Premium
Obesity and aspirin intolerance are risk factors for difficult‐to‐treat asthma in J apanese non‐atopic women
Author(s) -
Fukutomi Y.,
Taniguchi M.,
Tsuburai T.,
Tanimoto H.,
Oshikata C.,
Ono E.,
Sekiya K.,
Higashi N.,
Mori A.,
Hasegawa M.,
Nakamura H.,
Akiyama K.
Publication year - 2012
Publication title -
clinical and experimental allergy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.462
H-Index - 154
eISSN - 1365-2222
pISSN - 0954-7894
DOI - 10.1111/j.1365-2222.2011.03880.x
Subject(s) - medicine , odds ratio , asthma , aspirin , body mass index , confidence interval , atopy , obesity , risk factor
Summary Background Asthma is a clinical syndrome characterized by variabilities in disease expression and severity. The pathophysiological mechanism underlying anti‐asthma treatment resistance is also assumed to be different between disease phenotypes. Objective To elucidate the effect of gender and atopic phenotype on the relationship between clinical factors and the risk of treatment resistance. Methods We compared outpatients with difficult‐to‐treat asthma ( DTA ; n = 486) in a tertiary hospital for allergic diseases in central J apan with those with controlled severe asthma ( n = 621) with respect to clinical factors including body mass index ( BMI ) and aspirin intolerance using multivariate logistic regression analysis stratified by gender and atopic phenotype. Results When analysis was performed on the entire study populations, obesity ( BMI ≥ 30 kg/m 2 ; adjusted odds ratio ( OR ) 1.92; 95% confidence interval (95% CI : 1.07–3.43) and aspirin intolerance ( OR : 2.56, 95% CI : 1.44–4.57) were found to be the significant risk factors for DTA . However, after the stratification by gender and atopic phenotype, the association between obesity and DTA was significant only in women ( OR : 2.76, 95% CI : 1.31–5.78), but not in men ( OR : 1.03, 95% CI : 0.38–2.81), and only in non‐atopics ( OR : 4.03, 95% CI : 1.15–14.08), but not in atopics ( OR : 1.54, 95% CI : 0.79–3.02). The similar gender and phenotypic differences were also observed in the association between aspirin intolerance and DTA : namely, the association was significant only in women ( OR : 3.96, 95% CI : 1.84–8.50), but not in men ( OR : 1.19, 95% CI : 0.46–3.05); and only in non‐atopics ( OR : 5.49, 95% CI : 1.98–15.19), but not in atopics ( OR : 1.39, 95% CI : 0.65–2.98). Conclusions and Clinical Relevance Significant associations of obesity and aspirin intolerance with DTA were observed only in women and in non‐atopics. These findings suggest that a phenotype‐specific approach is needed to treat patients with DTA .