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Body mass index’s effect on CRSwNP extends to pathological endotype and recurrence
1Department of Otolaryngology-Head and Neck Surgery, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.
Elevated body mass index (BMI) in chronic rhinosinusitis with nasal polyps (CRSwNP) patients is linked to distinct immunological profiles and increased recurrence. Conventional recurrence predictors are less effective in overweight/obese CRSwNP individuals.
Area of Science:
- Otorhinolaryngology
- Immunology
- Obesity Research
Background:
- Elevated body mass index (BMI) is a known factor in corticosteroid insensitivity for chronic rhinosinusitis with nasal polyps (CRSwNP).
- Understanding the impact of BMI on CRSwNP immunological endotypes and disease recurrence is crucial.
Purpose of the Study:
- To investigate the effects of elevated BMI on the immunological endotype of CRSwNP.
- To determine the relationship between BMI and the recurrence of CRSwNP.
Main Methods:
- 325 CRSwNP patients undergoing FESS were stratified by BMI.
- Histological and immunohistochemical staining were used to evaluate inflammatory patterns.
- Multivariable logistic regression and ROC curves analyzed recurrence predictors across BMI groups.
Main Results:
- Overweight/obese CRSwNP patients (26.15%) showed higher symptom burden and distinct endotypes with eosinophil/neutrophil dominance and type 2/3 inflammation.
- Overweight/obese individuals had a higher recurrence rate.
- BMI was an independent predictor of recurrence, but conventional parameters showed poor predictive capacity in this group.
Conclusions:
- Overweight/obese CRSwNP represents a unique phenotype and endotype.
- Current biomarkers for predicting recurrence are inadequate for overweight/obese CRSwNP patients.
- Novel biomarkers are needed to predict recurrence in overweight/obese CRSwNP.
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