--- title: "Adiposity and level of asthma control. | Sutter Health" description: "Abdominal adiposity by waist-to-height ratio and poor sleep quality correlated with poorer asthma control in adults with uncontrolled asthma, after controlling for BMI and sociodemographics." url: "https://www.sutterhealth.org/research/publications/adiposity-and-level-of-asthma-control-1055312908" --- 1. [Home](https://www.sutterhealth.org/) / 2. [Research](https://www.sutterhealth.org/research) / 3. [Research publications](https://www.sutterhealth.org/research/publications) / 4. Adiposity and level of asthma control. # Abdominal and general adiposity and level of asthma control in adults with uncontrolled asthma. Lv N, Xiao L, Camargo CA Jr, Wilson SR, Buist AS, Strub P, Nadeau KC, & Ma J. _Ann Am Thorac Soc. 11(8):1218-24. doi: 10.1513/AnnalsATS.201405-214OC._ 2014-10-01 ## Abstract RATIONALE: Abdominal adiposity may be an important risk factor for uncontrolled asthma in adults, controlling for general obesity. Whether the relationship, if present, is explained by other factors (e.g., asthma onset age, sex, and/or coexisting conditions) is unclear. OBJECTIVES: To examine whether clinically applicable anthropometric measures of abdominal adiposity-waist circumference and waist-to-height ratio (WHtR)-are related to poorer asthma control in adults with uncontrolled asthma controlling for body mass index (BMI), and whether the relationship (if present) is explained by gastroesophageal reflux disorder (GERD), sleep quality, or obstructive sleep apnea (OSA) or differs by age of asthma onset or sex. METHODS: Patients aged 18 to 70 years with uncontrolled asthma (n = 90) participated in a 6-month randomized clinical trial. MEASUREMENTS AND MAIN RESULTS: Baseline measures included sociodemographics, standardized anthropometrics, Asthma Control Test (ACT), GERD Symptom Assessment Scale, Pittsburgh Sleep Quality Index, and Berlin Questionnaire for Sleep Apnea. Participants (mean \[SD\] age, 52 \[12\] yr) were racially and ethnically diverse, 67% women, and 69% overweight or obese, and 71% reported their age of asthma onset was 12 years or older. Participants had uncontrolled asthma (mean \[SD\] ACT score, 14.9 \[3.7\]) and low GERD symptoms score (0.6 \[0.4\]); 67% reported poor sleep quality, and 42% had a high OSA risk. General linear regression results showed that worse ACT scores were significantly associated with every SD increase in waist circumference (β= -1.03; 95% confidence interval \[CI\], -1.96 to -0.16; P = 0.02) and waist-to-height ratio (β= -1.16; 95% CI, -2.00 to -0.33; P = 0.008), controlling for sociodemographics. Waist-to-height ratio remained correlated with ACT (β= -2.30; 95% CI, -4.16 to -0.45; P = 0.02) after further adjusting for BMI. The BMI-controlled relationship between WHtR and ACT did not differ by age of asthma onset or sex (P > 0.05 for interactions) and persisted after additional adjustment for GERD, sleep quality, or OSA scores. Poor sleep quality was associated with worse ACT scores (β= -0.87; 95% CI, -1.71 to -0.03; P = 0.045) controlling for waist-to-height ratio, BMI, and sociodemographics. CONCLUSIONS: Abdominal adiposity by waist-to-height ratio and poor sleep quality correlated with poorer asthma control in adults with uncontrolled asthma, after controlling for BMI and sociodemographics. These results warrant replication in larger studies of diverse populations. Clinical trial registered with [www.clinicaltrials.gov](http://www.clinicaltrials.gov/) (NCT 01725945). [PubMed abstract](http://www.ncbi.nlm.nih.gov/pubmed/25343191) ## Research topics - [Asthma](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Asthma%5C%22%22) - [Disease Management](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Disease+Management%5C%22%22) - [Obesity](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Obesity%5C%22%22) ## Related publications [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) - Publication ### [Weight management interventions in adult and pediatric asthma populations: a systematic review.](https://www.sutterhealth.org/research/publications/wt-mgmt-adult-ped-asthma-review-1055312799) Lv N, Xiao L, Ma J. J Pulm Respir Med. 5:232. doi:10.4172/2161-105X.1000232 2014 Dec 26 - Publication ### [Weight management interventions in adult and pediatric asthma populations: a systematic review.](https://www.sutterhealth.org/research/publications/weight-mgmt-interventions-asthma-review-1055312909) Lv N, Xiao L, Ma J. J Pulm Respir Med. 5(232). pii: 1000232. 2015 Oct 01 - Publication ### [The Breathe Easier through Weight Loss Lifestyle (BE WELL) Intervention: a randomized controlled trial.](https://www.sutterhealth.org/research/publications/asthma-management-through-weight-loss-1055312542) Ma J, Strub P, Camargo CA Jr, Xiao L, Ayala E, Gardner CD, Buist AS, Haskell WL, Lavori PW, Wilson SR. BMC Pulm Med. 10:16. doi: 10.1186/1471-2466-10-16. 2010 Mar 24 - Publication ### [Behavioral weight loss and physical activity intervention in obese adults with asthma: a randomized trial.](https://www.sutterhealth.org/research/publications/behavioral-weight-loss-in-obese-asthmatic-adults-1055312842) Ma J, Strub P, Xiao L, Lavori PW, Camargo CA Jr, Wilson SR, Gardner CD, Buist AS, Haskell WL, Lv N. Ann Am Thorac Soc. 12(1):1-11. doi: 10.1513/AnnalsATS.201406-271OC. 2015 Jan 01 - Publication ### [Adult obesity and office-based quality of care in the United States.](https://www.sutterhealth.org/research/publications/adult-obesity-and-office-care-quality-1055312917) Ma J, Xiao L, Stafford RS. Obesity. 17(5):1077–1085. 2009 May 01 [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) ```json {"@context":"https://schema.org","@type":"MedicalOrganization","name":"Sutter Health","@id":"https://www.sutterhealth.org/#medicalorganization","url":"https://www.sutterhealth.org","logo":"https://www.sutterhealth.org/static/images/sutter-health-logo.svg","address":{"@type":"PostalAddress","streetAddress":"2200 River Plaza Drive","addressLocality":"Sacramento","addressRegion":"CA","postalCode":"95833","addressCountry":"US"},"areaServed":{"@type":"AdministrativeArea","name":"California"},"sameAs":["https://www.facebook.com/SutterHealth","https://www.instagram.com/sutterhealth/","https://x.com/SutterHealth","https://www.youtube.com/sutterhealth","https://www.linkedin.com/company/sutter-health","https://en.wikipedia.org/wiki/Sutter_Health"]} ``` ```json {"@context":"https://schema.org","@type":"BreadcrumbList","@id":"https://www.sutterhealth.org/research/publications/adiposity-and-level-of-asthma-control-1055312908#breadcrumblist","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https://www.sutterhealth.org/"},{"@type":"ListItem","position":2,"name":"Research","item":"https://www.sutterhealth.org/research"},{"@type":"ListItem","position":3,"name":"Research publications","item":"https://www.sutterhealth.org/research/publications"},{"@type":"ListItem","position":4,"name":"Adiposity and level of asthma control."}]} ``` ```json {"@context":"https://schema.org","@type":"MedicalScholarlyArticle","@id":"https://www.sutterhealth.org/research/publications/adiposity-and-level-of-asthma-control-1055312908#medicalscholarlyarticle","name":"Abdominal and general adiposity and level of asthma control in adults with uncontrolled asthma.","headline":"Adiposity and level of asthma control.","abstract":"RATIONALE: Abdominal adiposity may be an important risk factor for uncontrolled asthma in adults, controlling for general obesity. Whether the relationship, if present, is explained by other factors (e.g., asthma onset age, sex, and/or coexisting conditions) is unclear. OBJECTIVES: To examine whether clinically applicable anthropometric measures of abdominal adiposity-waist circumference and waist-to-height ratio (WHtR)-are related to poorer asthma control in adults with uncontrolled asthma controlling for body mass index (BMI), and whether the relationship (if present) is explained by gastroesophageal reflux disorder (GERD), sleep quality, or obstructive sleep apnea (OSA) or differs by age of asthma onset or sex. METHODS: Patients aged 18 to 70 years with uncontrolled asthma (n = 90) participated in a 6-month randomized clinical trial. MEASUREMENTS AND MAIN RESULTS: Baseline measures included sociodemographics, standardized anthropometrics, Asthma Control Test (ACT), GERD Symptom Assessment Scale, Pittsburgh Sleep Quality Index, and Berlin Questionnaire for Sleep Apnea. Participants (mean [SD] age, 52 [12] yr) were racially and ethnically diverse, 67% women, and 69% overweight or obese, and 71% reported their age of asthma onset was 12 years or older. Participants had uncontrolled asthma (mean [SD] ACT score, 14.9 [3.7]) and low GERD symptoms score (0.6 [0.4]); 67% reported poor sleep quality, and 42% had a high OSA risk. General linear regression results showed that worse ACT scores were significantly associated with every SD increase in waist circumference (β= -1.03; 95% confidence interval [CI], -1.96 to -0.16; P = 0.02) and waist-to-height ratio (β= -1.16; 95% CI, -2.00 to -0.33; P = 0.008), controlling for sociodemographics. Waist-to-height ratio remained correlated with ACT (β= -2.30; 95% CI, -4.16 to -0.45; P = 0.02) after further adjusting for BMI. The BMI-controlled relationship between WHtR and ACT did not differ by age of asthma onset or sex (P > 0.05 for interactions) and persisted after additional adjustment for GERD, sleep quality, or OSA scores. Poor sleep quality was associated with worse ACT scores (β= -0.87; 95% CI, -1.71 to -0.03; P = 0.045) controlling for waist-to-height ratio, BMI, and sociodemographics. CONCLUSIONS: Abdominal adiposity by waist-to-height ratio and poor sleep quality correlated with poorer asthma control in adults with uncontrolled asthma, after controlling for BMI and sociodemographics. These results warrant replication in larger studies of diverse populations. Clinical trial registered with www.clinicaltrials.gov (NCT 01725945).","description":"Abdominal adiposity by waist-to-height ratio and poor sleep quality correlated with poorer asthma control in adults with uncontrolled asthma, after controlling for BMI and sociodemographics.","keywords":["Asthma","Disease Management","Obesity"],"datePublished":"2014-10-01","url":"https://www.sutterhealth.org/research/publications/adiposity-and-level-of-asthma-control-1055312908","inLanguage":"en-US","identifier":[{"@type":"PropertyValue","propertyID":"PMID","value":"25343191"},{"@type":"PropertyValue","propertyID":"DOI","value":"10.1513/AnnalsATS.201405-214OC"}],"sameAs":["https://pubmed.ncbi.nlm.nih.gov/25343191/","https://doi.org/10.1513/AnnalsATS.201405-214OC"],"isPartOf":{"@type":"Periodical","name":"Ann Am Thorac Soc"},"author":[{"@type":"Person","name":"Lv N"},{"@type":"Person","name":"Xiao L"},{"@type":"Person","name":"Camargo CA Jr"},{"@type":"Person","name":"Wilson SR"},{"@type":"Person","name":"Buist AS"},{"@type":"Person","name":"Strub P"},{"@type":"Person","name":"Nadeau KC"},{"@type":"Person","name":"Ma J"}],"sourceOrganization":{"@type":"MedicalOrganization","name":"Palo Alto Medical Foundation Research Institute"},"about":[{"@type":"DefinedTerm","name":"Asthma","url":"https://www.sutterhealth.org/research-search-results?facets=%5B%7B%22i%22%3A%22c_researchTopics.name%22%2C%22v%22%3A%5B%22Asthma%22%5D%7D%5D&verticalKey=research_publication"},{"@type":"DefinedTerm","name":"Disease Management","url":"https://www.sutterhealth.org/research-search-results?facets=%5B%7B%22i%22%3A%22c_researchTopics.name%22%2C%22v%22%3A%5B%22Disease+Management%22%5D%7D%5D&verticalKey=research_publication"},{"@type":"DefinedTerm","name":"Obesity","url":"https://www.sutterhealth.org/research-search-results?facets=%5B%7B%22i%22%3A%22c_researchTopics.name%22%2C%22v%22%3A%5B%22Obesity%22%5D%7D%5D&verticalKey=research_publication"}],"mainEntityOfPage":{"@type":"WebPage","@id":"https://www.sutterhealth.org/research/publications/adiposity-and-level-of-asthma-control-1055312908","breadcrumb":{"@id":"https://www.sutterhealth.org/research/publications/adiposity-and-level-of-asthma-control-1055312908#breadcrumblist"}}} ```