Effect of increased body mass index on asthma risk, impairment and response to asthma controller therapy in African Americans

Curr Med Res Opin. 2010 Jul;26(7):1629-35. doi: 10.1185/03007995.2010.483113.

Abstract

Objective: To explore whether obesity alters the risk, impairment and response to treatment in African Americans with asthma.

Methods: The data used for this secondary analysis are from a 1-year study in African American subjects comparing fluticasone propionate/salmeterol 100/50 microg combination (FSC) and fluticasone propionate 100 microg (FP). Subjects were retrospectively stratified by body mass index (BMI) <20 [underweight], 20-24.9 [normal weight], 25-29.9 [overweight], 30-34.9 [obese I], 35-39.9 [obese II], and >or=40 [obese III] kg/m(2). Outcomes studied included impairment domains: FEV(1), morning and evening peak expiratory flow (AM and PM PEF), daily albuterol use, daily symptom scores and future risk domain: exacerbations.

Clinical trial registration: www.clinicaltrials.gov; NCT00102765.

Results: There were 475 subjects evenly distributed between FSC and FP by baseline parameters. There were 207 subjects with a BMI >or=30, including 70 subjects with a BMI >or=40. Baseline BMI >or=40 was associated with numerically lower baseline AM and PM PEF. There was an attenuation of response to both treatments for only PM PEF (p < 0.05). By contrast, subjects with lower degrees of obesity or overweight did not differ from those with normal weight. The total population exacerbation rate was 2-fold greater in obese III subjects (39%) compared with subjects in other BMI categories (16-21%) (p < 0.05). A potential study limitation is the retrospective analysis of existing data.

Discussion: Response to treatment was attenuated for PM PEF for subjects with BMI >or=40 and was also associated with an increased rate of asthma exacerbations.

Publication types

  • Evaluation Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • African Americans* / statistics & numerical data
  • Aged
  • Anti-Asthmatic Agents / therapeutic use*
  • Asthma / diagnosis
  • Asthma / drug therapy*
  • Asthma / ethnology
  • Asthma / etiology*
  • Body Mass Index*
  • Child
  • Double-Blind Method
  • Female
  • Humans
  • Male
  • Middle Aged
  • Multicenter Studies as Topic
  • Randomized Controlled Trials as Topic
  • Retrospective Studies
  • Risk Factors
  • Treatment Outcome
  • Young Adult

Substances

  • Anti-Asthmatic Agents

Associated data

  • ClinicalTrials.gov/NCT00102765