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1 Dept of Medical Sciences: Respiratory Medicine and Allergology, Uppsala University, Uppsala,, 4 Dept of Pulmonary Medicine and Allergology, University Hospital of Northern Sweden, Umeå,, 5 Section of Occupational and Environmental Medicine and Section of Allergology, Sahlgrenska University Hospital, Gothenburg, Sweden,, 2 Dept of Thoracic Medicine and Centre for Clinical Research, Haukeland University Hospital, Bergen, Norway, 3 Dept of Allergy and Respiratory Medicine, Landspitali University Hospital, Reykjavik, Iceland, 6 Foundation Tartu University Clinics, Lung Clinic, Tartu, Estonia, 7 Dept of Respiratory Diseases, University Hospital of Aarhus, Aarhus, Denmark
CORRESPONDENCE: M.I. Gunnbjörnsdóttir, Dept of Medical Sciences: Respiratory Medicine and Allergology, Akademiska Sjukhuset, SE 751 85 Uppsala, Sweden. Fax: 46 186110228. E-mail: maria.gunnbjornsdottir@medsci.uu.se
Keywords: Asthma, epidemiology, gastro-oesophageal reflux, habitual snoring, obesity, respiratory symptoms
Received: April 15, 2003
Accepted January 23, 2004
The study was supported financially by the Icelandic Research Council, the Swedish Heart and Lung Foundation, the Vårdal Foundation for Health Care Science and Allergy Research, the Swedish Association against Asthma and Allergy, the Norwegian Research Council, the Norwegian Asthma and Allergy Association, the Danish Lung Association and the Estonian Science Foundation.
Several studies have identified obesity as a risk factor for asthma in both children and adults. An increased prevalence of asthma in subjects with gastro-oesophageal reflux (GOR) and obstructive sleep apnoea syndrome has also been reported. The aim of this investigation was to study obesity, nocturnal GOR and snoring as independent risk factors for onset of asthma and respiratory symptoms in a Nordic population.
In a 5–10 yr follow-up study of the European Community Respiratory Health Survey in Iceland, Norway, Denmark, Sweden and Estonia, a postal questionnaire was sent to previous respondents.
A total of 16,191 participants responded to the questionnaire. Reported onset of asthma, wheeze and night-time symptoms as well as nocturnal GOR and habitual snoring increased in prevalence along with the increase in body mass index (BMI). After adjusting for nocturnal GOR, habitual snoring and other confounders, obesity (BMI >30) remained significantly related to the onset of asthma, wheeze and night-time symptoms. Nocturnal GOR was independently related to the onset of asthma and in addition, both nocturnal GOR and habitual snoring were independently related to onset of wheeze and night-time symptoms.
This study adds evidence to an independent relationship between obesity, nocturnal gastro-oesophageal reflux and habitual snoring and the onset of asthma and respiratory symptoms in adults.
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