Effect of increased body mass index on asthma risk, impairment and response to asthma controller therapy in African Americans

Carlos A. Camargo, E. Rand Sutherland, William Bailey, Mario Castro, Steven W. Yancey, Amanda H. Emmett, David A. Stempel

Research output: Contribution to journalArticlepeer-review

35 Scopus citations

Abstract

Objective: To explore whether obesity alters the risk, impairment and response to treatment in African Americans with asthma. Methods: The data used for this secondary analysis are from a 1-year study in African American subjects comparing fluticasone propionate/salmeterol 100/50g combination (FSC) and fluticasone propionate 100g (FP). Subjects were retrospectively stratified by body mass index (BMI) <20 [underweight], 2024.9 [normal weight], 2529.9 [overweight], 3034.9 [obese I], 3539.9 [obese II], and 40 [obese III] kg/m 2. Outcomes studied included impairment domains: FEV1, morning and evening peak expiratory flow (AM and PM PEF), daily albuterol use, daily symptom scores and future risk domain: exacerbations. Clinical trial registration: www.clinicaltrials.gov; NCT00102765 Results: There were 475 subjects evenly distributed between FSC and FP by baseline parameters. There were 207 subjects with a BMI 30, including 70 subjects with a BMI 40. Baseline BMI 40 was associated with numerically lower baseline AM and PM PEF. There was an attenuation of response to both treatments for only PM PEF (p<0.05). By contrast, subjects with lower degrees of obesity or overweight did not differ from those with normal weight. The total population exacerbation rate was 2-fold greater in obese III subjects (39) compared with subjects in other BMI categories (1621) (p<0.05). A potential study limitation is the retrospective analysis of existing data. Discussion: Response to treatment was attenuated for PM PEF for subjects with BMI 40 and was also associated with an increased rate of asthma exacerbations.

Original languageEnglish
Pages (from-to)1629-1635
Number of pages7
JournalCurrent Medical Research and Opinion
Volume26
Issue number7
DOIs
StatePublished - Jul 2010

Keywords

  • African American
  • Asthma
  • Body mass index
  • Fluticasone propionate
  • Salmeterol

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