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Imayama I, Eccles JD, Ascoli C, Kudlaty E, Park GY. Body Weight and Allergic Asthma: A Narrative Review. J Clin Med 2024; 13:4801. [PMID: 39200943 PMCID: PMC11355285 DOI: 10.3390/jcm13164801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2024] [Revised: 08/04/2024] [Accepted: 08/12/2024] [Indexed: 09/02/2024] Open
Abstract
Obesity is a known risk factor for asthma development, progression, and exacerbation. Nevertheless, the underlying pathophysiological mechanisms explaining how obesity contributes to the development and progression of asthma have yet to be established. Here, we review human studies examining the associations between asthma and obesity, focusing on the literature from the past 10 years. Overall, current evidence suggests that while both asthma and obesity are complex diseases with significant heterogeneity, they both share various features of chronic inflammation. Furthermore, the interactions between asthma and obesity likely involve allergen-specific T helper type 2 (type 2) immune responses, as well as diverse non-type 2 inflammatory pathways. However, despite considerable progress, studies to date have not definitively elucidated the mechanisms that account for the observed association. A large-scale population-based study combined with translational immunological research, including targeted asthma therapies and pharmacological weight loss therapies, may be required to properly dissect the details of obesity-related asthma pathophysiology.
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Affiliation(s)
- Ikuyo Imayama
- Division of Pulmonary, Critical Care, Sleep and Allergy, University of Illinois Chicago, Chicago, IL 60612, USA; (J.D.E.); (C.A.); (E.K.); (G.Y.P.)
- StatCare, Knoxville, TN 37919, USA
| | - Jacob D. Eccles
- Division of Pulmonary, Critical Care, Sleep and Allergy, University of Illinois Chicago, Chicago, IL 60612, USA; (J.D.E.); (C.A.); (E.K.); (G.Y.P.)
| | - Christian Ascoli
- Division of Pulmonary, Critical Care, Sleep and Allergy, University of Illinois Chicago, Chicago, IL 60612, USA; (J.D.E.); (C.A.); (E.K.); (G.Y.P.)
| | - Elizabeth Kudlaty
- Division of Pulmonary, Critical Care, Sleep and Allergy, University of Illinois Chicago, Chicago, IL 60612, USA; (J.D.E.); (C.A.); (E.K.); (G.Y.P.)
| | - Gye Young Park
- Division of Pulmonary, Critical Care, Sleep and Allergy, University of Illinois Chicago, Chicago, IL 60612, USA; (J.D.E.); (C.A.); (E.K.); (G.Y.P.)
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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.
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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
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Vigna L, Tirelli AS, Grossi E, Turolo S, Tomaino L. Metal Body Burden as Cardiovascular Risk Factor in Adults with Metabolic Syndrome and Overweight-Obesity Analysed with an Artificial Neural Network: The Role of Hair Mineralograms. Metabolites 2023; 13:679. [PMID: 37367837 DOI: 10.3390/metabo13060679] [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: 03/12/2023] [Revised: 05/18/2023] [Accepted: 05/19/2023] [Indexed: 06/28/2023] Open
Abstract
In determining the so-called "body burden", hair has been widely accepted for assessing toxic element exposure. However, its role in assessing essential elements is controversial. This study investigates the possible relationship between hair minerals, metabolic syndrome (MetS) and cardiovascular (CV) risk in non-occupationally exposed subjects with overweight-obesity. Ninety-five voluntary participants (aged 51 ± 12) were recruited in Northern Italy. Hair samples were collected and analysed via inductively coupled plasma mass spectrometry; the total toxicity index (TI) was calculated as well. To evaluate cardiovascular risk factors in the presence or absence of MetS, the following factors were considered via the innovative artificial neural network (ANN) method Auto-CM: hair mineralograms (31 elements) and 25 variables including blood pressure, anthropometric parameters, insulin resistance and biochemical serum markers assessing inflammation. The Framingham risk score, fatty liver index (FLI), visceral adiposity index and CV risk scores were also taken into consideration. As shown by the semantic map, which was subsequently confirmed by an activation and competition system (ACS), obesity parameters are strictly associated with CV risk factors, TI and inflammation; meanwhile, the single mineral elements seem to be unimportant. Data obtained via ANN demonstrate that MetS may be at least partly mediated by altered mineral levels also in the presence of obesity and that waist circumference is a crucial point to be monitored rather than BMI alone. Furthermore, the mineral body burden is one of the important factors for CV risk.
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Affiliation(s)
- Luisella Vigna
- Occupational Health Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Amedea Silvia Tirelli
- Occupational Health Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Enzo Grossi
- Villa Santa Maria Foundation, 22038 Tavernerio, Italy
| | - Stefano Turolo
- Pediatric Nephrology and Dialysis, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
| | - Laura Tomaino
- Emergency Medicine Residency Program, Università Politecnica delle Marche, 60126 Ancona, Italy
- Department of Clinical and Molecular Sciences, Università Politecnica delle Marche, 60020 Ancona, Italy
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Shanmugasundaram K, Bade G, Sampath M, Talwar A. Effect of Obesity on Airway Mechanics. Indian J Endocrinol Metab 2023; 27:161-166. [PMID: 37292068 PMCID: PMC10245307 DOI: 10.4103/ijem.ijem_363_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 01/15/2023] [Accepted: 01/27/2023] [Indexed: 06/10/2023] Open
Abstract
Background Obesity is known to induce lung function impairment. Previous studies of decline in lung function associated with obesity are well established. Materials and Methods In this cross-sectional study, to evaluate the effects of different obesity indices on lung mechanics, healthy subjects (males-23 and females-22) were recruited. Anthropometric parameters like body mass index (BMI), waist circumference (WC), hip circumference (HC) and neck circumference (NC) were measured and waist-hip ratio (WHR) was derived. Spirometry, impulse oscillometry (IOS) and fractional exhaled nitric oxide (FeNO) measurements were performed to assess lung function. Subgroups were divided and analysed. Results In males, increased WHR is associated with increased total airway resistance (R5). BMI correlates positively with R5, R5% predicted, resistance at 20 Hz (R20) and R20% predicted; likewise, WHR shows a positive correlation with R5. In females, increased WHR has significantly higher R5, R5% predicted, R20, R20% predicted, area of reactance (Ax), resonant frequency (Fres) and decreased reactance at 5 Hz (X5), reactance at 20 Hz (X20), X20% predicted. The female group with higher WC shows significantly increased R5, R5% predicted, R20, R20% predicted, Ax, Fres and lower fixed ratio of forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC), X5, X20, X20% predicted. The group with higher NC has a lower FEV1/FVC ratio. WHR positively correlated with R5% predicted and Fres while WC correlated positively with R5, R5% predicted, Ax and Fres; same way, NC with X5% predicted. Conclusion Obesity/overweight causes significant changes in lung volumes, capacity and airway mechanics, Higher WC and WHR are associated with significant changes in lung mechanics, which are more prominent in females than in males. NC is not associated with changes in lung mechanics.
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Affiliation(s)
| | - Geetanjali Bade
- Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
| | - Meghashree Sampath
- Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
| | - Anjana Talwar
- Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
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Silva-Reis A, Rodrigues Brandao-Rangel MA, Moraes-Ferreira R, Gonçalves-Alves TG, Souza-Palmeira VH, Aquino-Santos HC, Bachi ALL, de Oliveira LVF, Lopes-Martins RÁB, Oliveira-Silva I, Albertini R, Frison CR, Vieira RP. Combined resistance and aerobic training improves lung function and mechanics and fibrotic biomarkers in overweight and obese women. Front Physiol 2022; 13:946402. [PMID: 36160852 PMCID: PMC9491379 DOI: 10.3389/fphys.2022.946402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Accepted: 08/16/2022] [Indexed: 11/13/2022] Open
Abstract
Background: Obesity impairs lung function and mechanics and leads to low-grade inflammation, but the effects of combined physical exercise (CPE) on that are unknown. Methods: We investigated the effects of 12 weeks of combined physical exercise (aerobic + resistance training), in non-obese (n = 12), overweight (n = 17), and obese grade I (n = 11) women. Lung function and lung mechanics were evaluated. The systemic immune response was evaluated by whole blood analysis and biomarker measurements, while pulmonary fibrotic biomarkers were evaluated in the breath condensate. Result: CPE improved forced vital capacity (FVC) % (p < 0.001) and peak expiratory flow (PEF) % (p < 0.0003) in the obese group; resistance of the respiratory system (R5Hz) in non-obese (p < 0.0099), overweight (p < 0.0005), and obese (p < 0.0001) groups; resistance of proximal airways (R20Hz) in non-obese (p < 0.01), overweight (p < 0.0009), and obese (p < 0.0001) groups; resistance of distal airways (R5Hz–R20Hz) in non-obese (p < 0.01), overweight (p < 0.0012), and obese (p < 0.0001) groups; reactance of the respiratory system (X5Hz) in non-obese (p < 0.01), overweight (p < 0.0006), and obese (p < 0.0005) groups; impedance of the respiratory system (Z5Hz) in non-obese (p < 0.0099), overweight (p < 0.0005), and obese (p < 0.0001) groups; central resistance (RCentral) in non-obese (p < 0.01), overweight (p < 0.001), and obese (p < 0.0003) groups; and the peripheral resistance (RPeripheral) in non-obese (p < 0.03), overweight (p < 0.001), and obese (p < 0.0002) groups. CPE reduced the pro-fibrotic IGF-1 levels in BC in overweight (p < 0.0094) and obese groups (p < 0.0001) and increased anti-fibrotic Klotho levels in BC in obese (p < 0.0001) groups, and reduced levels of exhaled nitric oxide in overweight (p < 0.03) and obese (p < 0.0001) groups. Conclusion: CPE improves lung function, mechanics, and pulmonary immune response in overweight and obese grade I women by increasing anti-fibrotic protein Klotho and reducing pro-fibrotic IGF-1.
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Affiliation(s)
- Anamei Silva-Reis
- Post-graduation Program in Sciences of Human Movement and Rehabilitation, Federal University of Sao Paulo, São Paulo, Brazil
| | | | - Renilson Moraes-Ferreira
- Post-graduation Program in Sciences of Human Movement and Rehabilitation, Federal University of Sao Paulo, São Paulo, Brazil
| | - Thiago Gibson Gonçalves-Alves
- Post-graduation Program in Sciences of Human Movement and Rehabilitation, Federal University of Sao Paulo, São Paulo, Brazil
| | - Victor Hugo Souza-Palmeira
- Post-graduation Program in Sciences of Human Movement and Rehabilitation, Federal University of Sao Paulo, São Paulo, Brazil
| | - Helida Cristina Aquino-Santos
- Post-graduation Program in Sciences of Human Movement and Rehabilitation, Federal University of Sao Paulo, São Paulo, Brazil
| | | | | | | | - Iranse Oliveira-Silva
- Post-graduation Program in Human Movement and Rehabilitation, Centro Universitário UniEvangélica, Anápolis, Brazil
| | - Regiane Albertini
- Post-graduation Program in Sciences of Human Movement and Rehabilitation, Federal University of Sao Paulo, São Paulo, Brazil
| | - Claudio Ricardo Frison
- Post-graduation Program in Sciences of Human Movement and Rehabilitation, Federal University of Sao Paulo, São Paulo, Brazil
| | - Rodolfo P Vieira
- Post-graduation Program in Sciences of Human Movement and Rehabilitation, Federal University of Sao Paulo, São Paulo, Brazil
- Post-graduation Program in Human Movement and Rehabilitation, Centro Universitário UniEvangélica, Anápolis, Brazil
- *Correspondence: Rodolfo P Vieira,
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Knox-Brown B, Mulhern O, Feary J, Amaral AFS. Spirometry parameters used to define small airways obstruction in population-based studies: systematic review. Respir Res 2022; 23:67. [PMID: 35313875 PMCID: PMC8939095 DOI: 10.1186/s12931-022-01990-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 03/14/2022] [Indexed: 12/26/2022] Open
Abstract
Background The assessment of small airways obstruction (SAO) using spirometry is practiced in population-based studies. However, it is not clear what are the most used parameters and cut-offs to define abnormal results.
Methods We searched three databases (Medline, Web of Science, Google Scholar) for population-based studies, published by 1 May 2021, that used spirometry parameters to identify SAO and/or provided criteria for defining SAO. We systematically reviewed these studies and summarised evidence to determine the most widely used spirometry parameter and criteria for defining SAO. In addition, we extracted prevalence estimates and identified associated risk factors. To estimate a pooled prevalence of SAO, we conducted a meta-analysis and explored heterogeneity across studies using meta regression. Results Twenty-five studies used spirometry to identify SAO. The most widely utilised parameter (15 studies) was FEF25–75, either alone or in combination with other measurements. Ten studies provided criteria for the definition of SAO, of which percent predicted cut-offs were the most common (5 studies). However, there was no agreement on which cut-off value to use. Prevalence of SAO ranged from 7.5% to 45.9%. As a result of high heterogeneity across studies (I2 = 99.3%), explained by choice of spirometry parameter and WHO region, we do not present a pooled prevalence estimate. Conclusion There is a lack of consensus regarding the best spirometry parameter or defining criteria for identification of SAO. The value of continuing to measure SAO using spirometry is unclear without further research using large longitudinal data. PROSPERO registration number CRD42021250206 Supplementary Information The online version contains supplementary material available at 10.1186/s12931-022-01990-2.
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Affiliation(s)
- Ben Knox-Brown
- National Heart and Lung Institute, Imperial College London, 1B Manresa Road, London, SW3 6LR, UK.
| | - Octavia Mulhern
- National Heart and Lung Institute, Imperial College London, 1B Manresa Road, London, SW3 6LR, UK
| | - Johanna Feary
- National Heart and Lung Institute, Imperial College London, 1B Manresa Road, London, SW3 6LR, UK
| | - Andre F S Amaral
- National Heart and Lung Institute, Imperial College London, 1B Manresa Road, London, SW3 6LR, UK
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Salem AM. Th1/Th2 cytokines profile in overweight/obese young adults and their correlation with airways inflammation. J Taibah Univ Med Sci 2021; 17:38-44. [PMID: 35140563 PMCID: PMC8801473 DOI: 10.1016/j.jtumed.2021.09.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 08/21/2021] [Accepted: 09/07/2021] [Indexed: 11/01/2022] Open
Abstract
Objectives Methods Results Conclusion
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Molani Gol R, Rafraf M. Association between abdominal obesity and pulmonary function in apparently healthy adults: A systematic review. Obes Res Clin Pract 2021; 15:415-424. [PMID: 34261619 DOI: 10.1016/j.orcp.2021.06.011] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Revised: 06/06/2021] [Accepted: 06/27/2021] [Indexed: 01/10/2023]
Abstract
BACKGROUND Obesity, especially abdominal obesity as a chronic disorder is associated with a high risk of developing non-communicable diseases such as respiratory diseases. Impaired lung function is a sign of early respiratory injury. This review summarizes the current knowledge of the effects of abdominal obesity on pulmonary function in apparently healthy adults. METHODS Google Scholar, PubMed, Science Direct, and Scopus databases were searched from 2014 up to August 2020 using relevant keywords. All original articles written in English evaluating the effects of abdominal obesity on pulmonary function in apparently healthy adults were eligible for this review. RESULTS A total of 26 studies (23 cross-sectional and three cohort) involving 68,024 participants were included in this review. More than 88% of the included studies reported that abdominal obesity significantly inversely was associated with pulmonary function. CONCLUSION The findings indicate that in subjects with abdominal obesity respiratory function decline possibly due to mechanical compression and obesity-induced airway inflammation. Therefore, nutrition and lifestyle interventions are required for the reduction of abdominal obesity that leads to improving pulmonary function and metabolic disease.
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Affiliation(s)
- Roghayeh Molani Gol
- Student Research Committee, Tabriz university of Medical Sciences, Tabriz, Iran; Nutrition Research Center, Department of Community Nutrition, Faculty of Nutrition and Food Science, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Maryam Rafraf
- Nutrition Research Center, Department of Community Nutrition, Faculty of Nutrition and Food Science, Tabriz University of Medical Sciences, Tabriz, Iran.
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