Impact of metabolic and weight components on incident asthma using a real-world cohort
Melissa H Bloodworth1, Patrick J Staso1, Shi Huang2
1Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee.
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.
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