World Allergy Organization Journal (May 2025)
Role of body anthropometry in severe asthmatic patients: Evidences from the Severe Asthma Network in Italy (SANI) registry
- Erminia Ridolo, PhD,
- Martina Ottoni, MD,
- Francesca Nicoletta, MD,
- Francesca Locatelli, MD,
- Luigi Martinelli, MD,
- Matteo Maule, MD,
- Naila Arif Cheema, MD,
- Francesco Blasi, PhD,
- Pierluigi Paggiaro, MD,
- Enrico Heffler, PhD,
- Luisa Brussino, PhD,
- Giorgio Walter Canonica, MD,
- Gianenrico Senna, MD,
- Marco Caminati, MD,
- Diego Bagnasco, PhD,
- Cecilia Calabrese, PhD,
- Gianna Camiciottoli, MD,
- Giovanna Elisiana Carpagnano, PhD,
- Cristiano Caruso, MD,
- Angelo Guido Corsico, PhD,
- Maria Teresa Costantino, MD,
- Claudia Crimi, PhD,
- Alice D'Adda, MD,
- Simona D’Alò, MD,
- Maria D'Amato, PhD,
- Corrado D'Andria, MD,
- Stefano Del Giacco, MD,
- Fabiano Di Marco, PhD,
- Nicola Cosimo Facciolongo, MD,
- Alessandro Farsi, MD,
- Manuela Latorre, PhD,
- Manlio Milanese, PhD,
- Michele Mondoni, MD,
- Eustachio Nettis, MD,
- Girolamo Pelaia, MD,
- Laura Pini, MD,
- Luisa Ricciardi, PhD,
- Fabio Luigi Massimo Ricciardolo, PhD,
- Luca Richeldi, PhD,
- Pierachille Santus, PhD,
- Nicola Scichilone, PhD,
- Giulia Scioscia, PhD,
- Giuseppe Spadaro, MD,
- Antonio Spanevello, MD,
- Paolo Tarsia, MD,
- Mona Rita Yacoub, PhD
Affiliations
- Erminia Ridolo, PhD
- Department of Medicine and Surgery, University of Parma, Parma, Italy; Corresponding author. Department of Medicine and Surgery, University of Parma, via Gramsci 14, 43125, Parma, Italy.
- Martina Ottoni, MD
- Department of Medicine and Surgery, University of Parma, Parma, Italy
- Francesca Nicoletta, MD
- Department of Medicine and Surgery, University of Parma, Parma, Italy
- Francesca Locatelli, MD
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
- Luigi Martinelli, MD
- Unit of Epidemiology and Medical Statistics, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
- Matteo Maule, MD
- Allergy Unit and Asthma Center, Integrated Verona University Hospital, Verona, Italy; Department of Medicine, University of Verona, Verona, Italy
- Naila Arif Cheema, MD
- Department of Medicine, University of Verona, Verona, Italy
- Francesco Blasi, PhD
- Department of Pathophysiology and Transplantation, Università degli Studi di Milano, Milan, Italy; Internal Medicine Department, Respiratory Unit and Cystic Fibrosis Center, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico di Milano, Milan, Italy
- Pierluigi Paggiaro, MD
- Department of Surgery, Medicine, Molecular Biology and Critical Care, University of Pisa, Pisa, Italy
- Enrico Heffler, PhD
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy; Asthma & Allergy Unit-IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
- Luisa Brussino, PhD
- S.C.D.U. Immunologia e Allergologia, A.O. Ordine Mauriziano Torino, Italy
- Giorgio Walter Canonica, MD
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy; Asthma & Allergy Unit-IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
- Gianenrico Senna, MD
- Allergy Unit and Asthma Center, Integrated Verona University Hospital, Verona, Italy; Department of Medicine, University of Verona, Verona, Italy
- Marco Caminati, MD
- Allergy Unit and Asthma Center, Integrated Verona University Hospital, Verona, Italy; Department of Medicine, University of Verona, Verona, Italy
- Diego Bagnasco, PhD
- Respiratory Diseases and Allergy Department, IRCCS Polyclinic Hospital San Martino, Genoa, Italy
- Cecilia Calabrese, PhD
- Department of Translational Medical Sciences, University of Campania “Luigi Vanvitelli”, Naples, Italy
- Gianna Camiciottoli, MD
- UNIT ASMA GRAVE - Ambulatorio Asma Grave Pneumologia e Fisiopatologia Toraco-Polmonare, Azienda Ospedaliera Universitaria Careggi (FI), Florence, Italy
- Giovanna Elisiana Carpagnano, PhD
- Department of Translational Biomedicine and Neuroscience“DiBraiN”, University of Bari Aldo Moro, Bari, Italy; Section of Respiratory Diseases, Policlinico Hospital of Bari, Italy
- Cristiano Caruso, MD
- Allergologia dell'Istituto di Clinica Medica del Policlinico Gemelli, Università Cattolica di Roma, Rome, Italy
- Angelo Guido Corsico, PhD
- Division of Respiratory Diseases, IRCCS Policlinico San Matteo, Foundation and Department of Internal Medicine and Therapeutics, University of Pavia, Italy
- Maria Teresa Costantino, MD
- Allergy and Clinical Immunology Unit, Department of Medicine, ''Carlo Poma'' Hospital Mantova, Italy
- Claudia Crimi, PhD
- Respiratory Medicine Unit, Policlinico “G. Rodolico-San Marco” University Hospital, Catania, Italy
- Alice D'Adda, MD
- Broncopneumologia, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Simona D’Alò, MD
- UOC Allergologia - PO Civitanova Marche - AREA VASTA 3, Civitanova Marche, Italy
- Maria D'Amato, PhD
- Department of Respiratory Medicine, University “Federico II” of Naples, Italy
- Corrado D'Andria, MD
- Internal and Respiratory Medicine, SS Annunziata Hospital, Taranto, Italy
- Stefano Del Giacco, MD
- Unit of Allergy and Clinical Immunology, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
- Fabiano Di Marco, PhD
- Pulmonary Medicine Unit, ASST Papa Giovanni XXIII Hospital, Bergamo, Italy
- Nicola Cosimo Facciolongo, MD
- UOC di Pneumologia, Arcispedale S. Maria Nuova Azienda USL di Reggio Emilia, Italy
- Alessandro Farsi, MD
- SOSD Allergology and Clinical Immunology, Ospedale S. Stefano, USL Toscana Centro, Prato, Italy
- Manuela Latorre, PhD
- Pulmonary Unit, Nuovo Ospedale Apuano, Massa, Italy
- Manlio Milanese, PhD
- Pulmonology Unit, Santa Corona Hospital, Pietra Ligure, Savona, Italy
- Michele Mondoni, MD
- Respiratory Unit, ASST Santi Paolo e Carlo, San Paolo Hospital, Department of Health Sciences, University of Milan, Milan, Italy
- Eustachio Nettis, MD
- Department of Emergency and Organ Transplantation, School and Chair of Allergology and Clinical Immunology, University of Bari - Aldo Moro, Bari, Italy
- Girolamo Pelaia, MD
- U.O. Malattie dell’Apparato Respiratorio, A.O.U. Mater Domini, Catanzaro, Italy
- Laura Pini, MD
- Department of Clinical and experimental Sciences, University of Brescia - ASST Spedali Civili di Brescia, Italy
- Luisa Ricciardi, PhD
- Allergologia e Immunologia Clinica, AOU Policlinico G. Martino - Università di Messina, Messina Italy
- Fabio Luigi Massimo Ricciardolo, PhD
- Department of Clinical and Biological Sciences, University of Turin, San Luigi Gonzaga University Hospital, Orbassano, Turin, Italy
- Luca Richeldi, PhD
- Fondazione Policlinico Universitario A. Gemelli, IRCCS Catholic University of Rome, Italy
- Pierachille Santus, PhD
- Department of Clinical and Biomedical Sciences, University of Milan, Respiratory Diseases, Sacco University Hospital, ASST Fatebenefratelli-Sacco, Milan, Italy
- Nicola Scichilone, PhD
- U.O.C. Pneumologia, Azienda Ospedaliera Universitaria Policlinico P. Giaccone di Palermo, Italy
- Giulia Scioscia, PhD
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
- Giuseppe Spadaro, MD
- Center for Basic and Clinical Immunology Research (CISI), University of Naples Federico II, Naples, Italy
- Antonio Spanevello, MD
- Pneumologia Riabilitativa, ICS Maugeri IRCCS Tradate, Tradate (VA), Italy
- Paolo Tarsia, MD
- Pneumology Unit, Grande Ospedale Metropolitano Niguarda, Milan, Italy
- Mona Rita Yacoub, PhD
- Unit of Immunology, Rheumatology, Allergy and Rare Diseases, IRCCS San Raffaele Scientific Institute, Milan, Italy
- Journal volume & issue
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Vol. 18,
no. 5
p. 101056
Abstract
Asthma and obesity are both chronic diseases. Obesity is a common comorbidity and a risk factor of severe asthma, associated with increased asthma exacerbation risk, poorer asthma control and reduced quality of life. However, the responsible mechanisms are poorly understood. The aim of this study was to detect parameters associated with obesity in patients with severe asthma in order to check different pattern of inflammation in obese asthmatics. Baseline data from the Severe Asthma Network in Italy (SANI) registry were analysed in 1922 patients with severe asthma. Demographic, clinical and functional features were compared, according to body mass index (BMI). The prevalence of overweight and obesity among severe asthma patients was 34,8 and 20,3, respectively. Females were more prevalent in the obese cluster (p < 0.001). Asthma onset age in overweight and obese patients was higher than in normal population (p < 0.001). Obese subjects reported less frequently chronic rhinosinusitis with nasal polyposis (CRSwNP) and more frequently impaired sleep quality, cardiovascular disease, and type-2 diabetes (p < 0.001). Severe asthma patients with obesity had lower predicted FVC values (89.0 ± 19.2 vs 93.5 ± 20.2; p 0.002) and higher FEV1/FVC ratio (69.9 ± 11.5 vs 66.9 ± 12.4; p < 0.001) than patients without obesity. Obese asthmatics had lower blood eosinophilic count, and fractional exhaled nitric oxide (FeNO) levels than non-obese asthmatics. Asthma control test (ACT) was significantly poorer in obese patients (17, IQR 12–21) than other subgroups. Regarding treatment, overweight and obese patients were more likely to receive a GINA-Step 5 therapy (p 0.023), with more than 20 of obese asthmatics having frequent exacerbations requiring oral corticosteroid (OCS). Patients with severe asthma and obesity presented different characteristics that support the existence of distinct asthma phenotype in obese patients. Trial registration: Trial registry: ClinicalTrials.gov. ID: NCT06625216. Retrospectively registered October 3, 2024.
