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Many obese individuals experience wheezing, rather than asthma. A Mendelian randomization study of 86,019 adults

Yunus Çolak, Shoaib Afzal, Peter Lange, Børge Nordestgaard
European Respiratory Journal 2015 46: OA4463; DOI: 10.1183/13993003.congress-2015.OA4463
Yunus Çolak
1Department of Internal Medicine, Section of Respiratory Medicine, Herlev Hospital, Copenhagen University Hospital, Herlev, Denmark
2Department of Public Health, Section of Social Medicine, University of Copenhagen, Copenhagen, Denmark
3The Copenhagen General Population Study, Herlev Hospital, Copenhagen University Hospital, Herlev, Denmark
4Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Shoaib Afzal
3The Copenhagen General Population Study, Herlev Hospital, Copenhagen University Hospital, Herlev, Denmark
4Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
5Department of Clinical Biochemistry, Herlev Hospital, Copenhagen University Hospital, Herlev, Denmark
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Peter Lange
2Department of Public Health, Section of Social Medicine, University of Copenhagen, Copenhagen, Denmark
3The Copenhagen General Population Study, Herlev Hospital, Copenhagen University Hospital, Herlev, Denmark
4Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
6Medical Unit, Respiratory Section, Hvidovre Hospital, Copenhagen University Hospital, Hvidovre, Denmark
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Børge Nordestgaard
3The Copenhagen General Population Study, Herlev Hospital, Copenhagen University Hospital, Herlev, Denmark
4Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
5Department of Clinical Biochemistry, Herlev Hospital, Copenhagen University Hospital, Herlev, Denmark
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Abstract

Background: Observational studies suggest that obesity is associated with increased risk of asthma. However, it is unknown whether this could be explained by wheezing.

Objective: We tested the hypothesis that observational and genetic high body mass index(BMI) are associated with wheezing and asthma.

Methods: We genotyped 86,019 individuals aged 20-100 years from the Copenhagen General Population Study for FTO(rs9939609), MC4R(rs17782313), and TMEM18(rs6548238); 13,908 individuals experienced wheezing and 5,612 had asthma. Wheezing was self-reported, and asthma was ascertained through self-report, hospital contacts with asthma, and/or receiving medication for asthma.

Results: In observational analyses versus BMI of 18.5-22.4kg/m2, odds ratios(ORs) for wheezing were 2.68(95% confidence interval:2.49-2.88) for BMI of 30-34.9kg/m2, 4.20(3.79-4.66) for 35-39.9kg/m2, and 6.45(5.46-7.61) for BMI≥40kg/m2. Corresponding ORs for asthma were 1.46(1.32-1.62), 1.60(1.37-1.88), and 2.05(1.61-2.62), respectively. Compared with BMI allele score 0-2, score 3 and 4-6 were associated with 0.30 and 0.67kg/m2 higher BMI. In genetic analyses versus allele score 0-2, ORs for wheezing were 1.05(1.01-1.10) and 1.11(1.06-1.17) for allele score 3 and 4-6. Corresponding ORs for asthma were 1.02(0.95-1.08) and 1.02(0.95-1.10). Genetically determined ORs per unit higher BMI were 1.17(1.09-1.25) for wheezing and 1.03(0.93-1.14) for asthma. Corresponding observational ORs were 1.10(1.09-1.10) and 1.03(1.03-1.04).

Conclusions: Genetically high BMI was associated with wheezing, but not with asthma. Thus, these findings suggest that asthma may be misdiagnosed based on wheezing in many obese individuals.

  • Asthma - diagnosis
  • Genetics
  • Epidemiology
  • Copyright ©ERS 2015
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Many obese individuals experience wheezing, rather than asthma. A Mendelian randomization study of 86,019 adults
Yunus Çolak, Shoaib Afzal, Peter Lange, Børge Nordestgaard
European Respiratory Journal Sep 2015, 46 (suppl 59) OA4463; DOI: 10.1183/13993003.congress-2015.OA4463

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Many obese individuals experience wheezing, rather than asthma. A Mendelian randomization study of 86,019 adults
Yunus Çolak, Shoaib Afzal, Peter Lange, Børge Nordestgaard
European Respiratory Journal Sep 2015, 46 (suppl 59) OA4463; DOI: 10.1183/13993003.congress-2015.OA4463
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