Prevalence of Comorbidities in Asthma and Nonasthma Patients: A Meta-analysis

Abstract

This study compares the prevalence rates of comorbidities between asthma and nonasthma control patients reported in the literature.Literature was searched in several electronic databases. After the selection of studies by following précised eligibility criteria, meta-analyses of odds ratios were carried out with subgroup and sensitivity analyses.Eleven studies studying 117,548 asthma patients compared with 443,948 non-asthma controls were included in the meta-analysis. The prevalence of cardiovascular comorbidities (odds ratio (OR): [95% CI] 1.90 [1.70, 2.14]; P < 0.00001), cerebrovascular comorbidities (OR 1.44 [1.29, 1.60]; P < 0.00001), obesity (OR 1.51 [1.14, 2.01]; P < 0.00001), hypertension (OR 1.66 [1.47, 1.88]; P < 0.00001, diabetes (OR 1.25 [1.08, 1.44]; P < 0.00001), other metabolic and endocrine comorbidities (OR 1.60 [1.40, 1.83]; P < 0.00001), psychiatric and neurological comorbidities (OR 1.62 [1.44, 1.82]; P < 0.00001), gut and urinary comorbidities (OR 1.91 [1.47, 2.49]; P < 0.00001),), cancer (OR 1.17 [1.10, 1.25]; P < 0.00001), and respiratory comorbidities (OR 5.60 [4.22, 7.44]; P < 0.00001) were significantly higher in the asthma patients in comparison with nonasthma controls.Asthma is associated with significantly higher comorbidities including cardio-/cerebrovascular diseases, obesity, hypertension, diabetes, psychiatric and neurological comorbidities, gut and urinary conditions, cancer, and respiratory problems other than asthma. Respiratory comorbidities are found 5 times more prevalent in asthma than in non-asthma patients.

FIGURE 1

A flowchart of the literature search, study screening, and selection process.

FIGURE 2

A funnel plot of the overall meta-analysis of metabolic and endocrine comorbidities reflecting publication bias.

FIGURE 3

Forest plots showing significantly higher prevalence of cardiovascular and cerebrovascular comorbidities in asthma patients. CAD = coronary artery disease, CeVD = cerebrovascular disease, CHD = coronary heart disease, CHF = congestive heart failure, Cong. HD = congenital heart disease, CVD = cardiovascular disease, dis = disease/disorder, MI = myocardial infarction.

FIGURE 4

Forest plots showing significantly higher prevalence of metabolic comorbidities in asthma patients. dis. = disease/disorder, DYSLIP = dyslipidemia, HYPLIP = hyperlipidemia, THY = thyroid.

FIGURE 5

Forest plots showing significantly higher prevalence of neurological and psychiatric comorbidities in asthma patients. ANX = anxiety, COGN = cognitive impairment, DEM = dementia, DEP = depression, dis. = disease/disorder.

FIGURE 6

Forest plots showing significantly higher prevalence of gastrointestinal and urinary comorbidities in asthma patients. dis = disease/disorder, GERD = gastro-esophageal reflex disease.

FIGURE 7

Forest plots showing significantly higher prevalence of respiratory comorbidities in asthma patients. Bronch = bronchitis, ch = chronic, COPD = chronic obstructive pulmonary disease, Infect = infection/s, Resp = respiratory.

FIGURE 8

Forest plots showing significantly higher prevalence of cancer and other comorbidities in asthma patients. However, the prevalence of arthritis was not significantly different between asthma and nonasthma patients.