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Allergy Asthma Clin Immunol. 2016 Oct 19;12:50. eCollection 2016.

Interacting effects of obesity, race, ethnicity and sex on the incidence and control of adult-onset asthma.

Author information

1
Department of Research and Evaluation, Kaiser Permanente Southern California, 100 S. Los Robles, 2nd Floor, Pasadena, CA 91101 USA.
2
Institute for Health Research, Kaiser Permanente Colorado, 10065 E. Harvard Street Suite 300, Denver, CO 80231 USA.
3
Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA 94612 USA.
4
Mid-Atlantic Permanente Research Institute, Kaiser Permanente Mid-Atlantic States, 2101 East Jefferson Street 3 West, Rockville, MD 20852 USA.
5
Center for Health Research-Hawaii, Kaiser Permanente Hawaii, 501 Alakawa Street Suite 201, Honolulu, HI 96817 USA.

Abstract

BACKGROUND:

To improve care and control for patients with adult-onset asthma, a better understanding of determinants of their risk and outcomes is important. We investigated how associations between asthma, asthma control and obesity may be modified by patient demographic characteristics.

METHODS:

This retrospective study of adults enrolled in several health plans across the U.S. (n = 2,860,305) examined the interacting effects of obesity, age, race, and sex on adult-onset asthma and asthma control. Multivariable adjusted Cox and logistic regression models estimated hazard ratios (HR), and 95 % confidence intervals (CI) for the associations between body mass index (BMI) and study outcomes, and interactions of BMI with demographic characteristics.

RESULTS:

Compared with individuals who had a BMI <25 kg/m2, the hazard of adult-onset asthma progressively increased with increasing BMI, from a 12 % increase among persons with a BMI of 25.0-29.9 kg/m2 (HR 1.12, 95 % CI 1.10, 1.14) to an almost 250 % increase among persons with a BMI ≥50 kg/m2 (HR 2.49, 95 % CI 2.38, 2.60). The magnitude of the association between obesity and asthma risk was greater for women (compared with men) and lower for Blacks (compared with non-Hispanic Whites). Among individuals with asthma, obesity was associated with poorly controlled and high-risk asthma.

CONCLUSIONS:

The present study demonstrates that the magnitude of the associations between obesity and adult-onset asthma incidence and control are modified by race, age, and sex. Understanding the role of obesity in the development of adult-onset asthma will help to improve asthma treatment algorithms and to develop targeted interventions.

KEYWORDS:

Adult-onset; Asthma; Ethnicity; Obesity; Race; Sex

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