title: Association of obesity with asthma severity, control and quality of life.
abstract: BACKGROUND
  The association between asthma and obesity is becoming increasingly established but the mechanism that might explain the observed differences in asthma severity, control and quality of life between obese and non-obese adult asthmatics is not clear. THE PURPOSE OF THIS STUDY WAS: 1) to determine asthma severity, control and quality of life in obese asthmatics and 2) to explore, according to the body mass index (BMI), the systemic inflammatory state of asthmatic people.
  
  
  METHODS
  A cross-sectional study was conducted between 2009 and 2010. Two hundred adult asthmatic patients were included. Data analysis consisted of univariate analysis with chi-square comparison test followed by a multivariate logistic regression.
  
  
  RESULTS
  Obesity worsens the severity of asthma. This finding was more strongly observed among women than men. Obesity and overweight are associated with a poorer control of asthma. According to BMI, obese asthmatics had 6 times more frequent emergency visits, 5 times more frequent hospitalizations for asthma related complaints, increased missed work days and greater dose of inhaled corticosteroids (1025µg/day vs. 759µg/day of beclometasone equivalent). Mean serum level of C-reactive protein (CRP) and leptin was significantly correlated with asthma severity based on GINA classification (5.75 vs. 2.81 mg/l; 20.5 vs. 5.38 ng/ml; respectively).
  
  
  CONCLUSIONS
  In summary, it appears that obesity is significantly associated with a greater asthma severity and a poorer asthma control and quality of life. Chronic systemic inflammation state may explain the relationship between obesity and asthma.
authors.affiliation: Pulmonary Department, Abderrahmen Mami Hospital, University El Manar. Tunisia.
authors.forename: Sonia
authors.initials: S
authors.lastname: Maalej
authors.affiliation: Pulmonary Department, Abderrahmen Mami Hospital, University El Manar. Tunisia.
authors.forename: Zouhour
authors.initials: Z
authors.lastname: Yaacoub
authors.affiliation: Department of Preventive Medicine, University El Manar, Tunisia.
authors.forename: Radhouane
authors.initials: R
authors.lastname: Fakhfekh
authors.affiliation: Immunology Department, Abderrahmen Mami Hospital. University El Manar, Tunisia.
authors.forename: Sadok
authors.initials: S
authors.lastname: Yaalaoui
authors.affiliation: Pulmonary Department, Abderrahmen Mami Hospital, University El Manar. Tunisia.
authors.forename: Ali Ben
authors.initials: AB
authors.lastname: Kheder
authors.affiliation: Pulmonary Department, Abderrahmen Mami Hospital, University El Manar. Tunisia.
authors.forename: Ikram
authors.initials: I
authors.lastname: Drira
keywords: Asthma; Control; Leptin; Obesity; Quality of life; Severity