title: Obesity and asthma morbidity in a community-based adult cohort in a large urban area: the Chicago Initiative to Raise Asthma Health Equity (CHIRAH).
abstract: BACKGROUND
  Urban minority populations experience increased rates of obesity and increased asthma prevalence and severity. Objective. The authors sought to determine whether obesity, as measured by body mass index (BMI), was associated with asthma quality of life or asthma-related emergency department (ED)/urgent care utilization in an urban, community-based sample of adults.
  
  
  METHODS
  This is a cross-sectional analysis of 352 adult subjects (age 30.9 +/- 6.1, 77.8% females, forced expiratory volume in one second (FEV(1))% predicted = 87.0% +/- 18.5%) with physician-diagnosed asthma from a community-based Chicago cohort. Outcome variables included the Juniper Asthma Quality of Life Questionnaire (AQLQ) scores and health care utilization in the previous 12 months. Bivariate tests were used as appropriate to assess the relationship between BMI or obesity status and asthma outcome variables. Multivariate regression analyses were performed to predict asthma outcomes, controlling for demographics, income, depression score, and beta-agonist use.
  
  
  RESULTS
  One hundred ninety-one (54.3%) adults were obese (BMI > 30 kg/m(2)). Participants with a higher BMI were older (p = .008), African American (p < .001), female (p = .002), or from lower income households (p = .002). BMI was inversely related to overall AQLQ scores (r = -.174, p = .001) as well as to individual domains. In multivariate models, BMI remained an independent predictor of AQLQ. Obese participants were more likely to have received ED/urgent care for asthma than nonobese subjects (odds ratio [OR] = 1.8, p = .036).
  
  
  CONCLUSIONS
  In a community-based sample of urban asthmatic adults, obesity was related to worse asthma-specific quality of life and increased ED/urgent care utilization. However, compared to other variables measured such as depression, the contribution of obesity to lower AQLQ scores was relatively modest.
authors.affiliation: Division of Allergy-Immunology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA. l-grammer@northwestern.edu
authors.forename: Leslie C
authors.initials: LC
authors.lastname: Grammer
authors.forename: Kevin B
authors.initials: KB
authors.lastname: Weiss
authors.forename: Jennifer B
authors.initials: JB
authors.lastname: Pedicano
authors.forename: Linda G
authors.initials: LG
authors.lastname: Kimmel
authors.forename: Laura S
authors.initials: LS
authors.lastname: Curtis
authors.forename: Catherine D
authors.initials: CD
authors.lastname: Catrambone
authors.forename: Christopher S
authors.initials: CS
authors.lastname: Lyttle
authors.forename: Lisa K
authors.initials: LK
authors.lastname: Sharp
authors.forename: Laura S
authors.initials: LS
authors.lastname: Sadowski
mesh_terms: D000328:Adult; D017677:Age Distribution; D001249:Asthma / Q000175:diagnosis / Q000453:epidemiology*; D015992:Body Mass Index; D015897:Comorbidity; D003430:Cross-Sectional Studies; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006306:Health Surveys; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D008297:Male; D015999:Multivariate Analysis; D009765:Obesity / Q000175:diagnosis / Q000453:epidemiology*; D011336:Probability; D011788:Quality of Life; D012008:Recurrence; D012044:Regression Analysis; D012129:Respiratory Function Tests; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution; D015996:Survival Rate; D014505:Urban Population; D055815:Young Adult