Interacting effects of obesity, race, ethnicity and sex on the incidence and control of adult-onset asthma

Corinna Koebnick, Heidi Fischer, Matthew F. Daley, Assiamira Ferrara, Michael A. Horberg, Beth Waitzfelder, Deborah Rohm Young, Michael K. Gould

    Research output: Contribution to journalArticlepeer-review

    14 Scopus citations


    Background: To improve care and control for patients with adult-onset asthma, a better understanding of determinants of their risk and outcomes is important. We investigated how associations between asthma, asthma control and obesity may be modified by patient demographic characteristics. Methods: This retrospective study of adults enrolled in several health plans across the U.S. (n = 2,860,305) examined the interacting effects of obesity, age, race, and sex on adult-onset asthma and asthma control. Multivariable adjusted Cox and logistic regression models estimated hazard ratios (HR), and 95 % confidence intervals (CI) for the associations between body mass index (BMI) and study outcomes, and interactions of BMI with demographic characteristics. Results: Compared with individuals who had a BMI <25 kg/m2, the hazard of adult-onset asthma progressively increased with increasing BMI, from a 12 % increase among persons with a BMI of 25.0-29.9 kg/m2 (HR 1.12, 95 % CI 1.10, 1.14) to an almost 250 % increase among persons with a BMI ≥50 kg/m2 (HR 2.49, 95 % CI 2.38, 2.60). The magnitude of the association between obesity and asthma risk was greater for women (compared with men) and lower for Blacks (compared with non-Hispanic Whites). Among individuals with asthma, obesity was associated with poorly controlled and high-risk asthma. Conclusions: The present study demonstrates that the magnitude of the associations between obesity and adult-onset asthma incidence and control are modified by race, age, and sex. Understanding the role of obesity in the development of adult-onset asthma will help to improve asthma treatment algorithms and to develop targeted interventions.

    Original languageEnglish (US)
    Article number50
    JournalAllergy, Asthma and Clinical Immunology
    Issue number1
    StatePublished - Oct 19 2016


    • Adult-onset
    • Asthma
    • Ethnicity
    • Obesity
    • Race
    • Sex

    ASJC Scopus subject areas

    • Immunology and Allergy
    • Immunology
    • Pulmonary and Respiratory Medicine


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