Obesity affects type 2 biomarker levels in asthma
Varun Sharma1, Helen Clare Ricketts1, Femke Steffensen2
1College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, UK.
Summary
Obesity is linked to lower Type 2 (T2) inflammation biomarkers in asthma, even after accounting for steroid use. This finding impacts how asthma is classified and treated with biologics.
Area of Science:
- Respiratory Medicine
- Immunology
- Obesity Research
Background:
- Type 2 (T2) inflammation is a key target for biologic therapies in asthma.
- Obesity's influence on T2 biomarkers in asthma is not fully understood, especially considering corticosteroid use.
Purpose of the Study:
- To investigate the association between Body Mass Index (BMI) and T2 biomarkers (FeNO, eosinophils) in asthma.
- To determine if BMI affects T2 biomarker levels after adjusting for covariates like inhaled (ICS) and oral corticosteroid (OCS) use.
Main Methods:
- Retrospective analysis of data from 153 asthma participants.
- Measurements included BMI, fractional exhaled nitric oxide (FeNO), and eosinophil counts.
- Correlation and regression analyses were performed, adjusting for covariates.
Main Results:
- Increased BMI was associated with reduced FeNO levels overall and in difficult-to-treat asthma.
- Eosinophil levels were also lower in individuals with higher BMI in difficult-to-treat asthma.
- These associations persisted after adjusting for sex, age, smoking, atopy, rhinitis, ICS, and OCS use.
Conclusions:
- Higher BMI is associated with lower FeNO and eosinophil levels in asthma, independent of steroid use.
- Obesity may mask underlying T2-high asthma or indicate a distinct T2-low endotype.
- These findings have implications for asthma endotyping and biologic therapy eligibility.
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