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Leso V, Candia C, Pacella D, Molino A, Nocera C, Maniscalco M, Iavicoli I. Quality of life and work functionality in severe asthma patients: the impact of biological therapies. J Occup Med Toxicol 2024; 19:8. [PMID: 38509562 PMCID: PMC10953125 DOI: 10.1186/s12995-024-00406-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 02/28/2024] [Indexed: 03/22/2024] Open
Abstract
BACKGROUND Severe asthma can cause poor health status, poor health-related quality of life (HRQoL) and an impaired functioning at work. However, to date, limited data are available on the impact of the biological therapies on such outcomes. Therefore, aim of the present study was to prospectively assess the clinical, quality of life and work functionality issues in severe asthma patients both at baseline and after 6 months of biological therapies and determine which individual, pathological and occupational factors can influence such parameters. METHODS Fifty-two patients were enrolled between December 2022 and June 2023. Patients' personal, clinical, functional and occupational features were assessed. The Short Form Health Survey (SF-12), the Work Productivity and Activity Impairment (WPAI) questionnaire and the Work Ability Index (WAI) were employed to assess HRQoL, the employee's productivity and perception of work ability, respectively. RESULTS Among the enrolled patients, 30 (57.70%) were employed. Biological therapy induced a significant improvement in clinical and functional parameters, e.g., FEV1% (72 ± 12 vs.87 ± 13%; 72 ± 14 vs. 86 ± 14%), FVC% (92 ± 11 vs. 101 ± 11%; 90 ± 13 vs. 98 ± 14%) and FEV1/FVC (62 ± 11 vs. 71 ± 8%; 64 ± 9 vs. 70 ± 8%) in workers and non-workers, respectively (P < 0.001). Comparably, the perception of life quality significantly improved, as physical and mental health scores, in the overall cohort, increased from 40.7 ± 10.3 and 48.5 ± 8.5 to 46.8 ± 8.6 and 51.6 ± 6.4, respectively (P < 0.001). The work ability perception significantly improved from a moderate to a good one (34 ± 6 vs. 40 ± 6, P = 0.001). A significant reduction in the absenteeism (19 ± 15 vs. 3 ± 11%; P < 0.001) and presenteeism rate (53 ± 24 vs. 29 ± 26%; P < 0.001), and an improvement in daily (40 ± 27.5% vs. 28.9 ± 24.7%, P < 0.001, in the overall population) and work activities (57 ± 25 vs. 29 ± 27%, P < 0.001) was determined. Gender, age, symptoms control and pulmonary functionality were correlated with the physical and mental health perception, daily activity impairment and work ability. CONCLUSIONS Our study pointed out that biological therapies improved clinical, general life and occupational outcomes in patients with severe asthma. The correlation between clinical aspects and psychological and occupational issues suggest the relevance for a multidisciplinary management of the disease for an effective participation of patients in the world of work.
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Affiliation(s)
- Veruscka Leso
- Department of Public Health, Section of Occupational Medicine, University of Naples Federico II, Via S. Pansini 5, Naples, 80131, Italy.
| | - Claudio Candia
- Department of Clinical Medicine and Surgery, University of Naples "Federico II", Naples, 80131, Italy
| | - Daniela Pacella
- Department of Public Health, University of Naples Federico II, Via S. Pansini 5, Naples, 80131, Italy
| | - Antonio Molino
- Department of Clinical Medicine and Surgery, University of Naples "Federico II", Naples, 80131, Italy
| | - Caterina Nocera
- Department of Public Health, Section of Occupational Medicine, University of Naples Federico II, Via S. Pansini 5, Naples, 80131, Italy
| | - Mauro Maniscalco
- Department of Clinical Medicine and Surgery, University of Naples "Federico II", Naples, 80131, Italy
- Pulmonary Rehabilitation Unit of Telese Terme Institute, Istituti Clinici Scientifici Maugeri IRCCS, Telese Terme, 82037, Italy
| | - Ivo Iavicoli
- Department of Public Health, Section of Occupational Medicine, University of Naples Federico II, Via S. Pansini 5, Naples, 80131, Italy
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Croen LA, Ames JL, Qian Y, Alexeeff S, Ashwood P, Gunderson EP, Wu YW, Boghossian AS, Yolken R, Van de Water J, Weiss LA. Inflammatory Conditions During Pregnancy and Risk of Autism and Other Neurodevelopmental Disorders. BIOLOGICAL PSYCHIATRY GLOBAL OPEN SCIENCE 2024; 4:39-50. [PMID: 38045769 PMCID: PMC10689278 DOI: 10.1016/j.bpsgos.2023.09.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 09/20/2023] [Accepted: 09/25/2023] [Indexed: 12/05/2023] Open
Abstract
Background Maternal inflammation can result from immune dysregulation and metabolic perturbations during pregnancy. Whether conditions associated with inflammation during pregnancy increase the likelihood of autism spectrum disorder (ASD) or other neurodevelopmental disorders (DDs) is not well understood. Methods We conducted a case-control study among children born in California from 2011 to 2016 to investigate maternal immune-mediated and cardiometabolic conditions during pregnancy and risk of ASD (n = 311) and DDs (n = 1291) compared with children from the general population (n = 967). Data on maternal conditions and covariates were retrieved from electronic health records. Maternal genetic data were used to assess a causal relationship. Results Using multivariable logistic regression, we found that mothers with asthma were more likely to deliver infants later diagnosed with ASD (odds ratio [OR] = 1.62, 95% CI: 1.15-2.29) or DDs (OR = 1.30, 95% CI: 1.02-1.64). Maternal obesity was also associated with child ASD (OR = 1.51, 95% CI: 1.07-2.13). Mothers with both asthma and extreme obesity had the greatest odds of delivering an infant later diagnosed with ASD (OR = 16.9, 95% CI: 5.13-55.71). These increased ASD odds were observed among female children only. Polygenic risk scores for obesity, asthma, and their combination showed no association with ASD risk. Mendelian randomization did not support a causal relationship between maternal conditions and ASD. Conclusions Inflammatory conditions during pregnancy are associated with risk for neurodevelopmental disorders in children. These risks do not seem to be due to shared genetic risk; rather, inflammatory conditions may share nongenetic risk factors with neurodevelopmental disorders. Children whose mothers have both asthma and obesity during pregnancy may benefit from earlier screening and intervention.
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Affiliation(s)
- Lisa A. Croen
- Division of Research, Kaiser Permanente Northern California, Oakland, California
- Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California
| | - Jennifer L. Ames
- Division of Research, Kaiser Permanente Northern California, Oakland, California
| | - Yinge Qian
- Division of Research, Kaiser Permanente Northern California, Oakland, California
| | - Stacey Alexeeff
- Division of Research, Kaiser Permanente Northern California, Oakland, California
| | - Paul Ashwood
- Department of Medical Microbiology and Immunology and the MIND Institute, University of California, Davis, Davis, California
| | - Erica P. Gunderson
- Division of Research, Kaiser Permanente Northern California, Oakland, California
- Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California
| | - Yvonne W. Wu
- Departments of Neurology and Pediatrics, University of California San Francisco, San Francisco, California
| | - Andrew S. Boghossian
- Institute for Human Genetics, Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, California
| | - Robert Yolken
- Department of Medicine, Johns Hopkins University, Baltimore, Maryland
| | - Judy Van de Water
- Division of Rheumatology/Allergy/Clinical Immunology, Department of Internal Medicine, University of California at Davis, Davis, California
| | - Lauren A. Weiss
- Institute for Human Genetics, Department of Psychiatry and Behavioral Sciences, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, California
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Sharma V, Ricketts HC, Steffensen F, Goodfellow A, Cowan DC. Obesity affects type 2 biomarker levels in asthma. J Asthma 2023; 60:385-392. [PMID: 35260034 DOI: 10.1080/02770903.2022.2051548] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE Type 2 (T2) inflammation offers a therapeutic target for biologics. Previous trials suggest obesity influences T2-biomarker levels in asthma, though have not accounted for key variables, e.g. inhaled (ICS)/oral corticosteroid (OCS) use. We hypothesized that body mass index (BMI) would affect T2-biomarker levels, after adjusting for covariates. METHODS A retrospective analysis of data from two recent local trials of 153 participants with asthma (102 difficult-to-treat, 51 mild). Measurements included BMI, fractional exhaled nitric oxide (FeNO) and eosinophils. Correlation and regression analysis were performed for each biomarker to describe their relationship with BMI. Data was analyzed overall, and by asthma severity, T2-status and BMI tertile. RESULTS Increasing BMI was associated with reduction in FeNO when stratified by BMI tertile (25 ppb lowest tertile, 18 ppb highest tertile; p = 0.014). Spearmans rank showed a negative correlation between BMI and FeNO in difficult-to-treat asthma (ρ= -0.309, p = 0.002). Linear regression adjusting for sex, age, smoking, atopy, allergic/perennial rhinitis, ICS and OCS confirmed BMI as a predictor of FeNO overall (β= -2.848, p = 0.019). Eosinophils were reduced in the highest BMI tertile versus lowest in difficult-to-treat asthma (0.2x109/L, 0.3x109/L respectively; p = 0.02). CONCLUSIONS Increasing BMI is associated with lower FeNO in asthma when adjusted for relevant covariates, including steroid use. There also appears to be an effect on eosinophil levels. Obesity, therefore, affects T2 biomarker levels with implications for disease endotyping and determination of eligibility for biologic therapy. Whether this is due to masking of underlying T2-high status or development of a truly T2-low endotype requires further research.
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Affiliation(s)
- Varun Sharma
- College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Helen Clare Ricketts
- College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Femke Steffensen
- Glasgow Clinical Research Facility, Glasgow Royal Infirmary, Glasgow, UK
| | - Anna Goodfellow
- Glasgow Clinical Research Facility, Glasgow Royal Infirmary, Glasgow, UK
| | - Douglas C Cowan
- Respiratory Department, Glasgow Royal Infirmary, Glasgow, UK
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4
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Rugila DF, Oliveira JM, Machado FVC, Correia NS, Puzzi VC, Passos NFP, Freitas PD, Pitta F, Carvalho CRF, Furlanetto KC. Fat mass to fat-free mass ratio and its associations with clinical characteristics in asthma. Heart Lung 2022; 56:154-160. [PMID: 35908350 DOI: 10.1016/j.hrtlng.2022.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 07/16/2022] [Accepted: 07/20/2022] [Indexed: 11/04/2022]
Abstract
BACKGROUND Fat mass to fat-free mass ratio (FM/FFM) assesses the combined effect of the balance between fat mass and fat-free mass. AIMS to evaluate the associations beetween FM/FFM and clinical outcomes in asthma and to compare clinical characteristics between individuals with higher and lower FM/FFM. METHODS 128 participants with asthma underwent anthropometric, spirometry and bioelectrical impedance assessments. Physical activity in daily life (PADL) was assessed by the Actigraph for 7 days. Daily dose of inhaled medication, steps of pharmacological treatment, Asthma Control Questionnaire, Asthma Quality of Life Questionnaire and Hospital Anxiety and Depression Scale were also assessed. Participants were classified into two groups according to the 50th percentile of reference values for FM/FFM. RESULTS Individuals with higher FM/FFM (n=75) used higher daily doses of inhaled corticosteroids, had worse lung function and fewer steps/day when compared to those with lower FM/FFM (n=53) (P≤0.021). Associations were found between absolute values of FM/FFM with lung function (FEV1 and FVC [liters]): R2=0.207 and 0.364;P<0.0001), and between the categories of lower or higher FM/FFM with steps of medication treatment (Cramer's V=0.218;P=0.016) and level of PADL (Cramer's V=0.236;P=0.009). The highest FM/FFM was a determining factor of physical inactivity (OR: 3.21;95%CI:1.17-8.78) and highest steps of pharmacological treatment (OR: 8.89;95%CI:1.23-64.08). CONCLUSION Higher FM/FFM is significantly associated with worse clinical characteristics in individuals with asthma, such as higher doses of inhaled corticosteroids, worse lung function and fewer steps/day. Moreover, higher FM/FFM is a determining factor of physical inactivity and the highest steps of pharmacological treatment for asthma.
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Key Words
- ACQ, Asthma Control Questionnaire
- AQLQ, Asthma Quality of Life Questionnaire
- Asthma
- BMI, Body mass index
- Body composition
- Drug therapy
- FEV(1), Forced expiratory volume in the first second
- FEV(1)/FVC, Forced expiratory volume in the first second to forced vital capacity ratio
- FFM, Fat-free mass
- FM, Fat mass
- FM/FFM, Fat mass to fat-free mass ratio
- FVC, Forced vital capacity
- GINA, Global Initiative for Asthma
- HADS, Hospital Anxiety and Depression Scale
- Motor activity
- PADL, Physical Activity in Daily Life
- Respiratory function tests
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Affiliation(s)
- Diery Fernandes Rugila
- Postgraduate Program in Rehabilitation Sciences, Pitágoras-Unopar University (UNOPAR), Londrina, Paraná, Brazil; Department of Physical Therapy, Laboratory of Research in Respiratory Physiotherapy (LFIP), State University of Londrina (UEL), Londrina, Paraná, Brazil
| | - Joice Mara Oliveira
- Postgraduate Program in Rehabilitation Sciences, Pitágoras-Unopar University (UNOPAR), Londrina, Paraná, Brazil; Department of Physical Therapy, Laboratory of Research in Respiratory Physiotherapy (LFIP), State University of Londrina (UEL), Londrina, Paraná, Brazil
| | - Felipe Vilaça Cavallari Machado
- Department of Physical Therapy, Laboratory of Research in Respiratory Physiotherapy (LFIP), State University of Londrina (UEL), Londrina, Paraná, Brazil; Department of Research and Development, CIRO+, Horn, The Netherlands; NUTRIM School of Nutrition and Translational Research in Metabolism, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands; Department of Respiratory Medicine, Maastricht University Medical Center (MUMC+), Maastricht, The Netherlands
| | - Natielly Soares Correia
- Postgraduate Program in Rehabilitation Sciences, Pitágoras-Unopar University (UNOPAR), Londrina, Paraná, Brazil; Department of Physical Therapy, Laboratory of Research in Respiratory Physiotherapy (LFIP), State University of Londrina (UEL), Londrina, Paraná, Brazil
| | - Vitória Cavalheiro Puzzi
- Postgraduate Program in Rehabilitation Sciences, Pitágoras-Unopar University (UNOPAR), Londrina, Paraná, Brazil; Department of Physical Therapy, Laboratory of Research in Respiratory Physiotherapy (LFIP), State University of Londrina (UEL), Londrina, Paraná, Brazil
| | | | - Patrícia Duarte Freitas
- Department of Physical Therapy, School of Medicine, University of Sao Paulo (USP), Sao Paulo, Brazil
| | - Fabio Pitta
- Department of Physical Therapy, Laboratory of Research in Respiratory Physiotherapy (LFIP), State University of Londrina (UEL), Londrina, Paraná, Brazil
| | | | - Karina Couto Furlanetto
- Postgraduate Program in Rehabilitation Sciences, Pitágoras-Unopar University (UNOPAR), Londrina, Paraná, Brazil; Department of Physical Therapy, Laboratory of Research in Respiratory Physiotherapy (LFIP), State University of Londrina (UEL), Londrina, Paraná, Brazil.
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5
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Klepaker G, Henneberger PK, Torén K, Brunborg C, Kongerud J, Fell AKM. Association of respiratory symptoms with body mass index and occupational exposure comparing sexes and subjects with and without asthma: follow-up of a Norwegian population study (the Telemark study). BMJ Open Respir Res 2022; 9:9/1/e001186. [PMID: 35365552 PMCID: PMC8977753 DOI: 10.1136/bmjresp-2021-001186] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 03/22/2022] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Occupational exposure and increased body mass index (BMI) are associated with respiratory symptoms. This study investigated whether the association of a respiratory burden score with changes in BMI as well as changes in occupational exposure to vapours, gas, dust and fumes (VGDF) varied in subjects with and without asthma and in both sexes over a 5-year period. METHODS In a 5-year follow-up of a population-based study, 6350 subjects completed a postal questionnaire in 2013 and 2018. A respiratory burden score based on self-reported respiratory symptoms, BMI and frequency of occupational exposure to VGDF were calculated at both times. The association between change in respiratory burden score and change in BMI or VGDF exposure was assessed using stratified regression models. RESULTS Changes in respiratory burden score and BMI were associated with a β-coefficient of 0.05 (95% CI 0.04 to 0.07). This association did not vary significantly by sex, with 0.05 (0.03 to 0.07) for women and 0.06 (0.04 to 0.09) for men. The association was stronger among those with asthma (0.12; 0.06 to 0.18) compared with those without asthma (0.05; 0.03 to 0.06) (p=0.011). The association of change in respiratory burden score with change in VGDF exposure gave a β-coefficient of 0.15 (0.05 to 0.19). This association was somewhat greater for men versus women, with coefficients of 0.18 (0.12 to 0.24) and 0.13 (0.07 to 0.19), respectively (p=0.064). The estimate was similar among subjects with asthma (0.18; -0.02 to 0.38) and those without asthma (0.15; 0.11 to 0.19). CONCLUSIONS Increased BMI and exposure to VGDF were associated with increased respiratory burden scores. The change due to increased BMI was not affected by sex, but subjects with asthma had a significantly larger change than those without. Increased frequency of VGDF exposure was associated with increased respiratory burden score but without statistically significant differences with respect to sex or asthma status.
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Affiliation(s)
- Geir Klepaker
- Department of Occupational and Environmental Medicine, Telemark Hospital, Skien, Norway .,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Paul Keefer Henneberger
- Respiratory Health Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, West Virginia, USA
| | - Kjell Torén
- Department of Occupational and Environmental Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Cathrine Brunborg
- Oslo Centre for Biostatistics, Epidemiology and Health Economics, Oslo University Hospital, Oslo, Norway
| | - Johny Kongerud
- Department of Respiratory Medicine, University of Oslo, Oslo, Norway.,Department of Respiratory Medicine, Oslo University Hospital, Oslo, Norway
| | - Anne Kristin Møller Fell
- Department of Occupational and Environmental Medicine, Telemark Hospital, Skien, Norway.,Institute of Health and Society, Department of Community Medicine and Global Health, University of Oslo Faculty of Medicine, Oslo, Norway
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Clarhed UKE, Schiöler L, Torén K, Fell AKM, Hellgren J. BMI as a risk factor for the development of chronic rhinosinusitis: a prospective population-based study. Eur Arch Otorhinolaryngol 2022; 279:4953-4959. [PMID: 35305138 PMCID: PMC9474381 DOI: 10.1007/s00405-022-07320-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 02/11/2022] [Indexed: 01/05/2023]
Abstract
PURPOSE Obesity is a growing, global health problem and previous cross-sectional studies have demonstrated an association between obesity and chronic rhinosinusitis (CRS). There is, however, a lack of prospective studies regarding the impact of obesity on developing (new-onset) CRS. METHODS Questionnaire-based data (n = 5769) relating to new-onset CRS and Body Mass Index (BMI) were collected in 2013 and 2018 from the Telemark population study in Telemark, Norway. Odds ratios for the risk of new-onset CRS in 2018 in relation to BMI in 2013 were calculated, adjusted for smoking habits, asthma, gender and age. RESULTS When comparing the group with normal weight (18.5 ≤ BMI < 25) with the obese group (BMI ≥ 30), the odds of new-onset CRS was 53% higher [OR 1.53 (1.11, 2.10)] in the obese group. CONCLUSION CRS is a multifactorial disease with different phenotypes and it is important to consider obesity when assessing patients with CRS in a clinical setting.
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Affiliation(s)
- Ulrika K. E. Clarhed
- Department of Otorhinolaryngology, Head and Neck Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gröna Stråket 9, 413 45 Göteborg, Sweden ,Dept of Otorhinolaryngology, Region Västra Götaland, Sahlgrenska University Hospital, Göteborg, Sweden
| | - Linus Schiöler
- Occupational and Environmental Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
| | - Kjell Torén
- Occupational and Environmental Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Göteborg, Sweden
| | - Anne Kristin M. Fell
- Department of Occupational and Environmental Medicine, Telemark Hospital, Skien, Norway ,Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Johan Hellgren
- Department of Otorhinolaryngology, Head and Neck Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gröna Stråket 9, 413 45 Göteborg, Sweden ,Dept of Otorhinolaryngology, Region Västra Götaland, Sahlgrenska University Hospital, Göteborg, Sweden
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Abstract
Purpose of Review Obesity-associated difficult asthma continues to be a substantial problem and, despite a move to address treatable traits affecting asthma morbidity and mortality, it remains poorly understood with limited phenotype-specific treatments. The complex association between asthma, obesity, and inflammation is highlighted and recent advances in treatment options explored. Recent Findings Obesity negatively impacts asthma outcomes and has a causal link in the pathogenesis of adult-onset asthma. Imbalance in the adipose organ found in obesity favours a pro-inflammatory state both systemically and in airways. Obesity may impact currently available asthma biomarkers, and obesity-associated asthma specific biomarkers are needed. Whilst surgical weight loss interventions are associated with improvements in asthma control and quality of life, evidence for pragmatic conservative options are sparse. Innovative approaches tackling obesity-mediated airway inflammation may provide novel therapies. Summary The immunopathological mechanisms underlying obesity-associated asthma require further research that may lead to novel therapeutic options for this disease. However, weight loss appears to be effective in improving asthma in this cohort and focus is also needed on non-surgical treatments applicable in the real-world setting.
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Affiliation(s)
- Varun Sharma
- Institute of Infection, Immunity and Inflammation, University of Glasgow, Glasgow, UK. .,Glasgow Royal Infirmary, Glasgow, UK.
| | - Douglas C Cowan
- Institute of Infection, Immunity and Inflammation, University of Glasgow, Glasgow, UK. .,Glasgow Royal Infirmary, Glasgow, UK.
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Li P, Chen X, Yao Q. Body Mass and Income: Gender and Occupational Differences. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18189599. [PMID: 34574522 PMCID: PMC8468324 DOI: 10.3390/ijerph18189599] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 09/04/2021] [Accepted: 09/10/2021] [Indexed: 11/16/2022]
Abstract
This paper aims to examine the influence of body shape on income, which varies with gender and occupational structure in China. The data were obtained from the CGSS (Chinese General Social Survey) 2010-2017 Survey. The overall finding in this paper is that women and men face different body shape-income effects. For females, the obesity penalty is significant and is reinforced with increasing occupational rank. For men, the thinness penalty (or weight premium) is enhanced as the occupational class decreases. Body shape-income gaps are mainly caused by the occupational structure. Twenty-nine percent of the income gap between overweight and average weight women can be explained by the obesity penalty, 37% of the income gap between overweight and average weight men can be interpreted by the weight premium, and 11% of the gap between underweight and normal weight men can be explained by the thinness penalty. The findings also suggest that the effect of body shape on income consists of two pathways: body shape affects health capital and socialization, and therefore income. Healthy lifestyles and scientific employment concepts should be promoted, and measures to close the gender gap should be implemented.
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Affiliation(s)
- Ping Li
- School of Economics and Management, South China Normal University, Guangzhou 510006, China; (P.L.); (Q.Y.)
| | - Xiaozhou Chen
- School of Business Administration, Guangdong University of Finance, Guangzhou 510521, China
- Correspondence:
| | - Qi Yao
- School of Economics and Management, South China Normal University, Guangzhou 510006, China; (P.L.); (Q.Y.)
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9
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Klepaker G, Henneberger PK, Hertel JK, Holla ØL, Kongerud J, Fell AKM. Influence of asthma and obesity on respiratory symptoms, work ability and lung function: findings from a cross-sectional Norwegian population study. BMJ Open Respir Res 2021; 8:8/1/e000932. [PMID: 34489237 PMCID: PMC8422495 DOI: 10.1136/bmjresp-2021-000932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 07/21/2021] [Indexed: 11/04/2022] Open
Abstract
Background Although asthma and obesity are each associated with adverse respiratory outcomes, a possible interaction between them is less studied. This study assessed the extent to which asthma and overweight/obese status were independently associated with respiratory symptoms, lung function, Work Ability Score (WAS) and sick leave; and whether there was an interaction between asthma and body mass index (BMI) ≥25 kg/m2 regarding these outcomes. Methods In a cross-sectional study, 626 participants with physician-diagnosed asthma and 691 without asthma were examined. All participants completed a questionnaire and performed spirometry. The association of outcome variables with asthma and BMI category were assessed using regression models adjusted for age, sex, smoking status and education. Results Asthma was associated with reduced WAS (OR=1.9 (95% CI 1.4 to 2.5)), increased sick leave in the last 12 months (OR=1.4 (95% CI 1.1 to 1.8)) and increased symptom score (OR=7.3 (95% CI 5.5 to 9.7)). Obesity was associated with an increased symptom score (OR=1.7 (95% CI 1.2 to 2.4)). Asthma was associated with reduced prebronchodilator and postbronchodilator forced expiratory volume in 1 s (FEV1) (β=−6.6 (95% CI −8.2 to −5.1) and −5.2 (95% CI −6.7 to −3.4), respectively) and prebronchodilator forced vital capacity (FVC) (β=−2.3 (95% CI −3.6 to −0.96)). Obesity was associated with reduced prebronchodilator and postbronchodilator FEV1 (β=−2.9 (95% CI −5.1 to −0.7) and −2.8 (95% CI −4.9 to −0.7), respectively) and FVC (−5.2 (95% CI −7.0 to −3.4) and −4.2 (95% CI −6.1 to −2.3), respectively). The only significant interaction was between asthma and overweight status for prebronchodilator FVC (β=−3.6 (95% CI −6.6 to −0.6)). Conclusions Asthma and obesity had independent associations with increased symptom scores, reduced prebronchodilator and postbronchodilator FEV1 and reduced prebronchodilator FVC. Reduced WAS and higher odds of sick leave in the last 12 months were associated with asthma, but not with increased BMI. Besides a possible association with reduced FVC, we found no interactions between asthma and increased BMI.
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Affiliation(s)
- Geir Klepaker
- Occupational and Environmental Medicine, Telemark Hospital, Skien, Norway .,Institute of Clinical Medicine, University of Oslo Faculty of Medicine, Oslo, Norway
| | - Paul Keefer Henneberger
- Respiratory Health Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, West Virginia, USA
| | | | | | - Johny Kongerud
- Institute of Clinical Medicine, University of Oslo Faculty of Medicine, Oslo, Norway.,Department of Respiratory Medicine, Oslo University Hospital, Oslo, Norway
| | - Anne Kristin Møller Fell
- Occupational and Environmental Medicine, Telemark Hospital, Skien, Norway.,Institute of Health and Society, University of Oslo Faculty of Medicine, Oslo, Norway
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10
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Wang Y, Li Z, Li F. Nonlinear relationship between visceral adiposity index and lung function: a population-based study. Respir Res 2021; 22:161. [PMID: 34030678 PMCID: PMC8146652 DOI: 10.1186/s12931-021-01751-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 05/17/2021] [Indexed: 01/25/2023] Open
Abstract
Background As one of the critical indicators of obesity, the interaction between visceral fat content and lung disease is the focus of current research. However, the exact relationship between Visceral adipose index (VAI) and lung function is not fully understood. The purpose of this study was to evaluate the relationship between VAI and lung function, Methods Our study included all participants from the baseline survey population in Xinjiang in the Natural Population Cohort Study in Northwest China. A field survey was conducted in rural areas of Moyu County, Xinjiang, China, between 35 and 74 years old from June to December 2018. We collected standard questionnaires and completed physical examinations, visceral fat tests, and lung function measurements. Results The study included 2367 participants with a mean VAI of 10.35 ± 4.35, with males having a significantly higher VAI than females: 13.17 ± 3.91 vs. 7.58 ± 2.65. The piecewise linear spline models indicated a significant threshold effect between lung function and VAI in the general population and the males population, showing an inverted U-shaped curve. But there was no significant association between VAI and lung function in females. FEV1% predicted and FVC% predicted increased with the increase of VAI (β 0.76; 95% CI 0.30, 1.21) and (β 0.50; 95% CI 0.06, 0.94) in males with VAI ≤ 14, while FEV1% predicted and FVC% predicted decreased with the increase of VAI (β − 1.17; 95% CI − 1.90, − 0.45) and (β − 1.36; 95% CI − 2.08, − 0.64) in males with VAI ≥ 15. Conclusions The relationship between lung function and VAI in male participants showed an inverted U-shaped curve, with the turning point of VAI between 14 and 15. The association between visceral fat and lung function was more robust in males than in females. Supplementary Information The online version contains supplementary material available at 10.1186/s12931-021-01751-7.
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Affiliation(s)
- Yide Wang
- Department of Integrated Pulmonology, Fourth Clinical Medical College of Xinjiang Medical University, 116 Huanghe Road, Urumqi, Xinjiang, China
| | - Zheng Li
- Department of Integrated Pulmonology, Fourth Clinical Medical College of Xinjiang Medical University, 116 Huanghe Road, Urumqi, Xinjiang, China. .,Xinjiang National Clinical Research Base of Traditional Chinese Medicine, Xinjiang Medical University, 116 Huanghe Road, Urumqi, Xinjiang, China.
| | - Fengsen Li
- Department of Integrated Pulmonology, Fourth Clinical Medical College of Xinjiang Medical University, 116 Huanghe Road, Urumqi, Xinjiang, China. .,Xinjiang National Clinical Research Base of Traditional Chinese Medicine, Xinjiang Medical University, 116 Huanghe Road, Urumqi, Xinjiang, China.
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11
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Gaisberger M, Wass RE, Dobias H, Grabcanovic-Musija F, Weiss G, Lamprecht B, Kaiser B, Studnicka M, Hartl A. Acute Exposure to Environmental Tobacco Smoke: A Controlled Study in Adults with Asthma. Respiration 2020; 99:1-8. [PMID: 33296904 DOI: 10.1159/000508397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Accepted: 05/02/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Short-term, indoor exposure to environmental tobacco smoke (ETS) is still highly prevalent; however, little is known about the acute lung response in adult asthma. OBJECTIVES We investigated whether acute, experimental ETS exposure influences symptoms, lung function, and inflammatory parameters. METHODS Human subjects with asthma (n = 23) were exposed for 180 min to either room air or ETS at 250, 450, or 850 µg/m3. Respiratory symptoms, lung function, and exhaled nitric oxide (FeNO) were measured. Additionally, blood samples were analyzed for pro- and anti-inflammatory cytokines. RESULTS Humans with asthma demonstrate an increase in respiratory symptoms at all levels of ETS exposure, while the forced expiratory volume in 1 s (FEV1) and FeNO decrease with increasing ETS. The anti-inflammatory cytokine interleukin (IL)-10 increases at intermediate ETS concentrations, whereas tumor necrosis factor (TNF)-α and IL-8 increase only at the highest ETS concentration. CONCLUSION Following 180 min of acute, experimental ETS exposure, we observed a significant increase in respiratory symptoms, a decrease in lung function, and an increase in inflammatory cytokines, indicating an acute lung response in asthma.
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Affiliation(s)
- Martin Gaisberger
- Institute of Physiology and Pathophysiology, Paracelsus Medical University, Salzburg, Austria
- Gastein Research Institute, Paracelsus Medical University, Salzburg, Austria
- Ludwig Boltzmann Institute for Arthritis and Rehabilitation, Salzburg, Austria
| | - Romana Elisabeth Wass
- Department of Pneumology, Paracelsus Medical University, Salzburg, Austria
- Department of Pulmonary Medicine, General Hospital Linz (AKH), Linz, Austria
| | - Heidemarie Dobias
- Institute of Physiology and Pathophysiology, Paracelsus Medical University, Salzburg, Austria
- Gastein Research Institute, Paracelsus Medical University, Salzburg, Austria
- Ludwig Boltzmann Institute for Arthritis and Rehabilitation, Salzburg, Austria
| | | | - Gertraud Weiss
- Department of Pneumology, Paracelsus Medical University, Salzburg, Austria
| | - Bernd Lamprecht
- Department of Pulmonary Medicine, General Hospital Linz (AKH), Linz, Austria
| | - Bernhard Kaiser
- Department for Statistics, University of Linz, Linz, Austria
| | - Michael Studnicka
- Department of Pneumology, Paracelsus Medical University, Salzburg, Austria,
| | - Arnulf Hartl
- Institute of Ecomedicine, Paracelsus Medical University, Salzburg, Austria
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12
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Brock JM, Billeter A, Müller-Stich BP, Herth F. Obesity and the Lung: What We Know Today. Respiration 2020; 99:856-866. [PMID: 33242862 DOI: 10.1159/000509735] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Accepted: 06/23/2020] [Indexed: 11/19/2022] Open
Abstract
Obesity is becoming more and more prevalent especially in Western industrial nations. The understanding of adipose tissue as an endocrine organ as well as the detection of adipocytokines - hormones that are secreted from the adipose tissue - gave reason to examine the interactions between adipose tissue and target organs. These efforts have been intensified especially in the context of bariatric surgery as promising weight loss therapy. Interactions between the lung and adipose tissue have rarely been investigated and are not well understood. There are obvious mechanical effects of obesity on lung function explaining the associations between obesity and lung diseases, in particular obesity hypoventilation syndrome, obstructive sleep apnea syndrome, asthma, and chronic obstructive pulmonary disease. The rise in the prevalence of obesity affects the epidemiology of pulmonary diseases as well. The aim of this review is to summarize the current knowledge on interactions, associations, and consequences of obesity and weight loss on lung function and lung diseases. Based on these data, areas for future research are identified.
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Affiliation(s)
- Judith Maria Brock
- Department of Pneumology and Critical Care Medicine, Thoraxklinik and Translational Lung Research Center Heidelberg (TLRCH), University of Heidelberg, Heidelberg, Germany,
| | - Adrian Billeter
- Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany
| | - Beat Peter Müller-Stich
- Department of General, Visceral and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany
| | - Felix Herth
- Department of Pneumology and Critical Care Medicine, Thoraxklinik and Translational Lung Research Center Heidelberg (TLRCH), University of Heidelberg, Heidelberg, Germany
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13
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Soliman NA, Abdel Ghafar MT, El Kolaley RM, Hafez YM, Abo Elgheit RE, Atef MM. Cross talk between Hsp72, HMGB1 and RAGE/ERK1/2 signaling in the pathogenesis of bronchial asthma in obese patients. Mol Biol Rep 2020; 47:4109-4116. [PMID: 32424522 DOI: 10.1007/s11033-020-05531-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Accepted: 05/14/2020] [Indexed: 01/12/2023]
Abstract
BACKGROUND The incidence of obesity-related asthma has shown a remarkable increase. OBJECTIVES We aimed to explore the role of heat shock protein 72 (Hsp72) and receptor for advanced glycation end products (RAGE) axis with its downstream signaling in the pathogenesis of obesity-related asthma. METHODS We enrolled a total of 55 subjects and divided them into three groups. Groups I and II included healthy, normal weight (n = 15) and obese (n = 15) subjects, respectively. Twenty-five obese asthmatics (group III) were subdivided into group IIIa (10 patients with mild to moderate asthma) and group IIIb (15 patients with severe asthma). High mobility group box 1 (HMGB1), interleukin 8 (IL-8), monocyte chemoattractant protein 1 (MCP-1), extracellular signal-regulated protein kinases 1 and 2 (ERK1/2), and urinary Hsp72 were immunoassayed. Hydrogen peroxide (H2O2) and free fatty acids (FFAs) levels were photometrically measured. RAGE mRNA expression was relatively quantified by real-time PCR. RESULTS We found significant elevations of serum HMGB1, IL-8, MCP1, ERK1/2, FFAs, and H2O2 levels as well as urinary Hsp72 levels in obese subjects compared to healthy control. These were more evident in patients with severe asthma (group IIIb). Multivariate regression analysis identified Hsp72 and ERK1/2 as independent predictors of bronchial asthma severity. Receiver operating characteristic (ROC) curve analysis revealed that areas under the curve (AUC) for Hsp72 and ERK1/2 were 0.991 and 0.981, respectively, which denotes a strong predictive value for identifying the severity of bronchial asthma in obese patients. CONCLUSION The current study highlights the role of Hsp72 and HMGB1/RAGE/ERK1/2 signaling cascade in the pathogenesis of bronchial asthma and its link to obesity, which could be reflected on monitoring, severity grading, and management of this disease.
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Affiliation(s)
- Nema Ali Soliman
- Departments of Medical Biochemistry, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Muhammad Tarek Abdel Ghafar
- Departments of Clinical Pathology, Faculty of Medicine, Tanta University, Medical Campus, El-Gash St, Tanta, 31527, Egypt.
| | | | - Yasser Mostafa Hafez
- Departments of Internal Medicine, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Rehab E Abo Elgheit
- Departments of Physiology, Faculty of Medicine, Tanta University, Tanta, Egypt
| | - Marwa Mohamed Atef
- Departments of Medical Biochemistry, Faculty of Medicine, Tanta University, Tanta, Egypt
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14
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Hirvonen E, Karlsson A, Kilpeläinen M, Lindqvist A, Laitinen T. Development of self-assessed work ability among middle-aged asthma patients-a 10 year follow-up study. J Asthma 2020; 58:1042-1050. [PMID: 32308068 DOI: 10.1080/02770903.2020.1759089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVE The prevalence of asthma has been growing among working age people over the last decades. In this study, we examine the development of Work Ability Score (WAS) among middle-aged asthmatics in a longitudinal setting, in order to find risk factors for poor development. METHODS We followed the development of WAS trends during 10 years in a cohort of 529 middle-aged asthmatics, who were active in working life. Follow-up questionnaires were mailed in years 1, 2, 4, 6, 8, and 10. To study the development of WAS over time, we computed the discrete Frechet distance, which describes the similarity between the shapes of WAS curves. RESULTS Sixty-eight percent of the patients' WAS remained good or excellent throughout the follow-up period, while 24% of the patients WAS trend remained moderate. However, in 8%, the WAS was poor already in baseline and decreased further throughout the study. Using logistic regression, the moderate/poor development was associated significantly with high body mass index (BMI), pack years, adult onset asthma, physically strenuous work, number of co-morbidities, especially in psychiatric conditions, hypertension, and gastroesophageal reflux disease(GERD). When the model was adjusted for age and gender, adulthood onset of asthma and pack years lost their significance. Based on medication (high dose of inhaled corticosteroids (ICS) and second controller in use), 8% of the patients had severe asthma. CONCLUSION In the great majority of middle-aged asthma patients WAS remained stable throughout the follow-up period. However, 8% of the patients, who had more severe asthma and multiple co-morbidities, showed significantly poorer outcomes.
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Affiliation(s)
- Eveliina Hirvonen
- Pulmonary Diseases and Clinical Allergology, Turku University Hospital, Turku, Finland.,Pulmonary Diseases and Clinical Allergology, University of Turku, Turku, Finland
| | - Antti Karlsson
- Turku University Hospital and University of Turku, Auria Biobank, Turku, Finland
| | - Maritta Kilpeläinen
- Pulmonary Diseases and Clinical Allergology, Turku University Hospital, Turku, Finland
| | - Ari Lindqvist
- Clinical Research Unit of Pulmonary Diseases, HUS Helsinki University Hospital and Helsinki University, Helsinki, Finland
| | - Tarja Laitinen
- Pulmonary Diseases and Clinical Allergology, Turku University Hospital, Turku, Finland.,Research, Development and Innovation Centre, Tampere University Hospital, Tampere, Finland
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15
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Abrahamsen R, Gundersen GF, Svendsen MV, Klepaker G, Kongerud J, Fell AKM. Possible risk factors for poor asthma control assessed in a cross-sectional population-based study from Telemark, Norway. PLoS One 2020; 15:e0232621. [PMID: 32396562 PMCID: PMC7217450 DOI: 10.1371/journal.pone.0232621] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Accepted: 04/17/2020] [Indexed: 11/30/2022] Open
Abstract
This cross-sectional study of the general population of Telemark County, Norway, aimed to identify risk factors associated with poor asthma control as defined by the Asthma Control Test (ACT), and to determine the proportions of patients with poorly controlled asthma who had undergone spirometry, used asthma medication, or been examined by a pulmonary physician. In 2014–2015, the study recruited 326 subjects aged 16–50 years who had self-reported physician-diagnosed asthma and presence of respiratory symptoms during the previous 12 months. The clinical outcome measures were body mass index (BMI), forced vital capacity (FVC) and forced expiratory volume in one second (FEV1), fractional exhaled nitric oxide (FeNO), immunoglobulin E (IgE) in serum and serum C-reactive protein (CRP). An ACT score ≤ 19 was defined as poorly controlled asthma. Overall, 113 subjects (35%) reported poor asthma control. The odds ratios (ORs) and 95% confidence intervals (CIs) for factors associated with poorly controlled asthma were: self-reported occupational exposure to vapor, gas, dust, or fumes during the previous 12 months (OR 2.0; 95% CI 1.1–3.6), body mass index ≥ 30 kg/m2 (OR 2.2; 95% CI 1.2–4.1), female sex (OR 2.6; 95% CI 1.5–4.7), current smoking (OR 2.8; 95% CI 1.5–5.3), and past smoking (OR 2.3; 95% CI 1.3–4.0). Poor asthma control was also associated with reduced FEV1 after bronchodilation (β –3.6; 95% CI –7.0 to –0.2). Moreover, 13% of the participants with poor asthma control reported no use of asthma medication, 51% had not been assessed by a pulmonary physician, and 20% had never undergone spirometry. Because these data are cross-sectional, further studies assessing possible risk factors in general and objectively measured occupational exposure in particular are needed. However, our results suggest that there is room for improvement with regards to use of spirometry and pulmonary physician referrals when a patient’s asthma is inadequately controlled.
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Affiliation(s)
- Regine Abrahamsen
- Department of Occupational and Environmental Medicine, Telemark Hospital, Skien, Norway
| | | | - Martin Veel Svendsen
- Department of Occupational and Environmental Medicine, Telemark Hospital, Skien, Norway
| | - Geir Klepaker
- Department of Occupational and Environmental Medicine, Telemark Hospital, Skien, Norway
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Johny Kongerud
- Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
- Department of Respiratory Medicine, Oslo University Hospital, Oslo, Norway
| | - Anne Kristin Møller Fell
- Department of Occupational and Environmental Medicine, Telemark Hospital, Skien, Norway
- * E-mail:
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