The impact of bariatric surgery on asthma control differs among obese individuals with reported prior or current asthma, with or without metabolic syndrome.
Journal
PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081
Informations de publication
Date de publication:
2019
2019
Historique:
received:
30
10
2018
accepted:
19
03
2019
entrez:
10
4
2019
pubmed:
10
4
2019
medline:
20
12
2019
Statut:
epublish
Résumé
Both obesity and the metabolic syndrome have been independently associated with increased asthma morbidity. However, it is unclear whether metabolic syndrome limits the beneficial effects of weight loss on asthma. To evaluate whether bariatric weight loss is associated with improved asthma control, and whether this association varies by metabolic syndrome status. We determined the changes in asthma control, defined by the Asthma Control Test (ACT), before and after bariatric surgery among participants with asthma in the multi-center Longitudinal Assessment of Bariatric Surgery (LABS) study, stratifying our analysis by the presence or absence of metabolic syndrome. Among 2,458 LABS participants, 555 participants had an asthma diagnosis and were included in our analysis. Of these, 78% (n = 433) met criteria for metabolic syndrome (MetSyn) at baseline. In patients without MetSyn, mean ACT increased from 20.4 at baseline to 22.1 by 12-24 months, ending at 21.3 at 60 months. In contrast, among those with MetSyn there was no significant improvement in ACT scores. The proportion of patients without MetSyn with adequate asthma control (ACT >19) increased from 58% at baseline to 78% and 82% at 12 and 60 months, respectively, whereas among those with MetSyn, it was 73.8% at baseline, 77.1% at 12 months, dropping to 47.1% at 60 months (p = 0.004 for interaction between metabolic syndrome and time). Having MetSyn also increased the likelihood of losing asthma control during follow-up (HR = 1.92, 95% confidence interval [CI] 1.24-2.97, p = 0.003). Metabolic syndrome may negatively modify the effect of bariatric surgery-induced weight loss on asthma control.
Sections du résumé
BACKGROUND
Both obesity and the metabolic syndrome have been independently associated with increased asthma morbidity. However, it is unclear whether metabolic syndrome limits the beneficial effects of weight loss on asthma.
OBJECTIVES
To evaluate whether bariatric weight loss is associated with improved asthma control, and whether this association varies by metabolic syndrome status.
METHODS
We determined the changes in asthma control, defined by the Asthma Control Test (ACT), before and after bariatric surgery among participants with asthma in the multi-center Longitudinal Assessment of Bariatric Surgery (LABS) study, stratifying our analysis by the presence or absence of metabolic syndrome.
RESULTS
Among 2,458 LABS participants, 555 participants had an asthma diagnosis and were included in our analysis. Of these, 78% (n = 433) met criteria for metabolic syndrome (MetSyn) at baseline. In patients without MetSyn, mean ACT increased from 20.4 at baseline to 22.1 by 12-24 months, ending at 21.3 at 60 months. In contrast, among those with MetSyn there was no significant improvement in ACT scores. The proportion of patients without MetSyn with adequate asthma control (ACT >19) increased from 58% at baseline to 78% and 82% at 12 and 60 months, respectively, whereas among those with MetSyn, it was 73.8% at baseline, 77.1% at 12 months, dropping to 47.1% at 60 months (p = 0.004 for interaction between metabolic syndrome and time). Having MetSyn also increased the likelihood of losing asthma control during follow-up (HR = 1.92, 95% confidence interval [CI] 1.24-2.97, p = 0.003).
CONCLUSIONS
Metabolic syndrome may negatively modify the effect of bariatric surgery-induced weight loss on asthma control.
Identifiants
pubmed: 30964910
doi: 10.1371/journal.pone.0214730
pii: PONE-D-18-29872
pmc: PMC6456172
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
e0214730Subventions
Organisme : NIDDK NIH HHS
ID : U01 DK066557
Pays : United States
Organisme : NIDDK NIH HHS
ID : U01 DK066667
Pays : United States
Organisme : NIDDK NIH HHS
ID : U01 DK066568
Pays : United States
Organisme : NIDDK NIH HHS
ID : U01 DK066471
Pays : United States
Organisme : NIDDK NIH HHS
ID : U01 DK066526
Pays : United States
Organisme : NIDDK NIH HHS
ID : U01 DK066555
Pays : United States
Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
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