Long-term effect of asthma on the development of obesity among adults: an international cohort study, ECRHS

<jats:sec><jats:title>Introduction</jats:title><jats:p>Obesity is a known risk factor for asthma. Although some evidence showed asthma causing obesity in children, the link between asthma and obesity has not been investigated in adults.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>We used data from the European Community Respiratory Health Survey (ECRHS), a cohort study in 11 European countries and Australia in 3 waves between 1990 and 2014, at intervals of approximately 10 years. We considered two study periods: from ECRHS I (<jats:italic>t</jats:italic>) to ECRHS II (<jats:italic>t+1</jats:italic>), and from ECRHS II (<jats:italic>t</jats:italic>) to ECRHS III (<jats:italic>t+1</jats:italic>). We excluded obese (body mass index≥30 kg/m<jats:sup>2</jats:sup>) individuals at visit<jats:italic>t</jats:italic>. The relative risk (RR) of obesity at<jats:italic>t+1</jats:italic>associated with asthma at<jats:italic>t</jats:italic>was estimated by multivariable modified Poisson regression (lag) with repeated measurements. Additionally, we examined the association of atopy and asthma medication on the development of obesity.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>We included 7576 participants in the period ECRHS I-II (51.5% female, mean (SD) age of 34 (7) years) and 4976 in ECRHS II-III (51.3% female, 42 (8) years). 9% of participants became obese in ECRHS I-II and 15% in ECRHS II—III. The risk of developing obesity was higher among asthmatics than non-asthmatics (RR 1.22, 95% CI 1.07 to 1.38), and particularly higher among non-atopic than atopic (1.47; 1.17 to 1.86 vs 1.04; 0.86 to 1.27), those with longer disease duration (1.32; 1.10 to 1.59 in >20 years vs 1.12; 0.87 to 1.43 in ≤20 years) and those on oral corticosteroids (1.99; 1.26 to 3.15 vs 1.15; 1.03 to 1.28). Physical activity was not a mediator of this association.</jats:p></jats:sec><jats:sec><jats:title>Conclusion</jats:title><jats:p>This is the first study showing that adult asthmatics have a higher risk of developing obesity than non-asthmatics, particularly those non-atopic, of longer disease duration or on oral corticosteroids.</jats:p></jats:sec>