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Effect of Obesity on the Development and Clinical Presentation of Asthma

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Obesity and Lung Disease

Part of the book series: Respiratory Medicine ((RM,volume 19))

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Abstract

Obesity is associated with increased risk for both prevalent and incident asthma in a dose-response relationship. It is still not clear how this association is modified by atopy or sex. It appears that abdominal adiposity rather than global adiposity drives this association, but the role of visceral fat remains unstudied. The association further does not yet fully meet the causality criteria in humans. The mechanistic basis for the association is not fully known, but multiplicity of pathways is suspected including the mechanical and metabolic/inflammatory effects of obesity on the airways. Leptin and adiponectin have been suggested as mediators in the obesity-asthma association, but this data is currently better established in mice than in humans. Multiple comorbidities of obesity, such as gastroesophageal reflux disease, sleep apnea, and depression, may partly affect the disease manifestation in the obese subject. Interestingly, the clinical manifestations of asthma are more pronounced in obese than normal-weight asthmatics, but the physiological and inflammatory manifestations do not generally differ. Similarly, weight reduction improves clinical asthma outcomes without improving markers of airway eosinophilic inflammation. Obese patients with asthma also show a reduced beneficial response to asthma medications, particularly to inhaled corticosteroids. Currently, there remain critical gaps in our understanding of this association such as the “uniqueness” of the obesity-associated asthma phenotype.

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Authors and Affiliations

  1. Department of Medicine, University of New Mexico Health Sciences Center School of Medicine, 1 University of New Mexico MSC 10 5550, Albuquerque, NM, 87131, USA

    Akshay Sood M.D., M.PH.

  2. Department of Medicine, University of Vermont College of Medicine, 89 Beaumont Avenue Given D209, Burlington, VT, 05482, USA

    Anne E. Dixon M.A., BM, BCh

Authors
  1. Akshay Sood M.D., M.PH.
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  2. Anne E. Dixon M.A., BM, BCh
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Correspondence to Akshay Sood M.D., M.PH. .

Editor information

Editors and Affiliations

  1. , Pulmonary and Critical Care Medicine, University of Vermont College of Medicin, 89 Beaumont Ave., Burlington, 05405, Vermont, USA

    Anne E. Dixon

  2. , Clinical Development Medical Affairs, Respiratory Boehringer Ingelheim Pharmac, N/A, Ridgefield, 06877, Connecticut, USA

    Emmanuelle M. Clerisme-Beaty

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Sood, A., Dixon, A.E. (2013). Effect of Obesity on the Development and Clinical Presentation of Asthma. In: Dixon, A., Clerisme-Beaty, E. (eds) Obesity and Lung Disease. Respiratory Medicine, vol 19. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-62703-053-3_6

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  • DOI: https://doi.org/10.1007/978-1-62703-053-3_6

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