TY - JOUR T1 - Wheezing in morbidly obese patients is not always due to asthma JF - European Respiratory Journal JO - Eur Respir J VL - 38 IS - Suppl 55 SP - p4165 AU - Astrid van Huisstede AU - Arjan Rudolphus AU - Hans Zengerink AU - Gert-Jan van de Geijn AU - Pieter Hiemstra AU - Gert-Jan Braunstahl Y1 - 2011/09/01 UR - http://erj.ersjournals.com/content/38/Suppl_55/p4165.abstract N2 - Background: Morbid obesity is becoming a world wide epidemic. Morbidly obese patients are at risk for asthma.Aim of the study: To investigate the differences in symptoms and lung function test in morbidly obese patients with and without asthma.Methods: A group of 93 morbidly obese patients (BMI>35 kg/m2, age 18-50y) was studied. Asthma was defined as the presence of reversible airway obstruction (ΔFEV1≥12%) and/or PC20 methacholine of <8 mg/ml. Patients with a physician diagnosis asthma, but not fulfilling the criteria of asthma after stopping ICS were defined as “asthma-like symptoms” (asthma-l.s.).Results: 29 patients fulfilled the criteria of asthma, 14 had asthma-l.s., and 50 control group patients. Sex, age, BMI, smoking, abdominal circumference, atopy, FeNO, FVC, DLCO, Eppworth Sleepiness Scale score, GERD questionnaire and steps a day did not differ between the groups. Patients with asthma or asthma-l.s. had significantly more symptoms (wheezing [p<0.001], coughing [p<0.001]), and significant worse AQLQ-scores (mean 5.7 points [p=0.004], 5.5 points [p=0.002] respectively) and ACT-scores (mean 1.1 points [p=0.000] and 1.0 points [p=0.015] respectively) compared to controls (AQLQ 6.5 points, ACT 0.3 points). Patients with asthma had a significantly lower FEV1 (86% pred) and FEV1/FVC (76%pred) than the group with asthma-l.s. (102%pred [p<0.001], and 83%pred [p=0.001] respectively) and the control group (97%pred [p=0.001], and 81%pred [p=0.001] respectively).Conclusion: A significant proportion of the patients with morbid obesity and a history of asthma does not fulfill the criteria of asthma. These patients have the same symptom scores as “asthma-like symptoms” asthmatics, despite supranormal lung function parameters. ER -