Effect of multiple measures of obesity on asthma control among Nigerians
College of Medicine, University of Ibadan
Background: Asthma and obesity are disorders with a significant public health impact. There is evidence from literature suggesting that obesity is a risk factor for developing asthma and possible poor asthma control. The systemic inflammatory responses in obesity lead to metabolic, cardiovascular, and respiratory complications. There is a 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) the 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 the 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.
Airway obstruction , Spirometry , asthma control , adiposity , Obesity , Asthma , Research Subject Categories::MEDICINE
Ojo O, Ozoh O, Dania M, Adeyeye O, Adeniyi B, Fasanmade O, Bandele E. Effect of multiple measures of obesity on asthma control among Nigerians. Afr J Med Med Sci 2022;51:31-40