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Asthma
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Long-term effect of asthma on the development of obesity among adults: an international cohort study, ECRHS
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  • Published on: 12 January 2023
    Asthma and obesity. Associations exist, but they may not be in direct causal relationship
    • Markku Partinen, MD, PhD, Principal Investigator in Sleep Medicine Department of Clinical Neurosciences, Clinicum, University of Helsinki, Helsinki, Finland

    Dear Editor,

    I read with interest the recent publication by Subharta Moitra et al in Thorax.(1) The authors concluded that adult asthmatics have a higher risk of developing obesity than non-asthmatics. An association was found especially in non-atopic asthmatics with longer disease duration and the use of oral corticosteroids (OCS).

    Obesity is the strongest risk factor for sleep apnea, and sleep apnea is associated also with asthma.(2) Obesity has been regarded also as a risk factor for developing asthma,(3) but the reverse association is still not clear. Both asthma and obesity begin often in early childhood, and they may share a common background.(3)

    The relationships between smoking, physical activity, use of OCS and lung function were discussed in the paper. But why would asthma per se increase weight? Obesity may be considered also as a central nervous system disorder. Obesity and sleep apnea are associated with asthma. Short night sleep, sleep deprivation and chronic insomnia are associated with the development of obesity.(4) Studies have also shown an association between anxiety, depressive symptoms and the development of obesity.(4)

    The ECHRS cohort was initiated in 1990. The study was focused on asthma, and unfortunately the original questionnaires did not include questions on sleep, sleep disorders or mental health. Also, no sleep studies or psychological testing were done. This explains the lack of information on anxiety, depres...

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    Conflict of Interest:
    None declared.