Hormonal Influences:
Obesity and asthma share hormonal links, with hormones like sex hormones, incretins, and thyroid hormones potentially influencing asthma severity. Hormonal imbalances can exacerbate asthma symptoms, highlighting a common comorbidity pattern.
Obesity-Related Comorbidities Impacting Asthma:
Gastroesophageal Reflux Disease (GERD): Known to aggravate asthma by causing acid reflux into the lungs.
Obstructive Sleep Apnea (OSA): Can lead to nocturnal asthma exacerbations due to airway obstruction during sleep.
Metabolic Syndrome: Encompassing insulin resistance, dyslipidemia, hypertension, hyperuricemia, and non-alcoholic steatohepatitis, this condition can further complicate asthma management.
Physical and Inflammatory Effects:
Abdominal Girth: Increased abdominal fat can mechanically hinder lung function, directly worsening asthma.
Inflammation from Obesity: Chronic low-grade inflammation associated with obesity can intensify asthma symptoms through elevated levels of pro-inflammatory cytokines like IL-5, IL-6, IL-17A, IL-25, and increased neutrophil counts.
Insulin resistance in obese patients can be measured using the Homeostatic Model Assessment for Insulin Resistance, HOMA-IR. This is calculated using glucose and insulin blood levels. A calculator is available at mdcalc.com, and a cut-off level over 2 suggests insulin resistance. For more information, visit mdcalc.com.