Resum
Background: Asthma and obesity are disorders with
a significant public health impact. There is evidence
from literatures suggesting that obesity is a risk factor
for developing asthma and possible poor asthma
control. The systemic inflammatory responses in
obesity leads to metabolic, cardiovascular and
respiratory complications. There is paucity of data
regarding the prevalence of obesity among asthma
patients in Nigeria using different measures of
adiposity. In addition, the relationship between obesity
and asthma control has not been well elucidated. This
is a potential area of intervention in the management
of asthma to improve asthma control.
Aim: To determine the prevalence of obesity among
patients with asthma and explore the relationship
between different measures of adiposity and
measures of asthma control.
Methods: This was a cross sectional study among
asthma patients attending the Respiratory Clinic of
the Lagos University Teaching Hospital. We
measured Weight and height for body mass index
(BMI) calculation, waist circumference (WC) and
hip circumferences for waist-hip-ratio (WHR), and
triceps skin fold thickness (TSFT). We assessed
asthma control using the Asthma control test
questionnaire (ACT) scores and spirometry
measurement with pre-bronchodilator forced
expiratory volume in first second (PRE-FEV1)
values. We also explored the relationship between
different measures of adiposity and asthma control
using univariate and multivariate linear regression
analysis.
Results: Two hundred asthma patients who
performed adequate spirometry were included in the
analysis (96 females and 104 males). Frequency of
obesity using: BMI>30kg.m2 was 18.0%, WC >88cm
for females or >102 for males was 34.0%, WHR>0.85
for females or >0.9 for males was 56.5% and TSFT
>23mm for females or >12mm for males was 28.5%.
There was a significant inverse relationship between
the FEV1 and measures of adiposity on univariate
linear regression analysis (BMI: r2= -0.175 p =
0.013, WC: r2= -0.209 p= 0.003, WHR: r2= -0.148
p=0.036). There was no significant relationship
between measures of adiposity and ACT score. On
multivariate regression analysis after controlling for
age, sex, comorbidities (including smoking, GERD
and rhinitis), measures of adiposity were not
significant determinants of asthma control: ACT
[BMI-OR=0.569 : 95%CI(0.245-1.328) P=
0.193,WHR-OR= 0.996: 95%CI(0.467-2.114)
P=0.987 , TSFT-OR=0.699 : 95%CI(0.310-1.578)
P=0.389] and FEV1[BMI-OR= 1.392: 95%CI(0.591-
3.283) P= 0.449,WHR-OR= 1.191: 95%CI(0.551-
2.575) P=0.657 , TSFT-OR= 1.647: 95%CI(0.707-
3.833) P=0.247].
Conclusion: The prevalence of obesity among
patients with asthma varies depending on the measure
of adiposity used. Obesity negatively impacts on the
lung function. None of the measures of obesity was
an independent determinant of poor asthma control.
This is a potential target area for improving asthma
control among asthma patients.
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