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. 2024 Dec;133(6):660-666.e5.
doi: 10.1016/j.anai.2024.09.005. Epub 2024 Sep 16.

Impact of metabolic and weight components on incident asthma using a real-world cohort

Melissa H Bloodworth  1 , Patrick J Staso  1 , Shi Huang  2 , Eric Farber-Eger  1 , Kevin D Niswender  1 , Frank E Harrell Jr  2 , Quinn S Wells  3 , Leonard B Bacharier  4 , Megan M Shuey  1 , Katherine N Cahill  5
Affiliations

Impact of metabolic and weight components on incident asthma using a real-world cohort

Melissa H Bloodworth et al. Ann Allergy Asthma Immunol. 2024 Dec.

Abstract

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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Conflict of interest statement

Disclosures Dr Bacharier reports personal fees from GlaxoSmithKline, Genentech/Novartis, Merck, DBV Technologies, Teva, Boehringer Ingelheim, AstraZeneca, Avillion, WebMD/Medscape, Sanofi/Regeneron, Vectura, Circassia, OM Pharma, Elsevier, Kinaset, and Vertex outside the submitted work. Dr Cahill served on scientific advisory boards for AstraZeneca, Sanofi, Genentech, Regeneron, Novartis, and GlaxoSmithKline; served as a consultant for Ribon Therapeutics, Third Harmonic Bio, and Verantos; reports royalties from UpToDate; and reports research support from Novo Nordisk. The remaining authors have no conflicts of interest to report.

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