Mild asthma in overweight women: A new phenotype?

Engbers, Marissa; Vachier, Isabelle; Sterk, Peter; Bourdin, Arnaud; Gras, Delphine; Godard, Philippe; Chanez, Pascal

doi:10.1016/j.rmed.2010.02.016

« Previous Next »Respiratory Medicine
Volume 104, Issue 8 , Pages 1138-1144, August 2010

Mild asthma in overweight women: A new phenotype?

Marissa Engbers
- CHU-Montpellier, Respiratory Department, Hôpital Arnaud de Villeneuve, 371 av doyen Gaston Giraud, 34295 Montpellier Cx 5, France
- Amsterdam University Hospital, Amsterdam, The Netherlands
Isabelle Vachier
- CHU-Montpellier, Respiratory Department, Hôpital Arnaud de Villeneuve, 371 av doyen Gaston Giraud, 34295 Montpellier Cx 5, France
Peter Sterk
- Amsterdam University Hospital, Amsterdam, The Netherlands
Arnaud Bourdin
- CHU-Montpellier, Respiratory Department, Hôpital Arnaud de Villeneuve, 371 av doyen Gaston Giraud, 34295 Montpellier Cx 5, France
Delphine Gras
- Département des Maladies Respiratoires, AP-HM, Laboratoire d'immunologie INSERM CNRS U 600, UMR6212, Université de la Méditerranée, Marseille, France
Philippe Godard
- CHU-Montpellier, Respiratory Department, Hôpital Arnaud de Villeneuve, 371 av doyen Gaston Giraud, 34295 Montpellier Cx 5, France
Pascal Chanez
- CHU-Montpellier, Respiratory Department, Hôpital Arnaud de Villeneuve, 371 av doyen Gaston Giraud, 34295 Montpellier Cx 5, France
- Département des Maladies Respiratoires, AP-HM, Laboratoire d'immunologie INSERM CNRS U 600, UMR6212, Université de la Méditerranée, Marseille, France
- Corresponding author. Université de la Méditerranée, AP-HM, 270 boulevard de Sainte-Marguerite, F-13009 Marseille, France. Tel.: +33 49174 46 30; fax: +33 49174 16 06.

Received 7 April 2009; received in revised form 18 February 2010; accepted 19 February 2010. published online 05 April 2010.

Summary

Background

Epidemics of asthma and overweight have been linked recently. They might be associated with systemic inflammation. In asthma hyperresponsiveness to adenosine (AMP) is more closely related to inflammation than to methacholine (MCh). The aim of the study was to determine responsiveness to AMP and MCh in overweight compared with normal weight asthmatics.

Methods

Thirty women were enrolled (19 overweight) with mild controlled asthma according to GINA. A Body Mass Index (BMI) less than 25kg/m² was considered as normal and a BMI above 25kg/m² as overweight. We assessed the recent control of asthma (ACQ), pulmonary function tests, bronchial responsiveness to MCh and AMP (PC₂₀ and O'Connor two-point dose–response slope), perception of symptoms (Borg scale), and blood inflammatory markers (leptin and hs-CRP by ELISA).

Results

Overweight had a significant lower dose-response slope of the MCh challenge (p=0.009) as compared to normal weight patients, whereas no significant difference was observed for AMP challenge (p=0.27). Overweight patients had higher intercepts of the Borg scale measured before the MCh and AMP challenge tests (p=0.01 and p=0.03). Plasma leptin (p=0.001) and hs-CRP (p=0.05) concentrations were higher in overweight than normal weight patients. There was no correlation between challenges and inflammatory markers.

Conclusions

Overweight asthmatic women have more pronounced systemic inflammation, but are less responsive to MCh. AMP responsiveness appeared to be comparable between both groups. Our findings suggest that overweight asthmatic women do not feature increased airway inflammation, but do represent a distinct phenotype as compared to normal weight patients.

Keywords: Asthma, Overweight, Bronchial hyperresponsiveness, Inflammation