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Muanprasong S, Aqilah S, Hermayurisca F, Taneepanichskul N. Effectiveness of Asthma Home Management Manual and Low-Cost Air Filter on Quality of Life Among Asthma Adults: A 3-Arm Randomized Controlled Trial. J Multidiscip Healthc 2024; 17:2613-2622. [PMID: 38813091 PMCID: PMC11134058 DOI: 10.2147/jmdh.s397388] [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: 02/13/2024] [Accepted: 05/15/2024] [Indexed: 05/31/2024] Open
Abstract
Background Asthma affects the quality of life (QoL) of millions of people worldwide. Effective control is paramount to a decline in prevalence and severity. To address this, we aimed to investigate the effectiveness of an asthma home management manual and low-cost air filter in improving resource-limited settings. Patients and Methods This randomized controlled trial was conducted between March to July 2022. The participants were 18-55 years old outpatient with asthmatic patients. A total of 114 participants were recruited and randomly assigned to three groups: home management only, home management and air filtering, and control. Validated measurement tools were applied, and the Wilcoxon test was used to evaluate changes in QoL. Results Asthma burden was found in at least one-third of participants in each group. At baseline, there was no difference in mAQLQ scores among participants in all group allocations (p-value > 0.05), and the air filter group had an increase in the total mAQLQ score (p-value = 0.044) and post-intervention activity quality of life (p-value = 0.002). The environmental quality of life increased post-intervention (p-value = 0.004) and remained higher after four weeks of follow-up compared to baseline (p-value = 0.041) in the home management group participants. Conclusion The findings indicate that the enforcement of a home management manual and the application of low-cost filters in air circulation systems offer advantages in improving the quality of life of patients with moderate and mild asthma.
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Affiliation(s)
- Sirilak Muanprasong
- College of Public Health Sciences, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Syarifah Aqilah
- College of Public Health Sciences, Chulalongkorn University, Bangkok, 10330, Thailand
| | | | - Nutta Taneepanichskul
- College of Public Health Sciences, Chulalongkorn University, Bangkok, 10330, Thailand
- HAUS IAQ Research Unit, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University King Chulalongkorn Memorial Hospital, Bangkok, Thailand
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Lee HJ, Choi JW. Association between waist circumference change after smoking cessation and incidence of hypertension in Korean adults. Public Health 2024; 229:73-79. [PMID: 38402666 DOI: 10.1016/j.puhe.2024.01.028] [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: 08/09/2023] [Revised: 12/14/2023] [Accepted: 01/26/2024] [Indexed: 02/27/2024]
Abstract
OBJECTIVES This study investigates the association between smoking cessation and hypertension incidence, as well as the association between waist circumference change after smoking cessation and hypertension incidence. STUDY DESIGN This was a nationwide population-based cohort study. METHODS We used the Korean Health Screening Cohort data and included 158,505 participants who had undergone two or more health examinations between 2008 and 2011, with follow-ups throughout 2019. Smoking cessation and waist changes were captured based on difference between first and follow-up screening dates. Hazard ratio (HR) and 95% confidence interval (CI) for hypertension risk were estimated using multivariable Cox proportional hazard regression models. RESULTS There were 31,270 cases of hypertension during a median follow-up of 8.50 years. After adjusting for potential confounding factors, HR for hypertension were 1.01 (95% CI: 0.97-1.05), 0.91 (95% CI: 0.87-0.95), and 0.88 (95% CI: 0.85-0.91) for recent quitters, long-term quitters, and non-smokers, respectively, compared with current smokers. HR for hypertension, compared with current smokers, were 0.89 (95% CI: 0.84-0.94), 0.91 (95% CI: 0.85-0.97), and 0.99 (95% CI: 0.91-1.08) for long-term quitters with no waist gain, long-term quitters with waist gain of 0.1-5.0 cm, and long-term quitters with waist gain of ≥5.0 cm, respectively. CONCLUSIONS Long-term smoking cessation was significantly associated with decreased risk of hypertension, and long-term smoking cessation with no waist gain or less than 5.0 cm of waist gain was significantly associated with decreased risk of hypertension. However, more than 5.0 cm of waist gain can attenuate the effect of long-term smoking cessation on lowering the risk of hypertension.
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Affiliation(s)
- H J Lee
- Department of Statistics and Data Science, Yonsei University, Seoul, Republic of Korea
| | - J W Choi
- Health Insurance Research Institute, National Health Insurance Service, Wonju, Republic of Korea.
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Gonzalez-Uribe V, Navarrete-Rodríguez EM, Angeles-Tellez FS, Montiel-Gonzalez JA, Colin-Rubio J, Gonzalez-Chavarria CF, Mojica-Gonzalez ZS. Asthma exacerbations in the pediatric emergency area: Evaluation and prospects for improvement of pre-hospital care. Allergol Immunopathol (Madr) 2023; 51:37-44. [PMID: 37937494 DOI: 10.15586/aei.v51i6.909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 09/06/2023] [Indexed: 11/09/2023]
Abstract
INTRODUCTION The frequency of visits to emergency department for asthma is a significant public health problem in pediatrics. This study aimed to identify the characteristics of children who visited the pediatric emergency department for asthma exacerbation and evaluated their therapeutic management prior to admission. METHODS A prospective study was conducted over a 6-month period in the pediatric emergency departments of five hospitals involving children aged 1-16 years admitted to the department with a clinical diagnosis of asthma exacerbation. RESULTS In all, 143 patients were enrolled in the study. Asthma episodes were moderate to severe in 69.2% of cases (n = 99). Initial treatment prior to admission to the emergency department was adequate in only 17.5% of cases (n = 25). Hospitalization for more than 24 h occurred in 18.2% (n = 26) patients. In children aged <3 years, viral infection was present in 91.4% cases (n = 64) and exacerbations were more severe in younger patients (P = 0.002) and children belonging to low-income stratum (P = 0.025). Only 17.4% (n = 25) were positive for SARS-CoV-2 (antigen test or polymerase chain reaction test), suggesting that the involvement of traditional respiratory viruses in asthma exacerbation continued even during pandemic. Regarding the pre-hospital care, 70.6% (n = 101) had received prior treatment, but this treatment was inadequate in 53.1% cases (n = 76). CONCLUSION This study showed that asthmatic children and their families had little knowledge about the disease and that physicians must be sufficiently aware of current recommendations for managing asthmatic children. Admission to the emergency department for asthma could be avoided partially by better diagnosis and therapeutic education.
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Affiliation(s)
- Victor Gonzalez-Uribe
- Facultad Mexicana de Medicina, Universidad La Salle Mexico, Mexico City, Mexico
- Servicio de Alergia e Inmunología, Hospital Infantil de México Federico Gomez, Mexico City, Mexico;
| | | | | | | | - Jorge Colin-Rubio
- Facultad Mexicana de Medicina, Universidad La Salle Mexico, Mexico City, Mexico
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Choi J, Park SJ, Park YJ, Hong J, Jeong S, Chang J, Kim SM, Song J, Cho Y, Park SM. Association between antibiotics and asthma risk among adults aged over 40 years: a nationally representative retrospective cohort study. BMJ Open Respir Res 2023; 10:e001643. [PMID: 37914233 PMCID: PMC10649713 DOI: 10.1136/bmjresp-2023-001643] [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: 01/20/2023] [Accepted: 10/06/2023] [Indexed: 11/03/2023] Open
Abstract
INTRODUCTION Several studies have reported that exposure to antibiotics can lead to asthma during early childhood. However, the association between antibiotic use and risk of asthma in the adult population remains unclear. This study aimed to investigate the association between antibiotic use and asthma in adults. METHODS We used data from the National Health Insurance Service (NHIS)-Health Screening Cohort, which included participants aged ≥40 years who had health screening examination data in 2005-2006. A total of 248 961 participants with a mean age of 55.43 years were enrolled in this retrospective cohort study. To evaluate antibiotic exposure from the NHIS database for 5 years (2002-2006), cumulative usage and multiclass prescriptions were identified, respectively. During the follow-up period (2007-2019), 42 452 patients were diagnosed with asthma. A multivariate Cox proportional hazard regression model was used to assess the association between antibiotic use and newly diagnosed asthma. RESULTS Participants with antibiotic use for ≥91 days showed a higher risk of asthma (adjusted HR (aHR) 1.84, 95% CI 1.72 to 1.96) compared with participants who did not use antibiotics (n=38 450), with a duration-dependent association (ptrend<0.001). Furthermore, ≥4 antibiotic class user group had an increased risk of asthma (aHR 1.44, 95% CI 1.39 to 1.49) compared with one class of antibiotic use (n=64 698). Also, one class of antibiotic use had a higher risk of asthma (aHR 1.21, 95% CI 1.17 to 1.26) compared with non-users, and it also showed a duration-dependent relationship in all classes, including 1, 2, 3 and ≥4 class group (ptrend<0.001). The duration-response relationship between antibiotic use and increased risk of asthma remained in our sensitivity analyses with the washout and shifting of the index date. CONCLUSIONS The duration-response pattern observed in antibiotic use and asthma may suggest the implication of proper antibiotic use and management in adults.
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Affiliation(s)
- Jiwon Choi
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, The Republic of Korea
- Department of Public Health Science, Seoul National University, Gwanak-gu, The Republic of Korea
| | - Sun Jae Park
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, The Republic of Korea
| | - Young Jun Park
- Medical Research Center, Genomic Medicine Institute, Seoul National University, Seoul, The Republic of Korea
| | - Jaeyi Hong
- Department of Statistics, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA
| | - Seogsong Jeong
- Department of Biomedical Informatics, CHA University School of Medicine, Seongnam, The Republic of Korea
| | - Jooyoung Chang
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, The Republic of Korea
| | - Sung Min Kim
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, The Republic of Korea
| | - Jihun Song
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, The Republic of Korea
| | - Yoosun Cho
- Total Healthcare Center, Kangbuk Samsung Hospital,Sungkyunkwan University School of Medicine, Seoul, The Republic of Korea
| | - Sang Min Park
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, The Republic of Korea
- Department of Family Medicine, Seoul National University Hospital, Jongno-gu, The Republic of Korea
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Parasuaraman G, Ayyasamy L, Aune D, Sen A, Nagarajan R, Rajkumar P, Velusamy S, Manickam P, Sivaprakasam S. The association between body mass index, abdominal fatness, and weight change and the risk of adult asthma: a systematic review and meta-analysis of cohort studies. Sci Rep 2023; 13:7745. [PMID: 37173338 PMCID: PMC10182066 DOI: 10.1038/s41598-023-31373-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 03/10/2023] [Indexed: 05/15/2023] Open
Abstract
Obesity has been associated with increased risk of adult asthma, however, not all studies have found a clear association between overweight and the incidence of asthma, and data on other adiposity measures have been limited. Hence, we aimed to summarize evidence on association between adiposity and adult asthma. Relevant studies were retrieved through searches conducted in PubMed, and EMBASE up to March 2021. A total of sixteen studies (63,952 cases and 1,161,169 participants) were included in the quantitative synthesis. The summary RR was 1.32 (95% CI 1.21-1.44, I2 = 94.6%, pheterogeneity < 0.0001, n = 13) per 5 kg/m2 increase in BMI, 1.26 (95% CI 1.09-1.46, I2 = 88.6%, pheterogeneity < 0.0001, n = 5) per 10 cm increase in waist circumference and 1.33 (95% CI 1.22-1.44, I2 = 62.3%, pheterogeneity= 0.05, n = 4) per 10 kg increase in weight gain. Although the test for nonlinearity was significant for BMI (pnonlinearity < 0.00001), weight change (pnonlinearity = 0.002), and waist circumference (pnonlinearity = 0.02), there was a clear dose-response relationship between higher levels of adiposity and asthma risk. The magnitude of the associations and the consistency of the results across studies and adiposity measures provide strong evidence that overweight and obesity, waist circumference and weight gain increases asthma risk. These findings support policies to curb the global epidemic of overweight and obesity.
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Affiliation(s)
| | - Lavanya Ayyasamy
- Indian Council of Medical Research-National Institute of Epidemiology, Chennai, India
| | - Dagfinn Aune
- Department of Nutrition, Oslo New University College, Oslo, Norway
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
- Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway
| | - Abhijit Sen
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
- Center for Oral Health Services and Research (TkMidt), Trondheim, Norway
| | - Ramya Nagarajan
- Indian Council of Medical Research-National Institute of Epidemiology, Chennai, India
| | - Prabhu Rajkumar
- Indian Council of Medical Research-National Institute of Epidemiology, Chennai, India
| | | | - P Manickam
- Indian Council of Medical Research-National Institute of Epidemiology, Chennai, India
| | - Satish Sivaprakasam
- Indian Council of Medical Research-National Institute of Epidemiology, Chennai, India
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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.
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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
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Yu L, Chen Y, Xu M, Li R, Zhang J, Zhu S, He Z, Chen M, Wang G. Association of weight-adjusted-waist index with asthma prevalence and the age of first asthma onset in United States adults. Front Endocrinol (Lausanne) 2023; 14:1116621. [PMID: 36896186 PMCID: PMC9988541 DOI: 10.3389/fendo.2023.1116621] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 02/09/2023] [Indexed: 02/22/2023] Open
Abstract
Objective The objective of this study was to assess whether the weight-adjusted-waist index(WWI) is associated with the prevalence of asthma and age when first asthma onset appears in US adults. Methods For analysis we selected participants from the National Health and Nutrition Examination Survey(NHANES)database between 2001 and 2018. A dose-response curve was calculated using logistic regression,subgroup analysis,and a dose-response curve. Results The study included 44480 people over the age of 20,including 6061 reported with asthma, and the increase in asthma prevalence was 15% associated with each unit increase in the WWI, after adjusting for all confounders(odds ratio(OR)=1.15,95% CI:1.11,1.20). The sensitivity analysis was performed by trichotomizing the WWI, and compared to the lowest tertile, the highest tertile WWI group displayed a 29% increase in asthma prevalence(OR=1.29,95% CI:1.19,1.40). A nonlinear correlation was found between the WWI index and the risk of asthma onset, with a threshold saturation effect indicating an inflection point of 10.53 (log-likelihood ratio test, P<0.05), as well as a positive linear correlation with age at first asthma onset. Conclusions A higher WWI index was associated with an increased prevalence of asthma and an older age of first asthma onset.
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Affiliation(s)
- Longshan Yu
- Department of Emergency Medicine: The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
| | - Yan Chen
- Department of General Practice, Wuhu City Second People`s Hospital, Wuhu, Anhu, China
| | - Ming Xu
- Department of Emergency Medicine: The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
| | - Rongfu Li
- Department of Emergency Medicine: The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
| | - Juan Zhang
- Department of Emergency Medicine: The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
| | - Shouwei Zhu
- Department of Emergency Medicine: The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
| | - Zongbao He
- Department of Emergency Medicine: The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
| | - Mingwei Chen
- Department of Endocrinology, the First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China
| | - Gaosheng Wang
- Department of Emergency Medicine: The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
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Jacob L, Smith L, Koyanagi A, Konrad M, Haro JM, Shin JI, Kostev K. Sex-Differential Associations Between Body Mass Index and the Incidence of Dementia. J Alzheimers Dis 2022; 88:631-639. [PMID: 35662122 DOI: 10.3233/jad-220147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Little is known about the sex differences in the association between body mass index (BMI) and dementia in late life. OBJECTIVE Therefore, this retrospective cohort study aimed to analyze associations between BMI and dementia in older women and men separately in general practices in Germany. METHODS This study included patients followed in one of 832 general practices in Germany between 2006 and 2019 (index date: first visit date). Study variables included dementia (dependent variable), BMI (independent variable), age, sex, and comorbidities (control variables). Kaplan-Meier curves and adjusted Cox regression analyses were conducted to analyze associations between BMI and the 10-year incidence of dementia in women and men, separately. RESULTS There were 296,767 patients included in this study (mean [standard deviation] age 70.2 [5.9] years; 54.3% women). The proportion of underweight, normal weight, overweight, and obesity was 0.9%, 25.5%, 41.5%, and 32.1%, respectively. The 10-year incidence of dementia significantly decreased with increasing BMI, from 11.5% in women with underweight to 9.1% in those with obesity (log-rank p < 0.001). Respective figures in men were 12.0% and 8.2% (log-rank p < 0.001). In women, only overweight (versus normal weight) was significantly associated with dementia (HR = 0.93, 95% CI = 0.88-0.97). In contrast, in men, the only BMI category significantly associated with the incidence of dementia was underweight (HR = 1.58, 95% CI = 1.11-2.25). CONCLUSION In this study conducted in Germany, overweight was negatively associated with dementia in women, whereas there was a positive underweight-dementia relationship in men. More data are needed to confirm or refute these findings in other settings.
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Affiliation(s)
- Louis Jacob
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Dr. Antoni Pujadas, Sant Boi de Llobregat, Barcelona, Spain.,Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux, France
| | - Lee Smith
- Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Dr. Antoni Pujadas, Sant Boi de Llobregat, Barcelona, Spain.,Institució Catalana de Recerca i Estudis Avançats (ICREA), Pg. Lluis Companys, Barcelona, Spain
| | - Marcel Konrad
- Health & Social, FOM University of Applied Sciences for Economics and Management, Frankfurt am Main, Germany
| | - Josep Maria Haro
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Dr. Antoni Pujadas, Sant Boi de Llobregat, Barcelona, Spain
| | - Jae Il Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Republic of Korea
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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.
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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.
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Zhang Y, Huang L. Characteristics of older adult hospitalized patients with bronchial asthma: a retrospective study. Allergy Asthma Clin Immunol 2021; 17:122. [PMID: 34861886 PMCID: PMC8641253 DOI: 10.1186/s13223-021-00628-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Accepted: 11/18/2021] [Indexed: 11/10/2022] Open
Abstract
Background Bronchial asthma is a chronic inflammation of the airways. Older adult patients with bronchial asthma are defined as patients older than 65 and with a previous or current clear diagnosis of asthma. The purpose of this study was to determine the characteristics of older adult hospitalized patients with bronchial asthma. Methods We retrospectively analyzed the data from patients with bronchial asthma admitted to the General Hospital of the Northern Theater Command from September 2018 to January 2020. We divided them into the older adult (≥ 65 years) and the younger (< 65 years) groups. We compared the clinical and epidemiological characteristics of the two groups. Results There were 181 inpatients with bronchial asthma, including 41 older adult patients, accounting for 22.7%. There were significant differences in age, sex, smoking, duration of disease, age at diagnosis of asthma, hospital stays, hospitalization costs, number of acute attacks 1 year before admission, number of hospitalizations in our hospital one year before admission, asthma control test score, forced expiratory volume in 1 s (FEV1), FEV1/FVC, the severity of acute attacks, comorbidities, and inhaled corticosteroid dose between the two groups. There were many older adult patients with asthma (mostly late-onset asthma). The hospitalization costs were high. Most patients had many comorbidities, poor asthma control, severe attack, and heavy economic burdens. Conclusion Attention should be focused on achieving asthma control in older adult patients to improve their quality of life and reduce their economic burdens.
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Lajunen TK, Jaakkola JJK, Jaakkola MS. Different effects of smoking on atopic and non-atopic adult-onset asthma. Clin Transl Allergy 2021; 11:e12072. [PMID: 34667592 PMCID: PMC8504202 DOI: 10.1002/clt2.12072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 08/27/2021] [Accepted: 09/28/2021] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Both tobacco smoking and atopy increase the risk of adult-onset asthma. We studied if there are differences in the effects of smoking on the risks of atopic and non-atopic adult-onset asthma, and if gender modifies these effects. METHODS The Finnish Environment and Asthma Study (FEAS) includes 521 incident cases of adult-onset asthma and 932 population-based controls, aged 21 to 63 years, recruited from a geographically defined area of Pirkanmaa, South Finland. Asthma was defined based on symptoms and lung function measurements, atopy by IgE antibodies to common aeroallergens and smoking by the study questionnaire. RESULTS Altogether 212 cases were atopic, and 251 cases were non-atopic. Regular smoking increased the risk of atopic asthma (adjusted OR 1.24, 95% CI 0.83-1.85), this effect was seen in women (aOR 1.77, 1.06-2.95) but not in men (aOR 0.75, 0.39-1.45). Among regular smokers, the amount smoked was lowest among women with atopic asthma. Recent quitting of smoking was related to increased risk of both atopic (aOR 4.91, 2.26-10.65) and non-atopic (aOR 4.37, 1.87-10.21) asthma. Having quitted smoking over a year ago was related to increased risk of non-atopic asthma (aOR 1.57, 1.08-2.28), mainly in men (aOR 2.03, 1.06-3.88). CONCLUSIONS In women, rather small amounts of regular smoking increase the risk of atopic asthma. However, for non-atopic asthma, the smoking induced risk continues for longer after quitting, especially in men. In conclusion, the effects of smoking on the risks of atopic and non-atopic asthma differ, and gender modifies these effects.
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Affiliation(s)
- Taina K. Lajunen
- Center for Environmental and Respiratory Health ResearchUniversity of OuluOuluFinland
- BiocenterUniversity of OuluOuluFinland
- Medical Research CenterUniversity of OuluOuluFinland
| | - Jouni J. K. Jaakkola
- Center for Environmental and Respiratory Health ResearchUniversity of OuluOuluFinland
- BiocenterUniversity of OuluOuluFinland
- Medical Research CenterUniversity of OuluOuluFinland
- Finnish Meteorological InstituteHelsinkiFinland
| | - Maritta S. Jaakkola
- Center for Environmental and Respiratory Health ResearchUniversity of OuluOuluFinland
- BiocenterUniversity of OuluOuluFinland
- Medical Research CenterUniversity of OuluOuluFinland
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Ayuningrum DP, Fajariyah RN, Novirsa R, Astutik E. Relationship between Body Mass Index and Gender with Asthma. JURNAL BERKALA EPIDEMIOLOGI 2021. [DOI: 10.20473/jbe.v9i22021.115-122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background: Asthma is ranked 16th among the leading causes of years lived with disability (YLD) and ranks 28th among the causes of global burden of disease (GBD). Various potential factors can cause asthma, which include body mass index (BMI) and gender. Purpose: This research aimed to determine the relationship between BMI and gender in people living with asthma in Indonesia. Methods: This research employed secondary data obtained from the Indonesian family life support (IFLS) 5th edition. This research used an observational analysis technique with a cross-sectional approach. The number of respondents in this research were 30,713. In this study, the BMI category was based on WHO’s classification for Asians. Data was analyzed using logistic regression tests and chi square. Statistical significance was set at a value of p<0.05. Results: As many as 17,175 respondents had a normal BMI range (56.92%), out of which the majority were women—16,001 respondents (52.10%). After controlling the other variables, statistical test results with logistic regression indicated that male respondents had 1.23 times the odds of experiencing asthma compared to females (adjusted odds ratio (AOR)=1.23; 95% confidence interval (CI), 1.04–1.44; p=0.02). Again, after controlling the other variables, underweight respondents had 1.31 times the odds of experiencing asthma compared to respondents who had a normal BMI (AOR=1.31; 95%CI=1.07–1.59; p=0.01). Conclusion: A relationship between gender and the category of people who were underweight after determining their BMI could be established. Health counseling can be provided to help improve the respiratory conditions of these individuals.
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Wang T, Zhou Y, Kong N, Zhang J, Cheng G, Zheng Y. Weight gain from early to middle adulthood increases the risk of incident asthma later in life in the United States: a retrospective cohort study. Respir Res 2021; 22:139. [PMID: 33952267 PMCID: PMC8097961 DOI: 10.1186/s12931-021-01735-7] [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: 12/09/2020] [Accepted: 04/26/2021] [Indexed: 11/29/2022] Open
Abstract
Background Data describing the effects of weight change across adulthood on asthma are important for the prevention of asthma. This study aimed to investigate the association between weight change from early to middle adulthood and risk of incident asthma. Methods Using data from the National Health and Nutrition Examination Survey (NHANES), we performed a nationally retrospective cohort study of the U.S. general population. A total of 20,771 people aged 40–74 years with recalled weight at young and middle adulthood were included in the cohort. Four weight change groups were categorized: stable non-obesity, non-obesity to obesity, obesity to non-obesity, and stable obesity. Hazard ratios (HRs) and 95% confidence intervals (CIs) relating weight change to incident asthma over 10 years of follow-up were calculated using Cox models adjusting for covariates. Results Compared with the stable non-obesity group, the HRs of incident asthma were 1.63 (95% CI = 1.29 to 2.07, P < 0.001) for the non-obesity to obesity group, 1.41 (95% CI = 0.97 to 2.05, P = 0.075) for stable obesity group, and 1.21 (95% CI = 0.41 to 3.62, P = 0.730) for the obesity to non-obesity group. In addition, participants who gained more than 20 kg from young to middle adulthood had a HR of 1.53 (95% CI = 1.15 to 2.03, P = 0.004), compared with those whose weight remained stable (weight change within 2.5 kg). Conclusions Weight gain from early to middle adulthood was associated with higher risk of incident asthma as compared to those who maintained normal weight. Thus, maintaining normal weight throughout adulthood might be important for the primary prevention of adult-onset asthma. Supplementary Information The online version contains supplementary material available at 10.1186/s12931-021-01735-7.
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Affiliation(s)
- Tao Wang
- School of Public Health, Qingdao University, 308 Ningxia Road, Qingdao, 266071, Shandong, People's Republic of China
| | - Yunping Zhou
- School of Nursing, Qingdao University, 308 Ningxia Road, Qingdao, 266071, Shandong, People's Republic of China
| | - Nan Kong
- School of Public Health, Qingdao University, 308 Ningxia Road, Qingdao, 266071, Shandong, People's Republic of China
| | - Jianzhong Zhang
- School of Public Health, Qingdao University, 308 Ningxia Road, Qingdao, 266071, Shandong, People's Republic of China
| | - Guo Cheng
- Laboratory of Molecular Translational Medicine, Centre for Translational Medicine, Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China
| | - Yuxin Zheng
- School of Public Health, Qingdao University, 308 Ningxia Road, Qingdao, 266071, Shandong, People's Republic of China.
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