In patients with asthma, obesity status is associated with poor control and high exacerbation rates, which are reversed after bariatric surgery

IF 3.5 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Respiratory medicine Pub Date : 2025-01-01 DOI:10.1016/j.rmed.2024.107917

Manon Belhassen , Clarisse Marchal , Floriane Deygas , Flore Jacoud , Eric Van Ganse

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Abstract

Background

In asthma, obesity status is associated with poor control and high exacerbation rates. The primary objective was to determine the effect of bariatric surgery (BS) on asthma control and exacerbations.

Methods

Retrospective study with a 3-year cohort of obese patients before and after BS: a baseline period (P0) covering the 12 months before BS and P1 and P2 periods covering the first and second years after BS, respectively. Asthma control was assessed from the use of relievers, and severe exacerbation rates, i.e. use of oral corticosteroids and asthma-related hospitalizations (ARHs). P1 and P2 measures were compared with those of P0. Patients were matched with non-obese patients and compared over P0 using a generalized linear mixed model with random effects.

Results

2601 asthma patients undergoing BS were included. Of these, 2556 patients were matched with 2556 nonobese asthma patients. After BS, the risk of poor control decreased [OR = 0.26 (95 % CI: 0.21–0.32)] together with the mean exacerbation rate, with IRRs of 0.54 (95 % CI: 0.51–0.58) and 0.60 (95 % CI: 0.56–0.64) for P1 and P2, respectively, compared with P0. The incidence risk ratios (IRRs) were of 1.19 (95 % CI: 1.04–1.35) and 1.28 (95 % CI: 1.20–1.37) for poor control and severe exacerbation rates, respectively, in obese vs. nonobese asthma patients.

Conclusion

In patients with asthma, obesity is a major risk factor for poor control and increased exacerbation rates, with both outcomes highly reversible for at least two years following BS.

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在哮喘患者中，肥胖状态与控制不良和高加重率相关，这在减肥手术后是逆转的。

背景：在哮喘中，肥胖状态与控制不良和高加重率相关。主要目的是确定减肥手术（BS）对哮喘控制和恶化的影响。方法：对BS前后3年的肥胖患者进行回顾性研究：基线期（P0）分别为BS前12个月和BS后1年和2年的P1和P2期。从缓解剂的使用和严重恶化率（即口服皮质类固醇的使用和哮喘相关住院治疗（ARHs））来评估哮喘控制。将P1、P2措施与P0措施进行比较。将患者与非肥胖患者进行匹配，并使用具有随机效应的广义线性混合模型对P0进行比较。结果：纳入2,601例接受BS治疗的哮喘患者。其中，2556名患者与2556名非肥胖哮喘患者配对。BS后，控制不良的风险降低[OR=0.26 (95% CI: 0.21-0.32)]，平均加重率降低，与P0相比，P1和P2的irs分别为0.54 （95% CI: 0.51-0.58）和0.60 （95% CI: 0.56-0.64）。在肥胖和非肥胖哮喘患者中，控制不良和严重加重率的发生率风险比（IRRs）分别为1.19 （95% CI: 1.04-1.35）和1.28 （95% CI: 1.20-1.37）。结论：在哮喘患者中，肥胖是控制不良和加重率增加的主要危险因素，这两种结果在BS后至少两年内都是高度可逆的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Respiratory medicine 医学-呼吸系统

CiteScore

7.50

自引率

0.00%

发文量

199

审稿时长

38 days

期刊介绍： Respiratory Medicine is an internationally-renowned journal devoted to the rapid publication of clinically-relevant respiratory medicine research. It combines cutting-edge original research with state-of-the-art reviews dealing with all aspects of respiratory diseases and therapeutic interventions. Topics include adult and paediatric medicine, epidemiology, immunology and cell biology, physiology, occupational disorders, and the role of allergens and pollutants. Respiratory Medicine is increasingly the journal of choice for publication of phased trial work, commenting on effectiveness, dosage and methods of action.