Obesity's effect on asthma extends to diagnostic criteria

Njira Lugogo, Cynthia L. Green, Noah Agada, Siyi Zhang, Susanne Meghdadpour, Run Zhou, Siyun Yang, Kevin J. Anstrom, Elliot Israel, Richard Martin, Robert F. Lemanske, Homer Boushey, Stephen C. Lazarus, Stephen I. Wasserman, Mario Castro, William Calhoun, Stephen P. Peters, Emily DiMango, Vernon Chinchilli, Susan Kunselman & 3 others Tonya S. King, Nikolina Icitovic, Monica Kraft

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
JournalJournal of Allergy and Clinical Immunology
DOIs
StateAccepted/In press - 2017

Fingerprint

Eosinophils
Asthma
Obesity
Biomarkers
Inflammation
Sputum
Immunoglobulin E
Nitric Oxide
Eosinophilia
Pneumonia
Cell Count
Logistic Models
Regression Analysis
Weights and Measures
Sensitivity and Specificity
Research

Keywords

  • Asthma
  • Eosinophils
  • Fraction of exhaled nitric oxide
  • Inflammatory markers
  • Obesity

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology

Cite this

Lugogo, N., Green, C. L., Agada, N., Zhang, S., Meghdadpour, S., Zhou, R., ... Kraft, M. (Accepted/In press). Obesity's effect on asthma extends to diagnostic criteria. Journal of Allergy and Clinical Immunology. https://doi.org/10.1016/j.jaci.2017.04.047

Obesity's effect on asthma extends to diagnostic criteria. / Lugogo, Njira; Green, Cynthia L.; Agada, Noah; Zhang, Siyi; Meghdadpour, Susanne; Zhou, Run; Yang, Siyun; Anstrom, Kevin J.; Israel, Elliot; Martin, Richard; Lemanske, Robert F.; Boushey, Homer; Lazarus, Stephen C.; Wasserman, Stephen I.; Castro, Mario; Calhoun, William; Peters, Stephen P.; DiMango, Emily; Chinchilli, Vernon; Kunselman, Susan; King, Tonya S.; Icitovic, Nikolina; Kraft, Monica.

In: Journal of Allergy and Clinical Immunology, 2017.

Research output: Contribution to journalArticle

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 2017, 'Obesity's effect on asthma extends to diagnostic criteria', Journal of Allergy and Clinical Immunology. https://doi.org/10.1016/j.jaci.2017.04.047
Lugogo, Njira ; Green, Cynthia L. ; Agada, Noah ; Zhang, Siyi ; Meghdadpour, Susanne ; Zhou, Run ; Yang, Siyun ; Anstrom, Kevin J. ; Israel, Elliot ; Martin, Richard ; Lemanske, Robert F. ; Boushey, Homer ; Lazarus, Stephen C. ; Wasserman, Stephen I. ; Castro, Mario ; Calhoun, William ; Peters, Stephen P. ; DiMango, Emily ; Chinchilli, Vernon ; Kunselman, Susan ; King, Tonya S. ; Icitovic, Nikolina ; Kraft, Monica. / Obesity's effect on asthma extends to diagnostic criteria. In: Journal of Allergy and Clinical Immunology. 2017.
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abstract = "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.",
keywords = "Asthma, Eosinophils, Fraction of exhaled nitric oxide, Inflammatory markers, Obesity",
author = "Njira Lugogo and Green, {Cynthia L.} and Noah Agada and Siyi Zhang and Susanne Meghdadpour and Run Zhou and Siyun Yang and Anstrom, {Kevin J.} and Elliot Israel and Richard Martin and Lemanske, {Robert F.} and Homer Boushey and Lazarus, {Stephen C.} and Wasserman, {Stephen I.} and Mario Castro and William Calhoun and Peters, {Stephen P.} and Emily DiMango and Vernon Chinchilli and Susan Kunselman and King, {Tonya S.} and Nikolina Icitovic and Monica Kraft",
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T1 - Obesity's effect on asthma extends to diagnostic criteria

AU - Lugogo, Njira

AU - Green, Cynthia L.

AU - Agada, Noah

AU - Zhang, Siyi

AU - Meghdadpour, Susanne

AU - Zhou, Run

AU - Yang, Siyun

AU - Anstrom, Kevin J.

AU - Israel, Elliot

AU - Martin, Richard

AU - Lemanske, Robert F.

AU - Boushey, Homer

AU - Lazarus, Stephen C.

AU - Wasserman, Stephen I.

AU - Castro, Mario

AU - Calhoun, William

AU - Peters, Stephen P.

AU - DiMango, Emily

AU - Chinchilli, Vernon

AU - Kunselman, Susan

AU - King, Tonya S.

AU - Icitovic, Nikolina

AU - Kraft, Monica

PY - 2017

Y1 - 2017

N2 - 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.

AB - 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.

KW - Asthma

KW - Eosinophils

KW - Fraction of exhaled nitric oxide

KW - Inflammatory markers

KW - Obesity

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