Authors: Pinja Ilmarinen, Adrienn Pardo, Leena E. Tuomisto, Iida Vähätalo, Onni Niemelä, Pentti Nieminen, Hannu Kankaanranta
Published: 2020-10-08
DOI: 10.1183/13993003.01209-2020
Source: Full article
BackgroundObesity has been associated with poor outcomes of asthma in cross-sectional studies, but long-term effect of obesity on asthma remains unknown.AimsTo study the effects of obesity, found at the time of diagnosis of adult-onset asthma, on 12-year prognosis by focusing on oral corticosteroid (OCS) use and respiratory-related hospital admissions.MethodsPatients diagnosed with adult-onset asthma (n=203) were divided into three categories based on diagnostic body mass index (BMI) (<25 kg·m−2, 25–29.9 kg·m−2, ≥30 kg·m−2) and followed for 12 years as part of the Seinäjoki Adult Asthma Study. Self-reported and dispensed OCS were assessed for the 12-year period. Data on hospital admissions were analysed based on medical records.Results12 years after diagnosis, 86% of the patients who were obese (BMI ≥30 kg·m−2) at diagnosis remained obese. During the follow-up, no difference was found in weight gain between the BMI categories. During the 12-year follow-up, patients obese at diagnosis reported more frequent use of OCS courses (46.9%versus23.1%, p=0.028), were dispensed OCS more often (81.6%versus56.9%, p=0.014) and at higher doses (median 1350 (interquartile range 280–3180) mgversus600 (0–1650) mg prednisolone, p=0.010) compared to normal-weight patients. Furthermore, patients who were obese had more often one or more respiratory-related hospitalisations compared to normal-weight patients (38.8%versus16.9%, p=0.033). In multivariate logistic regression analyses, obesity predicted OCS use and hospital admissions.ConclusionsIn adult-onset asthma, patients obese at diagnosis mostly remained obese at long-term and had more exacerbations and respiratory-related hospital admissions compared to normal-weight patients during 12-year follow-up. Weight loss should be a priority in their treatment to prevent this outcome.