Asthma and extrapulmonary comorbidities in a middle-aged general population: results from the SCAPIS study

Asthma may increase the risk of comorbidities and systemic inflammation, but population data are scarce. This study aimed to compare comorbidities and systemic inflammation between those with and without current asthma and to identify characteristics linked to comorbidities and biomarkers.

In a cross-sectional analysis of 28 828 people aged 50-64 in the Swedish CArdioPulmonary bioImage Study, assessments included postbronchodilator forced expiratory volume in 1 s (FEV₁), forced vital capacity (FVC), serum levels of C reactive protein (CRP) and haemoglobin A1c (HbA1c). Data on current physician-diagnosed asthma, respiratory symptoms and comorbidities were obtained via a questionnaire.

The prevalence of current asthma was 6.3%. Current asthma was independently associated with a higher prevalence of hypertension (OR=1.30; 95% CI 1.16 to 1.46), hyperlipidaemia (OR=1.20; 95% CI 1.04 to 1.39), diabetes (OR=1.42; 95% CI 1.16 to 1.75), coeliac disease (OR=2.52; 95% CI 1.61 to 3.95) and rheumatic disease (OR=1.43; 95% CI 1.16 to 1.78). Asthma was also associated with higher levels of CRP (beta=0.25; 95% CI 0.06 to 0.44) and HbA1c (beta=0.47; 95% CI 0.18 to 0.77). In those with asthma, lower FVC % predicted was associated with a higher likelihood of hypertension (OR=1.10; 95% CI 1.01 to 1.19), diabetes (OR=1.47; 95% CI 1.26 to 1.71) and rheumatic disease (OR=1.22; 95% CI 1.05 to 1.42). Lower FEV₁ % predicted was associated with a higher likelihood of diabetes (OR=1.27; 95% CI 1.12 to 1.44). FVC % and FEV₁ % predicted were negatively associated with CRP and HbA1c.

Our findings suggest that in middle-aged people, asthma is independently associated with common comorbidities such as hypertension, diabetes and rheumatic disease, as well as elevated CRP and blood glucose. Our data suggest that some associations are connected with lung function impairment in those with asthma.