University of Oulu

Ilmarinen P, Pardo A, Tuomisto LE, et al. Long-term prognosis of new adult-onset asthma in obese patients. Eur Respir J 2021; 57: 2001209,

Long-term prognosis of new adult-onset asthma in obese patients

Saved in:
Author: Ilmarinen, Pinja1; Pardo, Adrienn1; Tuomisto, Leena E.1;
Organizations: 1Dept of Respiratory Medicine, Seinäjoki Central Hospital, Seinäjoki, Finland
2Dept of Laboratory Medicine, Seinäjoki Central Hospital, Seinäjoki, Finland
3Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
4Medical Informatics and Statistics Research Group, University of Oulu, Oulu, Finland
5Krefting Research Centre, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.6 MB)
Persistent link:
Language: English
Published: European Respiratory Society, 2021
Publish Date: 2022-03-09


Background: Obesity has been associated with poor outcomes of asthma in cross-sectional studies, but long-term effect of obesity on asthma remains unknown.

Aims: To study the effects of obesity, found at the time of diagnosis of adult-onset asthma, on 12-year prognosis by focusing on oral corticosteroid (OCS) use and respiratory-related hospital admissions.

Methods: Patients diagnosed with adult-onset asthma (n=203) were divided into three categories based on diagnostic body mass index (BMI) (<25 kg·m−2, 25–29.9 kg·m−2, ≥30 kg·m−2) and followed for 12 years as part of the Seinäjoki Adult Asthma Study. Self-reported and dispensed OCS were assessed for the 12-year period. Data on hospital admissions were analysed based on medical records.

Results: 12 years after diagnosis, 86% of the patients who were obese (BMI ≥30 kg·m−2) at diagnosis remained obese. During the follow-up, no difference was found in weight gain between the BMI categories. During the 12-year follow-up, patients obese at diagnosis reported more frequent use of OCS courses (46.9% versus 23.1%, p=0.028), were dispensed OCS more often (81.6% versus 56.9%, p=0.014) and at higher doses (median 1350 (interquartile range 280–3180) mg versus 600 (0–1650) mg prednisolone, p=0.010) compared to normal-weight patients. Furthermore, patients who were obese had more often one or more respiratory-related hospitalisations compared to normal-weight patients (38.8% versus 16.9%, p=0.033). In multivariate logistic regression analyses, obesity predicted OCS use and hospital admissions.

Conclusions: In adult-onset asthma, patients obese at diagnosis mostly remained obese at long-term and had more exacerbations and respiratory-related hospital admissions compared to normal-weight patients during 12-year follow-up. Weight loss should be a priority in their treatment to prevent this outcome.

see all

Series: European respiratory journal
ISSN: 0903-1936
ISSN-E: 1399-3003
ISSN-L: 0903-1936
Volume: 57
Issue: 4
Article number: 2001209
DOI: 10.1183/13993003.01209-2020
Type of Publication: A1 Journal article – refereed
Field of Science: 3121 General medicine, internal medicine and other clinical medicine
Funding: Supported by Tampere Tuberculosis Foundation and the Finnish Anti-Tuberculosis Foundation, the Competitive State Research Financing of the Expert Responsibility Area of Tampere University Hospital (Tampere, Finland), and the Medical Research Fund of Seinäjoki Central Hospital (Seinäjoki, Finland), the Research Foundation of the Pulmonary Diseases (Helsinki, Finland), the Ida Montini Foundation (Kerava, Finland), the Pirkanmaa Regional Fund of the Finnish Cultural Foundation (Helsinki, Finland), Allergy Research Foundation (Helsinki, Finland). None of the sponsors had any involvement in the planning, execution, drafting or write-up of this study. Funding information for this article has been deposited with the Crossref Funder Registry.
Copyright information: © ERS 2021. This version is distributed under the terms of the Creative Commons Attribution NonCommercial Licence 4.0. For commercial reproduction rights and permissions contact