Impact of metabolic and weight components on incident asthma using a real-world cohort

Ann Allergy Asthma Immunol. 2024 Dec;133(6):660-666.e5. doi: 10.1016/j.anai.2024.09.005. Epub 2024 Sep 16.

Abstract

Background: Obesity and metabolic dysregulation (MetD) have increasing prevalence and adversely affect asthma morbidity and therapeutic response.

Objective: To determine the role of weight and MetD on incident asthma in adulthood.

Methods: In a retrospective, longitudinal cohort of patients, we performed a time-to-asthma diagnosis analysis after a 3-year landmark period (t0-t3) during which weight and MetD components were evaluated. We assessed incident asthma risk with MetD components and weight.

Results: In total, 90,081 patients met the inclusion criteria, with 836 cases (0.93%) of incident asthma in our primary cohort. Diabetes present at t0, but no other MetD components, was associated with increased risk of asthma (adjusted hazard ratio = 1.85, 95% CI: 1.27-2.71, P = .0002). The effect of weight on asthma risk, independent of other MetD components, identified individuals with overweight or obesity as having a 10-year attributable risk of 15.4%. Metformin was prescribed more frequently, and hemoglobin A1c levels were lower in patients with diabetes in whom asthma did not develop (P < .0001).

Conclusion: Weight and diabetes prevention and management represent modifiable risk factors for adult asthma development.

MeSH terms

  • Adult
  • Aged
  • Asthma* / epidemiology
  • Body Weight
  • Diabetes Mellitus / epidemiology
  • Female
  • Glycated Hemoglobin / analysis
  • Glycated Hemoglobin / metabolism
  • Humans
  • Incidence
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Obesity* / complications
  • Obesity* / epidemiology
  • Retrospective Studies
  • Risk Factors

Substances

  • Glycated Hemoglobin