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Obesity, Waist Size, and Prevalence of Current Asthma in the California Teachers Study Cohort
  1. Julie Von Behren (jvonbehr{at}nccc.org)
  1. Northern California Cancer Center, United States
    1. Michael Lipsett
    1. California Department of Public Health, United States
      1. Pamela L. Horn-Ross
      1. Northern California Cancer Center, United States
        1. Ralph J Delfino
        1. Epidemiology Division, Department of Medicine, University of California, Irvine, United States
          1. Frank Gillilan
          1. Department of Preventive Medicine, USC Keck School of Medicine, United States
            1. Rob McConnell (rmcconne{at}usc.edu)
            1. Department of Preventive Medicine, USC Keck School of Medicine, United States
              1. Leslie Bernstein
              1. City of Hope National Medical Center, United States
                1. Christina A Clarke
                1. Northern California Cancer Center, United States
                  1. Peggy Reynolds
                  1. Northern California Cancer Center, United States

                    Abstract

                    Obesity is a risk factor for asthma, particularly in women, but few cohort studies have evaluated abdominal obesity, which reflects metabolic differences in visceral fat known to influence systemic inflammation. We examined the relationships of asthma prevalence with measures of abdominal obesity and adult weight gain, in addition to body mass index (BMI), in a large cohort of female teachers. We calculated prevalence odds ratios (ORs) for current asthma using multivariable linear modeling, adjusting for age, smoking, and race/ethnicity. Of the 88,304 women in the analyses, 13% (11,500) were obese (BMI ≥ 30 kg/m2) at baseline; 1,334 were extremely obese (BMI ≥ 40). Compared to those of normal weight, the adjusted OR for adult-onset asthma increased from 1.40 (95% confidence interval (CI): 1.31, 1.49) for overweight women to 3.30 (95% CI: 2.85, 3.82) for extremely obese women. Large waist circumference (> 88 cm) was associated with increased asthma prevalence even among women with a normal BMI (OR = 1.37, 95% CI: 1.18, 1.59). Among obese women, the OR for asthma was greater among those who were also abdominally obese compared to women whose waist was ≤88 cm (2.36 vs. 1.57). Obese and overweight women were at greater risk of severe asthma episodes, measured by urgent medical visits and hospitalizations. This study confirms the association between excess weight and asthma severity and prevalence, and showed that a large waist was associated with increased asthma prevalence even among women considered to have normal body weight.

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