Impact of metabolic and weight components on incident asthma using a real-world cohort.

BACKGROUND

Obesity and metabolic dysregulation (MetD) have increasing prevalence and adversely affect asthma morbidity and therapeutic response.

OBJECTIVE

To determine the role of weight and MetD on incident asthma in adulthood.

METHODS

In a retrospective, longitudinal cohort of patients, we performed a time-to-asthma diagnosis analysis after a 3-year landmark period (t-t) during which weight and MetD components were evaluated. We assessed incident asthma risk with MetD components and weight.

RESULTS

In total, 90,081 patients met the inclusion criteria, with 836 cases (0.93%) of incident asthma in our primary cohort. Diabetes present at t, but no other MetD components, was associated with increased risk of asthma (adjusted hazard ratio = 1.85, 95% CI: 1.27-2.71, P = .0002). The effect of weight on asthma risk, independent of other MetD components, identified individuals with overweight or obesity as having a 10-year attributable risk of 15.4%. Metformin was prescribed more frequently, and hemoglobin A1c levels were lower in patients with diabetes in whom asthma did not develop (P < .0001).

CONCLUSION

Weight and diabetes prevention and management represent modifiable risk factors for adult asthma development.