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Does Obesity Increase Respiratory Tract Infections (RTI) and Respiratory Sequelae in Patients with Asthma
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A2037 - Does Obesity Increase Respiratory Tract Infections (RTI) and Respiratory Sequelae in Patients with Asthma
Author Block: M. Tang1, R. J. Henderson2, J. T. Holbrook2, J. Lang1; 1Duke University, Durham, NC, United States, 2Bloomberg School of Public Health, Johns Hopkins Univ, Baltimore, MD, United States.
RATIONALE: Since respiratory tract infections (RTIs) precede most exacerbations, better understanding of the risk factors of RTIs and RTI-associated exacerbations in patients with asthma is a pressing public health need. Obesity in patients with asthma is associated with exacerbations and higher asthma-associated healthcare utilization. We aimed to study the association of body habitus on the risk of self-reported RTIs and related sequelae among adults and children with asthma.
METHODS: RTIs and RTI-related morbidity from five large asthma trials were analyzed for associations with body habitus, defined as normal weight, overweight and obese based on age-appropriate body mass index (BMI) or BMI-percentile conventions. The primary outcome was percent of visits with an RTI, documented using standardized clinic visit interviews. Secondary asthma outcomes included oral corticosteroids, healthcare contact, and hospitalization (total and RTI-associated for each), and upper respiratory infection (URI) severity (documented using standardized clinic visit interviews as mild =1, moderate=2, or severe=3). We used simple linear regression to analyze the effect of body habitus on the primary and secondary outcomes with SAS version 9.4 (SAS Institute Inc., Cary, NC, USA).
RESULTS: Body habitus did not affect the percent of visits with respiratory tract infections in children or adults (p=0.5478 and p=0.0819 respectively). In children, body habitus also did not affect the percent of visits with total or RTI-associated exacerbations, healthcare contact, or hospitalization. However, in adults, body habitus affected the percent of visits with exacerbations; the mean percent of visits with oral corticosteroid use was 1.1 (sd=5.1) in the normal weight group, 1.7 (sd=7.2) in the overweight group, and 2.4 (sd=7.6) in the obese group (p=0.007). Among adults reporting a RTI, greater body habitus was associated with significantly more exacerbations; the mean percent of visits with RTI-associated exacerbation was 2.0 (sd=9.5) in the normal weight group, 3.1 (sd=12.6) in the overweight group, and 5.1 (sd=15.3) in the obese group (p=0.002). Among adults reporting a URI, greater body habitus was associated with worse URI severity; mean URI severity was 1.46 (sd=0.58) in the normal weight group, 1.46 (sd=0.58) in the overweight group, and 1.67 (sd=0.67) in the obese groups (p=0.009).
CONCLUSIONS: Obesity in asthma does not increase the risk of acquiring RTIs. In adults, but not children, obesity increases the severity of URIs and leads to more RTI-associated asthma exacerbations.
Author Block: M. Tang1, R. J. Henderson2, J. T. Holbrook2, J. Lang1; 1Duke University, Durham, NC, United States, 2Bloomberg School of Public Health, Johns Hopkins Univ, Baltimore, MD, United States.
RATIONALE: Since respiratory tract infections (RTIs) precede most exacerbations, better understanding of the risk factors of RTIs and RTI-associated exacerbations in patients with asthma is a pressing public health need. Obesity in patients with asthma is associated with exacerbations and higher asthma-associated healthcare utilization. We aimed to study the association of body habitus on the risk of self-reported RTIs and related sequelae among adults and children with asthma.
METHODS: RTIs and RTI-related morbidity from five large asthma trials were analyzed for associations with body habitus, defined as normal weight, overweight and obese based on age-appropriate body mass index (BMI) or BMI-percentile conventions. The primary outcome was percent of visits with an RTI, documented using standardized clinic visit interviews. Secondary asthma outcomes included oral corticosteroids, healthcare contact, and hospitalization (total and RTI-associated for each), and upper respiratory infection (URI) severity (documented using standardized clinic visit interviews as mild =1, moderate=2, or severe=3). We used simple linear regression to analyze the effect of body habitus on the primary and secondary outcomes with SAS version 9.4 (SAS Institute Inc., Cary, NC, USA).
RESULTS: Body habitus did not affect the percent of visits with respiratory tract infections in children or adults (p=0.5478 and p=0.0819 respectively). In children, body habitus also did not affect the percent of visits with total or RTI-associated exacerbations, healthcare contact, or hospitalization. However, in adults, body habitus affected the percent of visits with exacerbations; the mean percent of visits with oral corticosteroid use was 1.1 (sd=5.1) in the normal weight group, 1.7 (sd=7.2) in the overweight group, and 2.4 (sd=7.6) in the obese group (p=0.007). Among adults reporting a RTI, greater body habitus was associated with significantly more exacerbations; the mean percent of visits with RTI-associated exacerbation was 2.0 (sd=9.5) in the normal weight group, 3.1 (sd=12.6) in the overweight group, and 5.1 (sd=15.3) in the obese group (p=0.002). Among adults reporting a URI, greater body habitus was associated with worse URI severity; mean URI severity was 1.46 (sd=0.58) in the normal weight group, 1.46 (sd=0.58) in the overweight group, and 1.67 (sd=0.67) in the obese groups (p=0.009).
CONCLUSIONS: Obesity in asthma does not increase the risk of acquiring RTIs. In adults, but not children, obesity increases the severity of URIs and leads to more RTI-associated asthma exacerbations.
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