Chest
Original ResearchAsthmaObesity and Asthma: A Specific Phenotype?
Section snippets
Subjects and Design
We recruited obese and nonobese subjects from Laval Hospital outpatient clinics and advertisements. Participants were eligible if they had documented physician-diagnosed asthma with airway responsiveness to methacholine < 16 mg/mL, were ≥ 18 years old, were obese (body mass index [BMI] ≥ 30 kg/m2) or nonobese (BMI < 25 kg/m2) according to the criteria of the current international classification,1 and were nonsmokers or ex-smokers for > 6 months. We aimed at recruiting patients receiving a
Results
Eighty-eight of the 96 subjects who agreed to take part in the study were eligible. Three obese and three nonobese subjects had a PC20 ≥ 16 mg/mL and thus were excluded. One participant was unable to perform the methacholine challenge, and another failed to attend the second visit. Half of the subjects (n = 44) used monotherapy with short-acting β2-agonists (SABAs), and the other half took SABAs combined with inhaled corticosteroids (ICS). The mean dose of ICS taken by subjects using these
Discussion
We found that obese subjects reported poorer asthma control than nonobese subjects. This was despite a similar perception of asthma symptoms during the methacholine challenge and comparable maintenance treatment of their asthma. It suggests no impairment or increase in acute symptom report following bronchoconstriction. To our knowledge, this is the first study comparing self-perception of asthma symptoms between obese and nonobese subjects. Airway hyperresponsiveness was comparable in both
Acknowledgment
The authors thank Line Ringuette, Philippe Prince, Marie-Eve Boulay, and nurses from the research center for their invaluable help, and the Laval University statistics department as well as Serge Simard for statistical analysis.
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Potential financial conflicts of interest: advisory boards: Dr. Boulet (Altana, AstraZeneca, GlaxoSmithKline, Merck Frosst, Novartis); lecture fees: Dr. Boulet (3M, Altana, AstraZeneca, GlaxoSmithKline, Merck Frosst, Novartis); sponsorhip for investigator-generated research: Dr. Boulet (AstraZeneca, GSK, Merck Frosst, Schering); research funding for participating in multicenter studies: Dr. Boulet (3M, Altana, AsthmaTx, AstraZeneca, Boehringer-Ingelheim, Dynavax, Genentech, GlaxoSmithKline, IVAX, Merck Frosst, MedImmune, Novartis, Roche, Schering, Topigen, Wyeth); support for the production of educational materials: Dr. Boulet (AstraZeneca, GlaxoSmithKline, Merck Frosst); governmental: Dr. Boulet (Adviser for the Conseil du Médicament du Québec, Member of the Quebec Workmen Compensation Board Respiratory Committee); organizational: Dr. Boulet (Chair of the Canadian Thoracic Society Guidelines Dissemination and Implementation Committee). Dr. Cormier is president and chief medical officer of a biotech company whose objective is to develop a new drug for the treatment of asthma. Dr. Lessard and Dr. Turcotte have no conflicts of interest to declare.
Support was provided by Réseau en Santé Respiratoire du Fonds de Recherche en Santé du Québec.
Reproduction of this article is prohibited without written permission from the American College of Chest Physicians (www.chestjournal.org/misc/reprints.shtml).