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Asthma is a disease with distinct phenotypes that have implications for both prognosis and therapy. Epidemiologic studies have demonstrated an association between asthma and obesity. Further studies have shown that obese asthmatics have poor asthma control and more severe asthma. This obese-asthma group may represent a unique phenotype. The mechani...
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Background & aim:
Previous clinical studies have demonstrated a relationship between gastro-esophageal reflux disease (GERD) with anxiety and depression; however few population-based studies have controlled for sleep disorders. The current study aimed to assess the relationship between GERD and anxiety, depression, and sleep disorders in a communi...
Citations
... [19] Gastro Esophageal Reflux Disease was significantly associated with poorly controlled asthma and this agree with other studies published before. [16,[20][21][22][23] conclusIon ...
Background
Asthma is one of the most common chronic diseases that is widely prevalent worldwide affecting different age groups. Many factors are involved in the pathogenesis and there are many trigger factors that can precipitate acute attacks or interfere with the disease control. Disease controlling inhalers are required to be taken for long duration to control the symptoms, and this is a real problem with the patients to maintain remission and prevent relapse or deterioration in the lung function.
Objective
The aim of this study is to know the prevalence of asthma control in adult patients in Kirkuk city.
Materials and Methods
Two thousand and five hundreds asthmatic patients were collected from Azadi teaching hospital and private clinics at Kirkuk city during the period from January 2017 to October 2022 (1775 were men and 725 were women. A proper history was taken from the patients regarding the duration of the asthma, treatment used and compliance, smoking, and presence or absence of gastroesophageal reflux disease (GERD). The body mass index (BMI) of the patients was also measured. Regarding the asthma control during the past 4 weeks, this was assessed by using the asthma control test.
Results
From the total 2500 asthmatic patients: 2280 (91.2%) were not well-controlled, 220 (8.8%) at least well-controlled, 1590 (63.9%) of patients were on treatment, 1370 (86%) of those on treatment were not well-controlled, and 220 (14%) were at least well-controlled. Obesity, smoking, passive smoking GERD, and non-adherence to inhalers are all associated with poorly controlled asthma.
Conclusion
The study shows that most of the asthmatic patients with uncontrolled smoking exposure, GERD, obesity, and non-adherence to controlling inhalers were significantly associated factors. Most of the patients were not on regular controlling inhaler therapy. Rejection of the diagnosis, cost, and technique were all causes for the non-adherence to disease-controlling inhalers.
... [19] Gastro Esophageal Reflux Disease was significantly associated with poorly controlled asthma and this agree with other studies published before. [16,[20][21][22][23] conclusIon ...
Background: Asthma is one of the most common chronic diseases that is widely prevalent worldwide affecting different age groups. Many factors are involved in the pathogenesis and there are many trigger factors that can precipitate acute attacks or interfere with the disease control. Disease controlling inhalers are required to be taken for long duration to control the symptoms, and this is a real problem with the patients to maintain remission and prevent relapse or deterioration in the lung function. Objective: The aim of this study is to know the prevalence of asthma control in adult patients in Kirkuk city. Materials and Methods: Two thousand and five hundreds asthmatic patients were collected from Azadi teaching hospital and private clinics at Kirkuk city during the period from January 2017 to October 2022 (1775 were men and 725 were women. A proper history was taken from the patients regarding the duration of the asthma, treatment used and compliance, smoking, and presence or absence of gastroesophageal reflux disease (GERD). The body mass index (BMI) of the patients was also measured. Regarding the asthma control during the past 4 weeks, this was assessed by using the asthma control test. Results: From the total 2500 asthmatic patients: 2280 (91.2%) were not well-controlled, 220 (8.8%) at least well-controlled, 1590 (63.9%) of patients were on treatment, 1370 (86%) of those on treatment were not well-controlled, and 220 (14%) were at least well-controlled. Obesity, smoking, passive smoking GERD, and non-adherence to inhalers are all associated with poorly controlled asthma. Conclusion: The study shows that most of the asthmatic patients with uncontrolled smoking exposure, GERD, obesity, and non-adherence to controlling inhalers were significantly associated factors. Most of the patients were not on regular controlling inhaler therapy. Rejection of the diagnosis, cost, and technique were all causes for the non-adherence to disease-controlling inhalers.
... Genetics influence overall asthma symptom severity variation, including wheezing and shortness of breath [12]. Obesity from childhood to adolescence predicts increased asthma incidence, potentially due to elevated proinflammatory serum leptin levels [13,14]. Maternal smoking during pregnancy is associated with adverse fetal outcomes and heightened childhood wheezing and asthma risk, independent of birth weight and pregnancy duration [15]. ...
Background
While the hereditary component of asthma has been established, its influence on early respiratory function changes in otherwise healthy offspring remains to be explored. Dynamic lung function tests assess airflow in and out of the lungs, providing valuable insights into respiratory health and detecting potential airflow limitations. This study aimed to compare the dynamic lung functions between offspring of asthmatic and non-asthmatic parents.
Methodology
A case-control design was employed comprising 30 cases (offspring of asthmatic parents) and 30 controls (offspring of non-asthmatic parents). Lung function parameters including forced vital capacity (FVC), forced expiratory volume in one second (FEV1), FEV1/FVC ratio, forced expiratory flow between 25% and 75% of the FVC (FEF 25-75%), and maximum mid-expiratory flow at 50% of the FVC (Vmax 50%) were measured. Statistical analysis was conducted to compare the parameters between cases and controls using the unpaired t-test.
Results
The mean age of controls was 20.46 ± 2.82 years and the cases was 19.83 ± 1.41 years. The study revealed that cases exhibited lower FEV1 and Vmax 50% values compared to controls, indicating potential airflow limitations and altered mid-exhalation flow rates in the offspring of asthmatic parents. While trends were observed in FVC, FEV1/FVC ratio, and FEF 25-75%, these differences were not statistically significant.
Conclusions
The findings suggest a potential association between parental asthma and altered lung function parameters, specifically in FEV1 and Vmax 50%, among their offspring. These early respiratory function changes underscore the potential impact of hereditary factors on lung health. Healthcare professionals should take parental asthma into account when evaluating lung functions. This may lead to earlier detection and intervention. Further investigation is warranted to elucidate the underlying mechanisms and long-term implications of these findings.
... The development of overweight and obesity can lead to several health disorders, such as diabetes mellitus, cardiovascular disease, osteoarthritis, cancer; and the body can become much more susceptible to the development of many diseases as well [8,9]. Furthermore, several methods are now available to measure and treat the overweight and obesity [10,11]. ...
With the advent of the Coronavirus and in addition to many factors, stress also appears to be more pronounced in people's lives. In addition, in a life full of constraints , the weight gain is also a function of time spent at home. A stressful lifestyle and home-spend time affects not only the mental but also physical health. Therefore, a number of chronic diseases have manifested, of which the appearance of abnormal weight gain is increasing. Obesity and overweight once considered the problem of high-income nations but now increasing in low-and middle income countries, particularly in urban areas. The prevalence of obesity nearly tripled between 1975 and 2016. It is estimated that over 340 million children and adolescents aged 5-19 were overweight or obese in 2016. Obesity rates in adults were found highest in several countries including Mexico, USA, New Zealand and others. In India, the prevalence of obesity is estimated around 40 %. The common health consequences of overweight and obesity are cardiovascular disease, diabetes mellitus, osteoarthritis, and cancer. The manuscript, therefore, first summarizes the nutritional suggestions for the prevention and treatment of overweight and obesity. Then it helps in practical implementation by presenting the possibilities offered by gastronomy. In doing so, we present foods that, with their energy and macronutrient content, greatly help to protect against overweight and obesity. Their other useful active ingredient contents are also important in achieving the normal body weight and optimizing energy levels. It is advised that an increased intake of energy-dense foods that are very rich in fats and sugars must be avoided by everyone. Further, the importance of daily regular physical activities should be highlighted in order to prevent overweight and obesity.
... A sthma is one of the most common chronic respiratory diseases and affects more than 300 million people worldwide [1][2][3] . The prevalence of asthma has increased dramatically along with the epidemic of obesity in the recent decades, especially in developed western countries, causing the comorbidity obesity-asthma 4 . Asthma is a heterogeneous disease that often begins in childhood, but can also occur throughout life. ...
Obesity and asthma are both common diseases with high population burden worldwide. Recent genetic association studies have shown that obesity is associated with asthma in adults. The relationship between childhood obesity and childhood asthma, and the underlying mechanisms linking obesity to asthma remain to be clarified. In the present study, leveraging large-scale genetic data from UK biobank and several other data sources, we investigated the shared genetic components between body mass index (BMI, n = 39620) in children and childhood asthma (ncase = 10524, ncontrol = 373393). We included GWAS summary statistics for nine obesity-related biomarkers to evaluate potential biological mediators underlying obesity and asthma. We found a genetic correlation (Rg = 0.10, P = 0.02) between childhood BMI and childhood asthma, whereas the genetic correlation between adult BMI (n = 371541) and childhood asthma was null (Rg = −0.03, P = 0.21). Genomic structural equation modeling analysis further provided evidence that the genetic effect of childhood BMI on childhood asthma (standardized effect size 0.17, P = 0.009) was not driven by the genetic component of adult BMI. Bayesian colocalization analysis identified a shared causal variant rs12436181 that was mapped to gene AMN using gene expression data in lung tissue. Mendelian randomization showed that the odds ratio of childhood asthma for one standard deviation higher of childhood BMI was 1.13 (95% confidence interval: 0.96–1.34). A systematic survey of obesity-related biomarkers showed that IL-6 and adiponectin are potential biological mediators linking obesity and asthma in children. This large-scale genetic study provides evidence that unique childhood obesity pathways could lead to childhood asthma. The findings shed light on childhood asthma pathogenic mechanisms and prevention.
... Asthma control also reduces due to respiratory restrictions resulting from weight gain (26). In this study, BMI and ACT scores were found to be negatively correlated. ...
Objective: Although obesity is known to have adverse effects on asthma, it is not fully known whether general or abdominal obesity affects asthma symptoms more. In this study, the effects of diet and general/abdominal obesity on respiratory functions were evaluated.
Methods: A total of 204 adult asthmatic individuals participated in the study. Anthropometric measurements, respiratory functions, asthma control test (ACT) scores, and 24-hour food consumption were recorded. The results were compared according to body mass index (BMI), waist circumference (WC), and waist-hip ratio (WHR) classification.
Results: FEV1, FVC, MEF25-75, MEF50, and MEF25 decreased with the increase in BMI, WC, and WHR. FEV1 showed a negative linear relationship with BMI, WC and WHR and these results were more significant in WC and WHR than BMI. Similarly, the ACT score also showed a negative correlation with BMI (r = −0.372; p = 0.023), WC (r = −0.402; p = 0.001) and WHR (r = −0.387; p = 0.011), and the results were more significant in WC and WHR than BMI. Individuals whose WC (OR: 2.170 CI (1.325-3.182)) and WHR (OR: 2.119 CI (1.246-3.338)) were at risk had higher odds of uncontrolled asthma than those with normal WC and WHR. Each 100-kcal increase in total energy consumption increased the odds of uncontrolled asthma (OR: 1.125 CI (1.086-2.217)) (p < 0.05).
Conclusions: The effects of WC and WHR, which are indicators of abdominal obesity, on respiratory functions and ACT score were found to be higher than BMI. Obese individuals should be referred to diet clinics to improve their asthma symptoms.
... As compared with all other asthma phenotypes, obese asthmatic patients are associated with additional symptoms, poor disease control, a higher rate of exacerbation, attenuated response to corticosteroid treatment, and reduced quality of life. Furthermore, most of the asthmatic patients that fall under the difficult-to-treat category are found to be obese [8,9]. Table 1. ...
Obesity is considered as an important risk factor for the onset of asthma and plays a key role in enhancing the disease's severity. Obese asthmatic individuals represent a distinct phenotype of asthma that is associated with additional symptoms, more severe exacerbation, decreased response to standard medication, and poor quality of life. Obesity impairs the function of the lung airway in asthmatic individuals, leading to increased inflammation and severe remodeling of the bronchus; however, the molecular events that trigger such changes are not completely understood. In this manuscript, we review the current findings from studies that focused on understanding the role of obesity in modulating the functions of airway cells, including lung immune cells, epithelial cells, smooth muscle cells, and fibroblasts, leading to airway inflammation and remodeling. Finally, the review sheds light on the current knowledge of different therapeutic approaches for treating obese asthmatic individuals. Given the fact that the prevalence of asthma and obesity has been increasing rapidly in recent years, it is necessary to understand the molecular mechanisms that play a role in the disease pathophysiology of obese asthmatic individuals for developing novel therapies.
... Notably, approximately 70% of patients were female and classified as overweight/ obese (BMI ≥ 25 kg/m 2 ). This is not unexpected, given that a positive association has been observed between obesity and asthma prevalence, predominantly in females, in Latin America (32), with obese patients having poor disease control and an increased risk of exacerbations (33)(34)(35). Consequently, educational programs may be required to increase awareness of the benefits of a healthier lifestyle, including dietary Table 3. Patients in the saBIna III latin american cohort who (a) received prescriptions for saBa monotherapy, (B) received prescriptions for saBa in addition to maintenance therapy, and (C) purchased saBa without a prescription in the 12 months before the study visit. changes and regular physical activity. ...
Objective:
Short-acting β2-agonist (SABA) over-reliance is associated with poor asthma outcomes. As part of the SABA Use IN Asthma (SABINA) III study, we assessed SABA prescriptions and clinical outcomes in patients from six Latin American countries.
Methods:
In this cross-sectional study, data on disease characteristics/asthma treatments were collected using electronic case report forms. Patients (aged ≥12 years) were classified by investigator-defined asthma severity (guided by the 2017 Global Initiative for Asthma) and practice type (primary/specialist care). Multivariable regression models analyzed the associations between SABA prescriptions and clinical outcomes.
Results:
Data from 1096 patients (mean age, 52.0 years) were analyzed. Most patients were female (70%), had moderate-to-severe asthma (79.4%), and were treated by specialists (87.6%). Asthma was partly controlled/uncontrolled in 61.5% of patients; 47.4% experienced ≥1 severe exacerbation in the previous 12 months. Overall, 39.8% of patients were prescribed ≥3 SABA canisters in the preceding 12 months (considered over-prescription). SABA canisters were purchased over the counter (OTC) by 17.2% of patients, of whom 38.8% purchased ≥3 canisters in the 12 months prior. Of patients who purchased SABA OTC, 73.5% were prescribed ≥3 SABA canisters. Higher SABA prescriptions (vs. 1 - 2 canisters) were associated with an increased incidence rate of severe exacerbations (ranging from 1.31 to 3.08) and lower odds ratios of having at least partly controlled asthma (ranging from 0.63 to 0.15).
Conclusions:
SABA over-prescription was common in Latin America, highlighting the need for urgent collaboration between healthcare providers and policymakers to align clinical practices with the latest evidence-based recommendations to address this public health concern.
... Especially late-onset asthma without eosinophilia, is thought to be associated with age-related changes in the immune system, obesity, smoking, and occupational exposure rather than atopy (4,(41)(42)(43)(44)(45)(46)(47). From the obesity perspective, studies classify obese asthma patients as a distinct phenotype (48)(49)(50). Considering that the majority of the cases in our group were obese, it is clear that the obesity-asthma phenotype is a common condition in our clinical practice. Several M a n u s c r i p t a c c e p t e d f o r p u b l i c a t i o n reports have documented an increased risk of asthma in obese patients particularly those who are nonallergic and/or noneosinophilic (51)(52)(53)(54). ...
Introduction. Asthma is a heterogeneous disease that combines different biological mechanisms, inflammatory pathways, and phenotypic features under the same umbrella. Our aim was to investigate the demographic and disease characteristics of our patients with asthma and to reveal the distribution of patients with different phenotypes according to endotype groups. Methods. The study was planned as a cross-sectional observational study. The Demographic and clinical data of asthmatic patients followed in our clinic for at least one year were collected from their file records. Patients were identified as eosinophilic if the absolute eosinophil count was measured at least once ≥ 300/μL during the oral corticosteroid free period or ≥ 150/μL under oral corticosteroids. Patients sensitive to at least one inhalant allergen with skin prick test and/or spIgE measurement consistent with their history and clinical features were defined as allergic. They were categorized into four main endotypes according to their eosinophilic/non-eosinophilic and allergic/non-allergic nature. Results. Data of 405 asthma patients (79.5% female) with a median age of 50.9 years were analyzed. The prominent clinical and phenotypic characteristics of the study group were being obese (43.2%) or overweight (32%), severe asthma (49.6%), adult-onset (56.1%) or late-onset asthma (35.3%). The distribution of the four main endotypes according to eosinophilic and/or allergic status, is as follows: 22.7% allergic-eosinophilic (AE), 27.9% nonallergic-eosinophilic (NAE), 22.9% allergic-noneosinophilic (ANE), 26.4% nonallergic-noneosinophilic (NANE). While most severe asthma patients were in the AE and NAE groups, those with early-onset asthma were in AE and ANE, and those with late-onset asthma were in the NAE and NANE groups. Finally, obese patients were mostly in NANE group. The proportion of uncontrolled patients was higher in the NAE group (NAE: 44.2% vs AE: 31.5%, ANE: 31.2%, NANE: 28%, respectively). Among the severe asthma patients, the rate of uncontrolled disease was higher in those with NANE asthma (NANE: 61.5%, NAE: 56.6%, ANE: 53.5%, AE: 37.7%). Conclusions. Our study showed that different phenotypes were more closely related to some endotypes. This may allow the clinicians to identify patients and predict appropriate treatment modalities and response for individualized care.
... This low-grade systemic inflammation can exacerbate the chronic inflammation caused by asthma, thereby increasing airway resistance and nonspecific airway hyperresponsiveness (AHR). As a result, clinically obese asthma patients exhibit a lower quality of life, experience more severe daily symptoms, use asthma medications at a higher frequency, and have a significantly increased risk of serious complications such as heart failure and respiratory failure [15][16][17]. In addition to the mechanical factors leading to the aggravation of asthma symptoms, obesity can also increase the release of asthma-related inflammatory factors. ...
Although natural killer T cells (NKT cells) are altered in obese asthmatic mice, their function remains completely unclear. To further explore the potential mechanism of NKT cells in airway inflammation of obesity-associated asthma, we examined the effects of α-galactosylceramide (KRN7000) on airway inflammation in obese asthmatic mice. Male C57BL/6J mice were divided into five groups: (1) control; (2) asthma; (3) A + KRN, asthma with KRN7000; (4) obese asthma; and (5) OA + KRN, obese asthma with KRN7000. Cytometric bead array (CBA) was used to detect interleukin-4 (IL-4), IL-10, tumor necrosis factor-α (TNF-α), and interferon-γ (IFN-γ) in the serum. Flow cytometry was used to detect NKT cells and CD69⁺ NKT cells. Airway inflammation was observed in pathological sections, and calmodulin (CaM) expression was observed by immunohistochemistry in lung tissues. Airway inflammation in the obese asthma group was more severe than that of the asthma group. Airway inflammation of the OA + KRN group was reduced more than that of the A + KRN group. CD69+ NKT cells were only significantly reduced in the OA + KRN group. The levels of serum IFN-γ and TNF-α increased more in the OA + KRN group than in the A + KRN group. CaM is widely expressed in the cytoplasm of the lung tissues and was sharply decreased in the OA + KRN group. KRN7000 can significantly reduce airway inflammation in obesity-associated asthma by regulating NKT cell cytokine secretion and intracellular calcium. These results may contribute to the development of novel therapeutic approaches.
