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Incidence of asthma and net change in symptoms in relation to changes in obesity

¹ Respiratory Epidemiology and Public Health Group, Imperial College London, London, UK. ² Institute of Social and Preventive Medicine, University of Basel, Basel, and, ⁴ Division of Pulmonary Medicine, University of Geneva, Geneva, Switzerland. ³ Centre de Recerca en Epidemiologia Ambiental (CREAL-IMIM), Universitat Pompeu Fabra (UPF), and, ⁸ Institució Catalana de Recerca i Estudis Avançats (ICREA), Barcelona, Spain. ⁵ INSERM - The French Institute of Health and Medical Research, Unit 700 - Epidemiology, Faculty of Medicine X Bichat, Paris, France. ⁶ University of Verona, Department of Medicine and Public Health, Division of Epidemiology and Statistics, Verona, Italy. ⁷ Respiratory Medicine and Allergology, University of Uppsala, Uppsala, Sweden. ⁹ Keck School of Medicine, University of Southern California, Los Angeles, CA, USA., ¹⁰ Dept of Thoracic Medicine, 5021 Haukeland Hospital, Bergen, Norway.

CORRESPONDENCE: S. Chinn, Dept of Public Health Sciences, King's College London, 5th Floor Capital House, 42 Weston Street, London, SE1 3QD, UK. Fax: 44 2078486605. E-mail: sue.chinn{at}kcl.ac.uk

Keywords: Asthma, incidence, obesity, prevalence, symptoms

Received: December 21, 2005
Accepted July 13, 2006

The incidence of asthma has been reported to be associated with obesity. An alternative analysis, of net change in prevalence, does not require exclusion of those with asthma at baseline.

Follow-up data were obtained from 9,552 participants in the European Community Respiratory Health Survey and the Swiss cohort Study on Air Pollution and Lung Disease in Adults. Incidence of asthma was analysed by proportional hazards regression, and net changes in symptoms and asthma status by generalised estimating equations, by obesity group.

Incidence and net change in ever having had asthma were greater in females than in males, and in participants who remained obese compared with those who were never obese (hazard ratio 2.00, 95% confidence interval 1.25–3.20; excess net change 2.8%, 0.4–5.3% per 10 yrs). The effect of being obese on net change in diagnosed asthma was greater in females than in males, but for net change in wheeze without a cold it was greater in males.

The present results are consistent with asthma being more frequently diagnosed in females, especially obese females. These findings may help to explain the reports of a stronger association between asthma and obesity in females than in males.

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