Body mass index and asthma severity in the National Asthma Survey

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Abstract
Background: The association between obesity and asthma severity remains controversial and limited to small studies. Methods: We determined the association of body mass index (BMI) and asthma severity in the National Asthma Survey. We included adults (age ⩾18 years) who self-reported symptoms of asthma in the past 5 years. A total of 3095 patients were divided into the following BMI categories: 1080 (35%) non-overweight (BMI Results: Compared with non-overweight subjects, obese subjects with asthma were more likely to report continuous symptoms (OR 1.66, 95% CI 1.09 to 2.54), miss more work days (OR 1.35, 95% CI 1.01 to 1.81), use short acting beta agonists (OR 1.36, 95% CI 1.06 to 1.75), use inhaled corticosteroids (OR 1.34, 95% CI 1.01 to 1.79) and use any controller medication according to GINA guidelines (OR 1.37, 95% CI 1.01 to 1.85). Also, obese respondents were less likely to be in asthma remission (OR 0.56, 95% CI 0.38 to 0.82) and were more likely to have severe persistent asthma (GINA IV) (OR 1.42, 95% CI 1.05 to 1.90). Conclusions: In a large, diverse sample of adults with asthma, obesity was associated with measures of asthma severity after adjusting for potential confounders.