Abstract
Background: Asthma in obese subjects is poorly understood and the effect of weight loss on asthma control is not well described.
Aim: To investigate the effects of bariatric surgery on asthma control, quality of life and lung function.
Methods: We performed a prospective study in patients with confirmed diagnosis asthma (ΔFEV1≥12% or PD20<1.76mg(=BHR)) and non asthmatic patients undergoing bariatric surgery(BMI >35kg/m2, age 18-50y). Lung function, medication and quality of life were assessed at baseline and 3 months after bariatric surgery. Obese asthmatics who did not undergo bariatric surgery served as an additional control group.
Results: 35 asthma patients(O+A) and 50 non-asthmatics(O-A) underwent bariatric surgery, 17 asthma patients served as controls(NO+A). There were no differences in ACQ, AQLQ, FEV1 or FeNO between O+A and NO+A at baseline. BMI of NO+A(40kg/m2) was significantly lower than O+A(47kg/m2). After bariatric surgery, BMI decreased to 38kg/m2 in O+A, and BHR decreased significantly in O+A(80% to 34%, p=0.003). In addition, use of ICS decreased with 50%. FEV1 improved significantly only in O+A(mean 85.6 to 94.6%pred, p=0.011). Following surgery, ACQ and AQLQ significantly improved in O+A group(1.1 to 0.5, p=0.022; resp. 5.7 to 6.3 p=0.004), whereas no change was detectable after 3 months in NO+A. ACQ and AQLQ were significantly better in O+A group compared to NO+A after 3 months(ACQ p=0.027, AQLQ p=0.002). No change in FeNO in any group.
Conclusion: Bariatric surgery improves lung function, asthma control and quality of life in patients with asthma and morbid obesity already after 3 months. So it can be speculated that weight loss is an important component of the management of obese asthmatics.
- © 2012 ERS