Association of obesity with asthma severity, control and quality of life

The association between asthma and obesity is becoming increasingly established but the mechanism that might explain the observed differences in asthma severity, control and quality of life between obese and non-obese adult asthmatics is not clear. The purpose of this study was: 1] to determine asthma severity, control and quality of life in obese asthmatics and 2] to explore, according to the body mass index [BMI], the systemic inflammatory state of asthmatic people. A cross-sectional study was conducted between 2009 and 2010. Two hundred adult asthmatic patients were included. Data analysis consisted of univariate analysis with chi-square comparison test followed by a multivariate logistic regression. Obesity worsens the severity of asthma. This finding was more strongly observed among women than men. Obesity and overweight are associated with a poorer control of asthma. According to BMI, obese asthmatics had 6 times more frequent emergency visits, 5 times more frequent hospitalizations for asthma related complaints, increased missed work days and greater dose of inhaled corticosteroids [1025 micro g/day vs. 759 micro g/day of beclometasone equivalent]. Mean serum level of C-reactive protein [CRP] and leptin was significantly correlated with asthma severity based on GINA classification [5.75 vs. 2.81 mg/l; 20.5 vs. 5.38 ng/ml; respectively]. In summary, it appears that obesity is significantly associated with a greater asthma severity and a poorer asthma control and quality of life. Chronic systemic inflammation state may explain the relationship between obesity and asthma

[Treatment compliance in asthma: a Tunisian transversal study]

As a chronic disease, asthma requires a continued treatment and poses the problem of compliance with medication. To study in a Tunisian population of asthmatics, the level of compliance and the factors affecting it, we included 190 adults with persistent asthma in a transversal study using a self-questionnaire. The mean age was 38.56 years. 2/3 of patients had medium or poor socioeconomic status. 1/3 had severe persistent asthma, progressing for 5 years in 68% of case. All patients received inhaled corticosteroids only 44 had high dosed corticosteroids. 29.5% of patients were compliant with medication in our study. Omission and intentional negligence were the two main reasons for non-compliance. Level of compliance was positively related to socioeconomic status, urban way of life, history of hospitalization, high dosed corticosteroids and knowledge of their indication. We conclude that treatment compliance in asthma is very low. Further efforts should be made to improve compliance: by increasing the accessibility of medication and by the educational programs which should be a priority in the management of asthma