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Obesity's effect on asthma extends to diagnostic criteria.

Publication ,  Journal Article
Lugogo, N; Green, CL; Agada, N; Zhang, S; Meghdadpour, S; Zhou, R; Yang, S; Anstrom, KJ; Israel, E; Martin, R; Lemanske, RF; Boushey, H ...
Published in: J Allergy Clin Immunol
March 2018

BACKGROUND: The use of inflammatory biomarkers to delineate the type of lung inflammation present in asthmatic subjects is increasingly common. However, the effect of obesity on these markers is unknown. OBJECTIVES: We aimed to determine the effect of obesity on conventional markers of inflammation in asthmatic subjects. METHODS: We performed secondary analysis of data from 652 subjects previously enrolled in 2 Asthma Clinical Research Network trials. We performed linear correlations between biomarkers and logistic regression analysis to determine the predictive value of IgE levels, blood eosinophil counts, and fraction of exhaled nitric oxide values in relationship to sputum eosinophil counts (>2%), as well as to determine whether cut points existed that would maximize the sensitivity and specificity for predicting sputum eosinophilia in the 3 weight groups. RESULTS: Overall, statistically significant but relatively weak correlations were observed among all 4 markers of inflammation. Within obese subjects, the only significant correlation found was between IgE levels and blood eosinophil counts (r = 0.33, P < .001); furthermore, all other correlations between inflammatory markers were approximately 0, including correlations with sputum eosinophil counts. In addition, the predictive value of each biomarker alone or in combination was poor in obese subjects. In fact, in obese subjects none of the biomarkers of inflammation significantly predicted the presence of high sputum eosinophil counts. Obese asthmatic subjects have lower cut points for IgE levels (268 IU), fraction of exhaled nitric oxide values (14.5 ppb), and blood eosinophil counts (96 cells/μL) than all other groups. CONCLUSIONS: In obese asthmatic subjects conventional biomarkers of inflammation are poorly predictive of eosinophilic airway inflammation. As such, biomarkers currently used to delineate eosinophilic inflammation in asthmatic subjects should be approached with caution in these subjects.

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Published In

J Allergy Clin Immunol

DOI

EISSN

1097-6825

Publication Date

March 2018

Volume

141

Issue

3

Start / End Page

1096 / 1104

Location

United States

Related Subject Headings

  • Obesity
  • Nitric Oxide
  • Middle Aged
  • Male
  • Leukocyte Count
  • Inflammation
  • Immunoglobulin E
  • Humans
  • Female
  • Eosinophils
 

Citation

APA
Chicago
ICMJE
MLA
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Lugogo, N., Green, C. L., Agada, N., Zhang, S., Meghdadpour, S., Zhou, R., … Kraft, M. (2018). Obesity's effect on asthma extends to diagnostic criteria. J Allergy Clin Immunol, 141(3), 1096–1104. https://doi.org/10.1016/j.jaci.2017.04.047
Lugogo, Njira, Cynthia L. Green, Noah Agada, Siyi Zhang, Susanne Meghdadpour, Run Zhou, Siyun Yang, et al. “Obesity's effect on asthma extends to diagnostic criteria.J Allergy Clin Immunol 141, no. 3 (March 2018): 1096–1104. https://doi.org/10.1016/j.jaci.2017.04.047.
Lugogo N, Green CL, Agada N, Zhang S, Meghdadpour S, Zhou R, et al. Obesity's effect on asthma extends to diagnostic criteria. J Allergy Clin Immunol. 2018 Mar;141(3):1096–104.
Lugogo, Njira, et al. “Obesity's effect on asthma extends to diagnostic criteria.J Allergy Clin Immunol, vol. 141, no. 3, Mar. 2018, pp. 1096–104. Pubmed, doi:10.1016/j.jaci.2017.04.047.
Lugogo N, Green CL, Agada N, Zhang S, Meghdadpour S, Zhou R, Yang S, Anstrom KJ, Israel E, Martin R, Lemanske RF, Boushey H, Lazarus SC, Wasserman SI, Castro M, Calhoun W, Peters SP, DiMango E, Chinchilli V, Kunselman S, King TS, Icitovic N, Kraft M. Obesity's effect on asthma extends to diagnostic criteria. J Allergy Clin Immunol. 2018 Mar;141(3):1096–1104.
Journal cover image

Published In

J Allergy Clin Immunol

DOI

EISSN

1097-6825

Publication Date

March 2018

Volume

141

Issue

3

Start / End Page

1096 / 1104

Location

United States

Related Subject Headings

  • Obesity
  • Nitric Oxide
  • Middle Aged
  • Male
  • Leukocyte Count
  • Inflammation
  • Immunoglobulin E
  • Humans
  • Female
  • Eosinophils