TY - JOUR T1 - Can overweight/obesity and smoking have combined effects on bronchial hyperresponsiveness? JF - European Respiratory Journal JO - Eur Respir J SP - 651 LP - 653 DO - 10.1183/09031936.00099513 VL - 43 IS - 2 AU - Bruno Sposato AU - Marco Scalese Y1 - 2014/02/01 UR - http://erj.ersjournals.com/content/43/2/651.2.abstract N2 - To the Editor:We read with interest the article by Juusela et al. [1], which showed a significant risk factor for bronchial hyperresponsiveness (BHR) with a dose-dependent pattern and which underlined that BHR severity increases with increased smoking (pack-years) in an adult sample of the general population. Unfortunately, in their study the authors did not analyse a possible additional influence of overweight/obese status on BHR. In fact, several researchers have shown that the overweight/obese condition may be a risk factor for BHR (adjusted for smoking), both in healthy subjects and, in particular, in asthmatics [2–4]. A fair amount of subjects of the study of Juusela et al. [1] were most likely affected by asthma: most of them had a marked BHR, some had forced expiratory volume in 1 s (FEV1) <80% and FEV1 to forced vital capacity (FVC) ratio <70, others were allergic, others had had a history of wheezing or asthma in childhood, while others had elevated exhaled nitric oxide fraction values. To the best of our knowledge, there are no studies that have investigated the combined impact of body mass index (BMI) and smoking on BHR. Therefore, we tried to investigate such a possible influence by retrospectively analysing a … ER -