Does higher body mass index contribute to worse asthma control in an urban population?
BACKGROUND
Epidemiologic findings support a positive association between asthma and obesity.


OBJECTIVE
Determine whether obesity or increasing level of body mass index (BMI) are associated with worse asthma control in an ethnically diverse urban population.


METHODS
Cross-sectional assessment of asthma control was performed in patients with asthma recruited from primary care offices by using 4 different validated asthma control questionnaires: the Asthma Control and Communication Instrument (ACCI), the Asthma Control Test (ACT), the Asthma Control Questionnaire (ACQ), and the Asthma Therapy Assessment Questionnaire (ATAQ). Multiple linear regression analysis was performed to evaluate the association between obesity and increasing BMI level and asthma control.


RESULTS
Of 292 subjects with a mean age of 47 years, the majority were women (82%) and African American (67%). There was a high prevalence of obesity with 63%, with only 15% normal weight. The mean score from all 4 questionnaires showed an average suboptimal asthma control (mean score/maximum possible score): ACCI (8.3/19), ACT (15.4/25), ACQ (2.1/6), and ATAQ (1.3/4). Regression analysis showed no association between obesity or increasing BMI level and asthma control using all 4 questionnaires. This finding persisted even after adjusting for FEV(1), smoking status, race, sex, selected comorbid illnesses, and long-term asthma controller use.


CONCLUSIONS
Using 4 validated asthma control questionnaires, we failed to find an association between obesity and asthma control in an urban population with asthma. Weight loss may not be an appropriate strategy to improve asthma control in this population.
Clerisme-Beaty
Emmanuelle M
EM
Department of Medicine, Johns Hopkins University, Baltimore, MD, USA.
Karam
Sabine
S
Rand
Cynthia
C
Patino
Cecilia M
CM
Bilderback
Andrew
A
Riekert
Kristin A
KA
Okelo
Sande O
SO
Diette
Gregory B
GB
D000368:Aged; D018927:Anti-Asthmatic Agents / Q000627:therapeutic use*; D001249:Asthma / Q000188:drug therapy* / Q000453:epidemiology / Q000503:physiopathology*; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D055553:Prescription Drugs; D013147:Spirometry; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology; D014505:Urban Population
D018927:Anti-Asthmatic Agents; D055553:Prescription Drugs