z.D.); (K.I.G.)
| | | | - Foteini Malli
- Respiratory Disorders Lab, Faculty of Nursing, University of Thessaly, 41500 Larissa, Greece;
- Department of Respiratory Medicine, Faculty of Medicine, University of Thessaly, 41110 Biopolis, Greece; (K.T.); (G.K.); (I.P.); (Z.D.); (K.I.G.)
| | - Ioannis Pantazopoulos
- Department of Respiratory Medicine, Faculty of Medicine, University of Thessaly, 41110 Biopolis, Greece; (K.T.); (G.K.); (I.P.); (Z.D.); (K.I.G.)
| | - Zoe Daniil
- Department of Respiratory Medicine, Faculty of Medicine, University of Thessaly, 41110 Biopolis, Greece; (K.T.); (G.K.); (I.P.); (Z.D.); (K.I.G.)
| | - Konstantinos I. Gourgoulianis
- Department of Respiratory Medicine, Faculty of Medicine, University of Thessaly, 41110 Biopolis, Greece; (K.T.); (G.K.); (I.P.); (Z.D.); (K.I.G.)
| |
Collapse
|
9
|
Suzuki M, Makita H, Konno S, Nishimura M. Clinical characteristics and natural course of chronic obstructive pulmonary disease and/or asthma in Japanese patients: a summary report of two Hokkaido-based cohort studies. Respir Investig 2023; 61:527-539. [PMID: 37300900 DOI: 10.1016/j.resinv.2023.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Revised: 04/16/2023] [Accepted: 05/01/2023] [Indexed: 06/12/2023]
Abstract
Chronic obstructive pulmonary disease (COPD) and asthma are the most common chronic airway diseases and are characterized by chronic airway inflammation and airflow limitation. Japanese patients with COPD or asthma have characteristics different from those of Westerners. Therefore, understanding the characteristics and clinical course of Japanese patients with COPD and those with asthma, particularly severe asthma, is critical for their management and appropriate treatment. The Hokkaido COPD cohort and Hokkaido-based Investigative Cohort Analysis for Refractory Asthma (Hi-CARAT) are high-quality cohort studies of COPD and asthma in the Japanese population and provide valuable data. This report summarizes the clinical findings from the two cohort studies and provides data for more appropriate management of Japanese patients with COPD and/or asthma. Overall, 279 patients with COPD were followed up for up to 10 years in the Hokkaido COPD cohort study, and 127 with severe asthma were followed up for up to 6 years in the Hi-CARAT study. Seventy-nine patients with mild-to-moderate asthma provided baseline data for the Hi-CARAT study. In each disease, several distinct factors, including systemic status and non-pulmonary factors, were associated with important clinical outcomes, such as lung function decline, exacerbations, impaired quality of life, and mortality. Therefore, multifaceted evaluation based on the characteristics of the Japanese population is necessary for the management of COPD and asthma.
Collapse
Affiliation(s)
- Masaru Suzuki
- Department of Respiratory Medicine, Faculty of Medicine, Hokkaido University, Sapporo, Japan
| | - Hironi Makita
- Department of Respiratory Medicine, Faculty of Medicine, Hokkaido University, Sapporo, Japan; Hokkaido Medical Research Institute for Respiratory Diseases, Sapporo, Japan
| | - Satoshi Konno
- Department of Respiratory Medicine, Faculty of Medicine, Hokkaido University, Sapporo, Japan
| | - Masaharu Nishimura
- Department of Respiratory Medicine, Faculty of Medicine, Hokkaido University, Sapporo, Japan; Hokkaido Medical Research Institute for Respiratory Diseases, Sapporo, Japan.
| |
Collapse
|
10
|
Kisiel MA, Arnfelt O, Lindberg E, Jogi O, Malinovschi A, Johannessen A, Benediktsdottir B, Franklin K, Holm M, Real FG, Sigsgaard T, Gislason T, Modig L, Janson C. Association between abdominal and general obesity and respiratory symptoms, asthma and COPD. Results from the RHINE study. Respir Med 2023; 211:107213. [PMID: 36933674 DOI: 10.1016/j.rmed.2023.107213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 03/10/2023] [Accepted: 03/13/2023] [Indexed: 03/20/2023]
Abstract
INTRODUCTION Previous studies on the association between abdominal and general obesity and respiratory disease have provided conflicting results. AIMS AND OBJECTIVES We aimed to explore the associations of abdominal obesity with respiratory symptoms, asthma, and chronic obstructive pulmonary disease independently from general obesity in women and men. METHODS This cross-sectional study was based on the Respiratory Health in Northern Europe (RHINE) III questionnaire (n = 12 290) conducted in 2010-2012. Abdominal obesity was self-measured waist circumference using a sex-specific standard cut-off point: ≥102 cm in males and ≥88 cm in females. General obesity was defined as self-reported BMI ≥30.0 kg/m2. RESULTS There were 4261 subjects (63% women) with abdominal obesity and 1837 subjects (50% women) with general obesity. Both abdominal and general obesity was independent of each other and associated with respiratory symptoms (odds ratio (OR) from 1.25 to 2.00)). Asthma was significantly associated with abdominal and general obesity in women, OR (95% CI) 1.56 (1.30-1.87) and 1.95 (1.56-2.43), respectively, but not in men, OR 1.22 (0.97-3.17) and 1.28 (0.97-1.68) respectively. A similar sex difference was found for self-reported chronic obstructive pulmonary disease. CONCLUSIONS General and abdominal obesity were independent factors associated with respiratory symptoms in adults. Asthma and chronic obstructive pulmonary disease were independently linked to abdominal and general obesity in women but not men.
Collapse
Affiliation(s)
- Marta A Kisiel
- Department of Medical Sciences: Environmental and Occupational Medicine, Uppsala University, Uppsala, Sweden.
| | - Oscar Arnfelt
- Department of Medical Sciences: Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
| | - Eva Lindberg
- Department of Medical Sciences: Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
| | - Oscar Jogi
- Lung Clinic, Tartu University Hospital, Tartu, Estonia
| | - Andrei Malinovschi
- Department of Medical Sciences: Clinical Physiology, Uppsala University, Uppsala, Sweden
| | - Ane Johannessen
- Centre for International Health, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Bryndis Benediktsdottir
- The Medical Faculty, University of Iceland, Reykjavik, Iceland; Department of Sleep, Landspitali University Hospital Reykjavik, Reykjavik, Iceland
| | - Karl Franklin
- Department of Surgical and Perioperative Sciences, Surgery, Umeå University, Umeå, Sweden
| | - Mathias Holm
- Section of Occupational and Environmental Medicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Francisco Gomez Real
- Department of Clinical Science, University of Bergen, Bergen, Norway; Department of Obstetrics and Gynecology, Haukeland University Hospital, Bergen, Norway
| | - Torben Sigsgaard
- Department of Public Health, Danish Ramazzini Centre, Aarhus University, Aarhus, Denmark
| | - Thorarinn Gislason
- The Medical Faculty, University of Iceland, Reykjavik, Iceland; Department of Sleep, Landspitali University Hospital Reykjavik, Reykjavik, Iceland
| | - Lars Modig
- Department of Public Health and Clinical Medicine, Section of Sustainable Health, Umeå University, Umeå, Sweden
| | - Christer Janson
- Department of Medical Sciences: Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
| |
Collapse
|
11
|
Zhang H, Hu Z, Wang S, Xu J, Li S, Song X. Association of general and abdominal obesity with lung function, FeNO, and blood eosinophils in adult asthmatics: Findings from NHANES 2007-2012. Front Physiol 2023; 14:1019123. [PMID: 36846327 PMCID: PMC9950393 DOI: 10.3389/fphys.2023.1019123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Accepted: 02/02/2023] [Indexed: 02/12/2023] Open
Abstract
Purpose: Obesity is considered a risk factor for asthma exacerbation. However, limited studies have focused on the association of different levels of weight clusters with asthma. As such, we study the associations between different weight clusters with FeNO, blood eosinophils, and lung function among adult asthmatics. Methods: Data from 789 participants aged 20 years or older in the National Health and Nutrition Examination Survey 2007-2012 were analyzed. Body mass index (BMI) and waist circumference (WC) were used to determine the weight status. The study population was divided into five groups, including normal weight and low WC (153), normal weight and high WC (43), overweight and high WC (67), overweight and abdominal obesity (128), and general and abdominal obesity (398). A Multivariate linear regression model was used to evaluate the abovementioned associations after adjusting for potential confounding factors. Results: The adjusted models showed that general and abdominal obesity cluster (adjusted β = -0.63, 95% confidence interval (CI): -1.08, -0.17 p < 0.01), and the normal weight with high WC cluster (adjusted β = -0.96, 95% CI: -1.74, -0.19 p < 0.05) were associated with lower levels of blood eosinophils percentage than normal weight and low WC cluster. A similar tendency was shown in the levels of FeNO, but the differences were not significant (p > 0.05). Furthermore, abdominal obesity clusters were significantly associated with lower FVC, FVC% predicted, and FEV1 measures than normal weight and low WC cluster, especially those individuals with general and abdominal obesity cluster. No association was found between different weight clusters and FEV1/FVCF ratio. The two other weight clusters did not show the association with any of the lung function measures. Conclusion: General and abdominal obesity were associated with lung function impairment and a significant reduction of FeNO and blood eosinophil percentage. This study emphasized the importance of concurrent determination of BMI and WC in asthma clinical practice.
Collapse
Affiliation(s)
- Haoyu Zhang
- Department of Respiratory and Critical Care Medicine, The First College of Clinical Medicine Science, China Three Gorges University, Yichang, China,Department of Respiratory and Critical Care Medicine, Yichang Central People’s Hospital, Yichang, China
| | - Zhigang Hu
- Department of Respiratory and Critical Care Medicine, The First College of Clinical Medicine Science, China Three Gorges University, Yichang, China,Department of Respiratory and Critical Care Medicine, Yichang Central People’s Hospital, Yichang, China
| | - Sufei Wang
- Department of Respiratory and Critical Care Medicine, NHC Key Laboratory of Pulmonary Diseases, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Jiangli Xu
- Department of Respiratory and Critical Care Medicine, The First College of Clinical Medicine Science, China Three Gorges University, Yichang, China,Department of Respiratory and Critical Care Medicine, Yichang Central People’s Hospital, Yichang, China
| | - Sijia Li
- Department of Respiratory and Critical Care Medicine, The First College of Clinical Medicine Science, China Three Gorges University, Yichang, China,Department of Respiratory and Critical Care Medicine, Yichang Central People’s Hospital, Yichang, China
| | - Xinyu Song
- Department of Respiratory and Critical Care Medicine, The First College of Clinical Medicine Science, China Three Gorges University, Yichang, China,Department of Respiratory and Critical Care Medicine, Yichang Central People’s Hospital, Yichang, China,*Correspondence: Xinyu Song,
| |
Collapse
|
12
|
Association of serum CC16 levels with eosinophilic inflammation and respiratory dysfunction in severe asthma. Respir Med 2023; 206:107089. [PMID: 36542961 DOI: 10.1016/j.rmed.2022.107089] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 12/01/2022] [Accepted: 12/10/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND There are knowledge gaps in the potential role of Club cell 16-kDa secretory protein (CC16) in severe asthma phenotypes and type 2 inflammation, as well as the longitudinal effect of CC16 on pulmonary function tests and exacerbation risk in epidemiological studies. OBJECTIVE AND METHODS To assess whether serum CC16 is associated with eosinophilic inflammation in patients with severe asthma. We also examined the effect of this protein on the annual decline in forced expiratory volume in the first second (FEV1) and the risk of exacerbation using a longitudinal approach. We recruited 127 patients with severe asthma from 30 hospitals/pulmonary clinics in Hokkaido, Japan. The least square means and standard error were calculated for T-helper 2 (Th2) biomarkers and pulmonary function test across CC16 tertiles at baseline. We did the same for asthma exacerbation and annual decline in FEV1 with 3 and 5 years' follow-up, respectively. RESULTS We found that serum CC16 was inversely associated with sputum eosinophils and blood periostin in a dose-response manner. Baseline CC16 and FEV1/forced vital capacity ratio were positively associated in adjusted models (p for trend = 0.008). Patients with the lowest tertile of serum CC16 levels at baseline had a -14.3 mL decline in FEV1 than those with the highest tertile over 5 years of follow-up (p for trend = 0.031, fully adjusted model). We did not find any association of CC16 with exacerbation risk. CONCLUSION Patients with severe asthma with lower circulatory CC16 had enhanced eosinophilic inflammation with rapid FEV1 decline over time.
Collapse
|
13
|
Tooba R, Wu TD. Obesity and asthma: A focused review. Respir Med 2022; 204:107012. [PMID: 36279813 PMCID: PMC9671155 DOI: 10.1016/j.rmed.2022.107012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 10/08/2022] [Accepted: 10/11/2022] [Indexed: 11/19/2022]
Affiliation(s)
- Rubabin Tooba
- Department of Pulmonary and Critical Care Medicine, Baylor College of Medicine, Houston, TX, USA.
| | - Tianshi David Wu
- Department of Pulmonary and Critical Care Medicine, Baylor College of Medicine, Houston, TX, USA; Center for Innovations in Quality, Effectiveness, and Safety, Michael E. DeBakey VA Medical Center, Houston, TX, USA.
| |
Collapse
|
14
|
Yücel ÜÖ, Çalış AG. The Relationship Between General and Abdominal Obesity, Nutrition and Respiratory Functions in Adult Asthmatics. J Asthma 2022; 60:1183-1190. [PMID: 36239386 DOI: 10.1080/02770903.2022.2137038] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
Objective: Although obesity is known to have adverse effects on asthma, it is not fully known whether general or abdominal obesity affects asthma symptoms more. In this study, the effects of diet and general/abdominal obesity on respiratory functions were evaluated.Methods: A total of 204 adult asthmatic individuals participated in the study. Anthropometric measurements, respiratory functions, asthma control test (ACT) scores, and 24-hour food consumption were recorded. The results were compared according to body mass index (BMI), waist circumference (WC), and waist-hip ratio (WHR) classification.Results: FEV1, FVC, MEF25-75, MEF50, and MEF25 decreased with the increase in BMI, WC, and WHR. FEV1 showed a negative linear relationship with BMI, WC and WHR and these results were more significant in WC and WHR than BMI. Similarly, the ACT score also showed a negative correlation with BMI (r = -0.372; p = 0.023), WC (r = -0.402; p = 0.001) and WHR (r = -0.387; p = 0.011), and the results were more significant in WC and WHR than BMI. Individuals whose WC (OR: 2.170 CI (1.325-3.182)) and WHR (OR: 2.119 CI (1.246-3.338)) were at risk had higher odds of uncontrolled asthma than those with normal WC and WHR. Each 100-kcal increase in total energy consumption increased the odds of uncontrolled asthma (OR: 1.125 CI (1.086-2.217)) (p < 0.05).Conclusions: The effects of WC and WHR, which are indicators of abdominal obesity, on respiratory functions and ACT score were found to be higher than BMI. Obese individuals should be referred to diet clinics to improve their asthma symptoms.
Collapse
Affiliation(s)
- Ümüş Özbey Yücel
- Department of Nutrition and Diet, Faculty of Health Sciences, Amasya University. Amasya, Turkey
| | - Aliye Gamze Çalış
- Department of Chest Disease, Alanya Training and Research Hospital, Antalya, Turkey
| |
Collapse
|
15
|
Effects of obesity on CC16 and their potential role in overweight/obese asthma. Respir Res 2022; 23:174. [PMID: 35768822 PMCID: PMC9241210 DOI: 10.1186/s12931-022-02038-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 04/24/2022] [Indexed: 11/21/2022] Open
Abstract
Introduction Club cell secretory protein-16 (CC16) is a major anti-inflammatory protein expressed in the airway; however, the potential role of CC16 on overweight/obese asthma has not been assessed. In this study, we examined whether obesity reduces airway/circulatory CC16 levels using experimental and epidemiological studies. Then, we explored the mediatory role of CC16 in the relationship of overweight/obesity with clinical asthma measures. Methods Circulating CC16 levels were assessed by ELISA in three independent human populations, including two groups of healthy and general populations and asthma patients. The percentage of cells expressing club markers in obese vs. non-obese mice and human airways was determined by immunohistochemistry. A causal mediation analysis was conducted to determine whether circulatory CC16 acted as a mediator between overweight/obesity and clinical asthma measures. Results BMI was significantly and monotonously associated with reduced circulating CC16 levels in all populations. The percentage of CC16-expressing cells was reduced in the small airways of both mice and humans with obesity. Finally, mediation analysis revealed significant contributions of circulatory CC16 in the association between BMI and clinical asthma measures; 21.8% of its total effect in BMI’s association with airway hyperresponsiveness of healthy subjects (p = 0.09), 26.4% with asthma severity (p = 0.030), and 23% with the required dose of inhaled corticosteroid (p = 0.042). In logistic regression analysis, 1-SD decrease in serum CC16 levels of asthma patients was associated with 87% increased odds for high dose ICS requirement (p < 0.001). Conclusions We demonstrate that airway/circulating CC16, which is inversely associated with BMI, may mediate development and severity in overweight/obese asthma. Supplementary Information The online version contains supplementary material available at 10.1186/s12931-022-02038-1.
Collapse
|
16
|
Matsumoto-Sasaki M, Suzuki M, Kimura H, Shimizu K, Makita H, Nishimura M, Konno S. Association of longitudinal changes in quality of life with comorbidities and exacerbations in patients with severe asthma. Allergol Int 2022; 71:481-489. [PMID: 35718710 DOI: 10.1016/j.alit.2022.05.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 04/15/2022] [Accepted: 05/16/2022] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Quality of life (QoL) assessment is important in the management of severe asthma, and comorbidities and/or exacerbations may affect longitudinal QoL. However, there are few reports on the longitudinal assessment of QoL in patients with asthma over multiple years and its related factors. This study aimed to clarify the relationship of longitudinal changes in QoL with comorbidities and/or exacerbations during a prolonged observation period in patients with severe asthma. METHODS A total of 105 subjects who participated in the Hokkaido-based Investigative Cohort Analysis for Refractory Asthma (Hi-CARAT) with a six-year follow-up were analyzed. QoL was assessed annually, using the Standardized Asthma Quality of Life Questionnaire, and the subjects were divided into three groups: (1) persistently good QoL, (2) persistently poor QoL, and (3) fluctuating QoL. Assessed comorbidities comprised depression, gastroesophageal reflux disease, and excessive daytime sleepiness (EDS), a key symptom of obstructive sleep apnea. RESULTS Of 105 subjects with severe asthma, 53 (50%) were classified in the persistently good QoL group, 10 (10%) in the persistently poor QoL group, and 42 (40%) in the fluctuating QoL group. The persistently poor QoL group was associated with shorter time to hospitalization due to exacerbation and the presence of multiple comorbidities. In addition, the presence of EDS was an independent contributor to the fluctuating QoL group compared to the persistently good QoL group. CONCLUSIONS The presence of multiple comorbidities and hospitalization due to exacerbation contribute to longitudinal changes in QoL in patients with severe asthma.
Collapse
Affiliation(s)
- Machiko Matsumoto-Sasaki
- Department of Respiratory Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Masaru Suzuki
- Department of Respiratory Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan.
| | - Hirokazu Kimura
- Department of Respiratory Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Kaoruko Shimizu
- Department of Respiratory Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Hironi Makita
- Department of Respiratory Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Masaharu Nishimura
- Department of Respiratory Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| | - Satoshi Konno
- Department of Respiratory Medicine, Faculty of Medicine and Graduate School of Medicine, Hokkaido University, Sapporo, Japan
| |
Collapse
|
17
|
Stapel B, Jelinic M, Drummond GR, Hartung D, Kahl KG. Adipose Tissue Compartments, Inflammation, and Cardiovascular Risk in the Context of Depression. Front Psychiatry 2022; 13:831358. [PMID: 35444568 PMCID: PMC9013771 DOI: 10.3389/fpsyt.2022.831358] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 02/07/2022] [Indexed: 12/20/2022] Open
Abstract
The neurobiological and behavioral underpinnings linking mental disorders, in particular, major depressive disorder (MDD), with cardiovascular disorders are a matter of debate. Recent research focuses on visceral (intra-abdominal and epicardial) adipose tissue and inflammation and their impact on the development of cardiometabolic disorders. Intra-abdominal adipose tissue is defined as an endocrine active fat compartment surrounding inner organs and is associated with type 2 diabetes mellitus, a risk factor for the later development of cardiovascular disorders. Epicardial (pericardial) adipose tissue is a fat compartment surrounding the heart with close proximity to the arteries supporting the heart. Visceral adipose tissue (VAT) is an important source of inflammatory mediators that, in concert with other risk factors, plays a leading role in cardiovascular diseases. In conjunction with the behavioral (physical inactivity, sedentary lifestyle), psychological (adherence problems), and hormonal (dysfunction of the hypothalamus-pituitary-adrenal axis with subsequent hypercortisolism) alterations frequently accompanying MDD, an enhanced risk for cardiovascular disorders results.
Collapse
Affiliation(s)
- Britta Stapel
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hanover, Germany
| | - Maria Jelinic
- Department of Physiology, Anatomy and Microbiology, Centre for Cardiovascular Biology and Disease Research, School of Life Sciences, La Trobe University, Bundoora, VIC, Australia
| | - Grant R. Drummond
- Department of Physiology, Anatomy and Microbiology, Centre for Cardiovascular Biology and Disease Research, School of Life Sciences, La Trobe University, Bundoora, VIC, Australia
| | - Dagmar Hartung
- Hannover Medical School, Institute for Diagnostic and Interventional Radiology, Hanover, Germany
| | - Kai G. Kahl
- Department of Psychiatry, Social Psychiatry and Psychotherapy, Hannover Medical School, Hanover, Germany
| |
Collapse
|
18
|
Goudarzi H, Kimura H, Makita H, Abe Y, Oguma A, Sato M, Matsumoto M, Takei N, Kimura H, Shimizu K, Suzuki M, Ito YM, Nishimura M, Konno S. Association of abdominal visceral adiposity with sputum IL-5 levels in asthma. Allergol Int 2022; 71:137-139. [PMID: 34535401 DOI: 10.1016/j.alit.2021.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 07/16/2021] [Accepted: 07/23/2021] [Indexed: 11/26/2022] Open
|
19
|
Abstract
Purpose of Review Obesity-associated difficult asthma continues to be a substantial problem and, despite a move to address treatable traits affecting asthma morbidity and mortality, it remains poorly understood with limited phenotype-specific treatments. The complex association between asthma, obesity, and inflammation is highlighted and recent advances in treatment options explored. Recent Findings Obesity negatively impacts asthma outcomes and has a causal link in the pathogenesis of adult-onset asthma. Imbalance in the adipose organ found in obesity favours a pro-inflammatory state both systemically and in airways. Obesity may impact currently available asthma biomarkers, and obesity-associated asthma specific biomarkers are needed. Whilst surgical weight loss interventions are associated with improvements in asthma control and quality of life, evidence for pragmatic conservative options are sparse. Innovative approaches tackling obesity-mediated airway inflammation may provide novel therapies. Summary The immunopathological mechanisms underlying obesity-associated asthma require further research that may lead to novel therapeutic options for this disease. However, weight loss appears to be effective in improving asthma in this cohort and focus is also needed on non-surgical treatments applicable in the real-world setting.
Collapse
Affiliation(s)
- Varun Sharma
- Institute of Infection, Immunity and Inflammation, University of Glasgow, Glasgow, UK. .,Glasgow Royal Infirmary, Glasgow, UK.
| | - Douglas C Cowan
- Institute of Infection, Immunity and Inflammation, University of Glasgow, Glasgow, UK. .,Glasgow Royal Infirmary, Glasgow, UK.
| |
Collapse
|
20
|
Huang YJ, Chu YC, Huang HL, Hwang JS, Chan TC. The Effects of Asthma on the Association Between Pulmonary Function and Obesity: A 16-Year Longitudinal Study. J Asthma Allergy 2021; 14:347-359. [PMID: 33854341 PMCID: PMC8041605 DOI: 10.2147/jaa.s299186] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2020] [Accepted: 03/01/2021] [Indexed: 12/14/2022] Open
Abstract
Background Asthma and obesity are important public health issues around the world. Obesity is considered a risk factor associated with the severity and incidence of asthma. We investigated the relationships between poor pulmonary function (defined by forced vital capacity (FVC) and percentage of predicted FVC (FVC%)) and obesity. Methods This is a retrospective longitudinal study using the MJ health examination database in Taiwan from 2000 to 2015. There were 160,609 participants aged ≥20 years with complete obesity indicators and lung function data, and having at least two visits. A generalized estimation equation (GEE) model was applied to estimate the association between lung function and obesity. Results BMI was the best indicator to predict poor pulmonary function for our participants. Results of BMI are presented as an example: Obesity (body mass index (BMI) ≥27.0 kg/m2) is significantly associated with lower FVC [adjusted coefficients (β) for asthmatics: -0.11 L (95% CI: -0.14, -0.08); adjusted β for non-asthmatics: -0.08 L (-0.09, -0.08)] and FVC% [adjusted β for asthmatics: -1.91% (95% CI: -2.64, -1.19); adjusted β for non-asthmatics: 1.48% (-1.63, -1.33)]. Annual change of BMI (ΔBMI/year) is an independent risk factor for decreased FVC [adjusted β for asthmatics: -0.030 L (-0.048, -0.013); adjusted β for non-asthmatics: -0.019 L (-0.022, -0.016)] and FVC% [adjusted β for non-asthmatics: -0.603% (-1.063, -0.142); adjusted β for non-asthmatics: -0.304% (-0.393, -0.214)], and is significantly associated with accelerated FVC decline [adjusted β of ΔFVC/year and ΔFVC %/year for asthmatics: -0.038 L (-0.054, -0.022) and -0.873% (-1.312, -0.435); adjusted β of ΔFVC/year and ΔFVC %/year for non-asthmatics: -0.033 L (-0.042, -0.024) and -0.889% (-1.326, -0.452)]. Conclusion Obesity is significantly associated with decreased lung function, and asthmatics had a higher risk than non-asthmatics.
Collapse
Affiliation(s)
- Ying-Jhen Huang
- Research Center for Humanities and Social Sciences, Academia Sinica, Taipei, Taiwan
| | - Yi-Chi Chu
- Research Center for Humanities and Social Sciences, Academia Sinica, Taipei, Taiwan
| | - Hung-Ling Huang
- Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung, Taiwan.,Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.,Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | | | - Ta-Chien Chan
- Research Center for Humanities and Social Sciences, Academia Sinica, Taipei, Taiwan.,Institute of Public Health, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| |
Collapse
|
21
|
Yano C, Kawayama T, Kinoshita T, Tokunaga Y, Sasaki J, Sakazaki Y, Matsuoka M, Imaoka H, Nishiyama M, Matsunaga K, Furukawa K, Hoshino T. Overweight improves long-term survival in Japanese patients with asthma. Allergol Int 2021; 70:201-207. [PMID: 33199207 DOI: 10.1016/j.alit.2020.09.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 09/23/2020] [Accepted: 09/25/2020] [Indexed: 10/23/2022] Open
Abstract
BACKGROUND Obesity is a risk factor for severe and difficult-to-treat asthma. However, the impact of different physiques on long-term outcomes is poorly understood. We aimed to investigate the correlation between obesity and asthma-associated long-term mortality in Japanese adults. METHODS From the data on 3146 individuals with air pollution-related respiratory diseases in the Omuta City Air Pollution-Related Health Damage Cohort Program, 697 adult patients with asthma were analyzed. Hazard ratios for long-term all-cause and respiratory disease -related mortality were compared in patients with different physiques using the Cox proportional hazard models. The classification of physiques was based on the WHO obesity criteria. RESULTS Of the 697 patients, 439 died during the median observation period of 26.3 years. The number (% of total) of underweight, normal-weight, pre-obese, and obese class I-III individuals were 75 (10.8%), 459 (65.9%), 140 (20.1%), and 23 (3.3%), respectively. The Cox proportional hazard model (adjusted hazard ratio [95% confidence interval], P value) showed that pre-obese group had a significantly reduced risk for all-cause (0.65 [0.51 to 0.83], P < 0.05) and respiratory disease (0.55 [0.37 to 0.81], P < 0.05)-related mortality related to normal-weight group. CONCLUSIONS Our cohort program demonstrated that being slightly overweight may reduce the risk of long-term mortality in patients with asthma. However, the influence of obesity on long-term outcomes remains unclear in asthma, because of the small number of obese patients included in our study. Our findings suggest that interventions, including nutrition and exercises, should be provided to Japanese patients with asthma.
Collapse
|
22
|
Kim YJ, Womble JT, Gunsch CK, Ingram JL. The Gut/Lung Microbiome Axis in Obesity, Asthma, and Bariatric Surgery: A Literature Review. Obesity (Silver Spring) 2021; 29:636-644. [PMID: 33759390 PMCID: PMC7995617 DOI: 10.1002/oby.23107] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 10/29/2020] [Accepted: 11/30/2020] [Indexed: 12/18/2022]
Abstract
Mounting evidence suggests that obesity, parameters of metabolic syndrome, and asthma are significantly associated. Interestingly, these conditions are also associated with microbiome dysbiosis, notably in the airway microbiome for patients with asthma and in the gut microbiome for patients with obesity and/or metabolic syndrome. Considering that improvements in asthma control, lung function, and airway hyperresponsiveness are often reported after bariatric surgery, this review investigated the potential role of bacterial gut and airway microbiome changes after bariatric surgery in ameliorating asthma symptoms. Rapid and persistent gut microbiota alterations were reported following surgery, some of which can be sustained for years. The gut microbiome is thought to modulate airway cellular responses via short-chain fatty acids and inflammatory mediators, such that increased propionate and butyrate levels following surgery may aid in reducing asthma symptoms. In addition, increased prevalence of Akkermansia muciniphila after Roux-en-Y gastric bypass and sleeve gastrectomy may confer protection against airway hyperreactivity and inflammation. Metabolic syndrome parameters also improved following bariatric surgery, and whether weight-loss-independent metabolic changes affect airway processes and asthma pathobiology merits further research. Fulfilling knowledge gaps outlined in this review could facilitate the development of new therapeutic options for patients with obesity and asthma.
Collapse
Affiliation(s)
- Yeon Ji Kim
- Department of Civil and Environmental Engineering, Pratt School of Engineering, Duke University, Durham, North Carolina
| | - Jack T. Womble
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, Duke University Medical Center, Durham, North Carolina
| | - Claudia K. Gunsch
- Department of Civil and Environmental Engineering, Pratt School of Engineering, Duke University, Durham, North Carolina
| | - Jennifer L. Ingram
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Medicine, Duke University Medical Center, Durham, North Carolina
| |
Collapse
|
23
|
He S, Yang J, Li X, Gu H, Su Q, Qin L. Visceral adiposity index is associated with lung function impairment: a population-based study. Respir Res 2021; 22:2. [PMID: 33407481 PMCID: PMC7789783 DOI: 10.1186/s12931-020-01599-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 12/10/2020] [Indexed: 02/07/2023] Open
Abstract
Background The effects of visceral adiposity on decreased lung function have drawn much attention. Recently, the visceral adiposity index (VAI) has been proposed as a visceral fat distribution and dysfunction marker. However, the relationship between the VAI and lung function has not been investigated. The objective of the study was to analyze the association between the VAI and lung function and evaluate the potential of VAI as a predictor of lung function. Methods We collected data from a population-based study of 1786 subjects aged 40 years or older. All subjects completed a questionnaire and underwent anthropometric measurements and laboratory tests. Linear and logistic regression models were developed to assess the association between the VAI and lung function. Results The VAI was inversely related to FVC%predicted in men and negatively associated with both FVC%predicted and FEV1%predicted in women. In the linear regression analysis, the decrease in FVC%predicted associated with each 10% increase in the VAI was 1.127% in men and 1.943% in women; the decrease in FEV1%predicted associated with each 10%increase in the VAI was 0.663% in men and 1.738% in women. Further regression analysis revealed that the VAI was positively correlated with FVC and FEV1 impairment in women. Conclusions We were the first to show a clear correlation between the VAI and lung function impairment in the Chinese population. The VAI could be a simple and reliable approach in daily practice, and individuals, especially women with a high VAI, should receive additional screening and preventive interventions for respiratory disease.
Collapse
Affiliation(s)
- Sunyue He
- Department of Endocrinology, Xinhua Hospital Chongming Branch, School of Medicine, Shanghai Jiaotong University, 25 Nanmen Road, Shanghai, China
| | - Jie Yang
- Department of Endocrinology, Xinhua Hospital Chongming Branch, School of Medicine, Shanghai Jiaotong University, 25 Nanmen Road, Shanghai, China
| | - Xiaoyong Li
- Department of Endocrinology, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, 1665 Kongjiang Road, Shanghai, 200092, China
| | - Hongxia Gu
- Department of Endocrinology, Xinhua Hospital Chongming Branch, School of Medicine, Shanghai Jiaotong University, 25 Nanmen Road, Shanghai, China
| | - Qing Su
- Department of Endocrinology, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, 1665 Kongjiang Road, Shanghai, 200092, China.
| | - Li Qin
- Department of Endocrinology, Xinhua Hospital Chongming Branch, School of Medicine, Shanghai Jiaotong University, 25 Nanmen Road, Shanghai, China. .,Department of Endocrinology, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, 1665 Kongjiang Road, Shanghai, 200092, China.
| |
Collapse
|
24
|
Schatz M, Sicherer SH, Khan DA, Zeiger RS. The Journal of Allergy and Clinical Immunology: In Practice 2019 Highlights. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2020; 8:912-936. [PMID: 31980411 DOI: 10.1016/j.jaip.2020.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Accepted: 01/03/2020] [Indexed: 10/25/2022]
Abstract
This article provides highlights of the clinically impactful original studies and reviews published in The Journal of Allergy and Clinical Immunology: In Practice in 2019 on the subjects of anaphylaxis, asthma, dermatitis, drug allergy, food allergy, immunodeficiency, immunotherapy, rhinitis/sinusitis, and urticaria/angioedema/mast cell disorders. Within each topic, practical aspects of diagnosis and management are emphasized. Treatments discussed include lifestyle modifications, allergen avoidance therapy, positive and negative effects of pharmacologic therapy, and various forms of immunologic and desensitization management. We designed this review to help readers consolidate and use this extensive and practical knowledge for the benefit of their patients.
Collapse
Affiliation(s)
- Michael Schatz
- Department of Allergy, Kaiser Permanente Southern California, San Diego, Calif.
| | - Scott H Sicherer
- Jaffe Food Allergy Institute, Icahn School of Medicine at Mount Sinai, New York, NY
| | - David A Khan
- Department of Internal Medicine, Division of Allergy & Immunology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Robert S Zeiger
- Department of Allergy, Kaiser Permanente Southern California, San Diego, Calif; Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, Calif
| |
Collapse
|
25
|
Abstract
Asthma affects approximately 300 million people worldwide and approximately 7.5% of adults in the United States. Asthma is characterized by inflammation of the airways, variable airflow obstruction, and bronchial hyperresponsiveness. The diagnosis of asthma is a clinical one with the history and physical examination being significant, but objective measures, such as pulmonary function testing, can be used to aid in the diagnosis. There are multiple associated comorbidities with asthma, including rhinitis, sinusitis, gastroesophageal reflux disease, obstructive sleep apnea, and depression. There is often an allergic component of asthma, and patient education is vital.
Collapse
Affiliation(s)
- Anil Nanda
- Asthma and Allergy Center, 724 West Main Street, Suite 160, Lewisville, TX 75067, USA; Asthma and Allergy Center, 4900 Long Prairie Road, Suite 100, Flower Mound, TX, USA; Division of Allergy and Immunology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
| | - Anita N Wasan
- Allergy and Asthma Center, 6824 Elm Street, Suite 120, McLean, VA 22101, USA
| |
Collapse
|
26
|
Abstract
PURPOSE OF REVIEW Asthma, a common respiratory disease that affects about 10% of the US population, represents a significant public health issue. In the last decade, cumulative evidence has demonstrated sex disparities in asthma, including significant differences in epidemiology, clinical presentation, response to therapies, and health outcomes. Understanding sex-related differences in asthma enables clinicians to provide personalized asthma care and improve asthma outcome. RECENT FINDINGS Recent studies on sex-related differences in asthma inform us on mechanism underlying asthma pathogenesis across all age groups. Sex hormones directly modulate immune pathways crucial in asthma pathogenesis and affect individual's response to environmental triggers and medications, such as leukokotriene inhibitors. Not surprisingly, the use of external sex hormone supplementations appears to modulate asthma risk. Identification of sex-specific asthma risk loci through genome-wide association studies also provides supporting evidence on sex-related differences in asthma. There is an interaction between sex and obesity, an interaction that could place females at higher risk for systemic inflammation and, consequently, asthma. In this article, we review epidemiological and clinical studies on sex-related differences in asthma, with a special focus on the role of sex hormones, including hormonal therapies and the asthma-obesity interaction.
Collapse
Affiliation(s)
- Peng Zhang
- From the Respiratory Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44106, USA
| | - Joe Zein
- From the Respiratory Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44106, USA.
| |
Collapse
|