Abstract
Background : With increasing prevalence of overweight and obesity, it is important to study how BMI change may affect lung function among subjects with asthma. There are few prospective studies on this topic, especially with separate analyses of those with normal and high BMI.
Aim : To prospectively study the association between annual BMI change and annual lung function decline, separately among those with normal initial BMI and overweight/obesity, in an adult asthma cohort.
Methods : A population-based adult asthma cohort was examined at study entry between 1986–2001 and at follow-up between 2012–2014 (n=945). Annual BMI change was analysed in association to annual decline in FEV1, FVC and FEV1/FVC separately in those with normal weight (BMI=18.5–24.9) and overweight/obesity (BMI≥25) at study entry. Regression models were used to adjust for sex, age, smoking, ICS use and occupational exposure to gas, dust, or fumes.
Results : Subjects with overweight/obesity had lower FEV1 and FVC but slower annual FEV1 and FVC decline compared to those with normal weight. After adjustment through regression modelling, the association between BMI change with FEV1 and FVC decline remained significant for both BMI groups, but with stronger associations among the overweight/obese (FEV1 B[Overweight/obese]=−25 ml versus B[normal weight]=−15 ml). However, when including only those with BMI increase during follow-up, the associations remained significant among those with overweight/obesity, but not in the normal weight group. No associations were seen for FEV1/FVC.
Conclusions : BMI increase is associated with faster FEV1 and FVC decline among overweight and obese adults with asthma in comparison with their normal weight counterparts.
Footnotes
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Conflict of interest: Hannu Kankaanranta has received consulting fees from AstraZeneca, Chiesi Pharma, GlaxoSmithKline, SanofiGenzyme, MSD and Novartis, outside the submitted work. Personal fees for lectures at educational events outside the submitted work received from AstraZeneca, Boehringer-Ingelheim and Orion Pharma.
Conflict of interest: Caroline Stridsman has received personal fees for lectures at educational events outside the submitted work from AstraZeneca, Boehringer-Ingelheim and Novartis.
Conflict of interest: Anne Lindberg has received personal fees for Advisory Board from AstraZeneca, GlaxoSmithKline, Novartis and Boehringer Ingelhem, outside the submitted work.
Conflict of interest: Eva Rönmark has recueced support for the present manuscript from Swedish Heart and Lung foundation, Swedish asthma and Allergy foundation, Swedish research council, ALF - a regional agreement between Umeå University and Västerbotten County Council, Norrbotten County Council, AstraZeneca, SanofiEnzyme, GlaxoSmithKline and AstraZeneca.
Conflict of interest: Helena Backman has received personal fees for presentation at scientific meetings from AstraZeneca and Boehringer Ingelheim, outside the submitted work.
Conflict of interest: The remaining authors have nothing to disclose.
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- Received February 26, 2022.
- Accepted July 21, 2022.
- Copyright ©The authors 2022
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