Journal of Asthma and Allergy (Apr 2023)

Asthma Prevalence and Phenotyping in the General Population: The LEAD (Lung, hEart, sociAl, boDy) Study

  • Schiffers C,
  • Wouters EF,
  • Breyer-Kohansal R,
  • Buhl R,
  • Pohl W,
  • Irvin CG,
  • Breyer MK,
  • Hartl S

Journal volume & issue
Vol. Volume 16
pp. 367 – 382

Abstract

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Caspar Schiffers,1 Emiel FM Wouters,1,2 Robab Breyer-Kohansal,1,3 Roland Buhl,4 Wolfgang Pohl,5 Charles G Irvin,6 Marie-Kathrin Breyer,1,7 Sylvia Hartl1,7,8 1Ludwig Boltzmann Institute for Lung Health, Vienna, Austria; 2NUTRIM, School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Center, Maastricht, the Netherlands; 3Department of Respiratory and Pulmonary Diseases, Clinic Hietzing, Vienna Healthcare Group, Vienna, Austria; 4Pulmonology Department, Mainz University Hospital, Mainz, Germany; 5Karl Landsteiner Gesellschaft, Institute for Clinical and Experimental Pneumology, Vienna, Austria; 6Pulmonary and Critical Care, Larner College of Medicine, University of Vermont, Burlington, VT, USA; 7Department of Respiratory and Pulmonary Diseases, Clinic Penzing, Vienna Healthcare Group, Vienna, Austria; 8Sigmund Freud University, Faculty for Medicine, Vienna, AustriaCorrespondence: Caspar Schiffers, Ludwig Boltzmann Institute for Lung Health, Vienna, 1140, Austria, Email [email protected]: Asthma is a chronic heterogeneous respiratory disease involving differential pathophysiological pathways and consequently distinct asthma phenotypes.Objective and Methods: In the LEAD Study, a general population cohort (n=11.423) in Vienna ranging from 6– 82 years of age, we addressed the prevalence of asthma and explored inflammatory asthma phenotypes that included allergic and non-allergic asthma, and within these phenotypes, an eosinophilic (eosinophils ≥ 300 cells/μL, or ≥ 150 cells/μL in the presence of ICS medication) or non-eosinophilic (eosinophils < 300 cells/μL, or < 150 cells/μL in the presence of ICS) phenotype. In addition, we compared various factors related to biomarkers, body composition, lung function, and symptoms in control subjects versus subjects with current asthma (current doctor’s diagnosis of asthma).Results: An overall prevalence of 4.6% was observed for current asthma. Furthermore, an age-dependent shift from allergic to non-allergic asthma was found. The non-eosinophilic phenotype was more prominent. Obesity was a prevalent condition, and body composition including visceral adipose tissue (VAT), is affected in current asthma versus controls.Conclusion: This broad-aged and large general population cohort identified differential patterns of inflammatory asthma phenotypes that were age-dependent. The presence of eosinophilia was associated with worse asthma control, increased asthma medication, increased VAT, and lower lung function, the opposite was found for the presence of an allergic asthma.Keywords: asthma, prevalence, phenotyping, pulmonary function testing, spirometry, general population, body composition

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