Search tips
Search criteria 


Logo of thoraxThoraxVisit this articleSubmit a manuscriptReceive email alertsContact usBMJ
Thorax. 2002 December; 57(12): 1028–1033.
PMCID: PMC1758811

Relation of bronchial responsiveness to body mass index in the ECRHS


Background: There is substantial evidence for an association between symptoms of asthma and overweight or obesity. However, a study that reported no association between bronchial responsiveness (BHR) and body mass index (BMI) suggested that the relation of symptoms to obesity was due to increased diagnosis of asthma. The relation of BHR to BMI was therefore investigated in a large multicentre study.

Methods: Data were obtained for 11 277 participants in stage II of the European Community Respiratory Health Survey (ECRHS). BHR to methacholine was analysed in relation to BMI adjusted for a number of factors known to be associated with BHR, including baseline lung function and allergen sensitisation, and combined across 34 centres using random effects meta-analysis.

Results: BHR increased with increasing BMI in men (ECRHS slope changed by –0.027 for each unit increase in BMI, 95% confidence interval –0.044 to –0.010, p=0.002), but the relation in women was weak (–0.014, 95% CI –0.033 to 0.005, p=0.14). There was no evidence for an interaction of sex with BMI (p=0.41).

Conclusions: BHR is related to BMI in the ECRHS. This suggests that the association is not due to greater diagnosis or perception of symptoms in obese people compared with those of normal weight. The data do not support the finding by some studies of a relation between asthma and obesity in women but not in men.

Full Text

The Full Text of this article is available as a PDF (149K).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.
  • Chen Y, Dales R, Krewski D, Breithaupt K. Increased effects of smoking and obesity on asthma among female Canadians: the National Population Health Survey, 1994-1995. Am J Epidemiol. 1999 Aug 1;150(3):255–262. [PubMed]
  • Wilson MM, Irwin RS. The association of asthma and obesity: is it real or a matter of definition, Presbyterian minister's salaries, and earlobe creases? Arch Intern Med. 1999 Nov 22;159(21):2513–2514. [PubMed]
  • Shaheen SO, Sterne JA, Montgomery SM, Azima H. Birth weight, body mass index and asthma in young adults. Thorax. 1999 May;54(5):396–402. [PMC free article] [PubMed]
  • Stenius-Aarniala B, Poussa T, Kvarnström J, Grönlund EL, Ylikahri M, Mustajoki P. Immediate and long term effects of weight reduction in obese people with asthma: randomised controlled study. BMJ. 2000 Mar 25;320(7238):827–832. [PMC free article] [PubMed]
  • Young SY, Gunzenhauser JD, Malone KE, McTiernan A. Body mass index and asthma in the military population of the northwestern United States. Arch Intern Med. 2001 Jul 9;161(13):1605–1611. [PubMed]
  • Jarvis D, Chinn S, Potts J, Burney P. Association of body mass index with respiratory symptoms and atopy: results from the European Community Respiratory Health Survey. Clin Exp Allergy. 2002 Jun;32(6):831–837. [PubMed]
  • Luder E, Melnik TA, DiMaio M. Association of being overweight with greater asthma symptoms in inner city black and Hispanic children. J Pediatr. 1998 Apr;132(4):699–703. [PubMed]
  • Gennuso J, Epstein LH, Paluch RA, Cerny F. The relationship between asthma and obesity in urban minority children and adolescents. Arch Pediatr Adolesc Med. 1998 Dec;152(12):1197–1200. [PubMed]
  • Castro-Rodríguez JA, Holberg CJ, Morgan WJ, Wright AL, Martinez FD. Increased incidence of asthmalike symptoms in girls who become overweight or obese during the school years. Am J Respir Crit Care Med. 2001 May;163(6):1344–1349. [PubMed]
  • Figueroa-Muñoz JI, Chinn S, Rona RJ. Association between obesity and asthma in 4-11 year old children in the UK. Thorax. 2001 Feb;56(2):133–137. [PMC free article] [PubMed]
  • von Kries R, Hermann M, Grunert VP, von Mutius E. Is obesity a risk factor for childhood asthma? Allergy. 2001 Apr;56(4):318–322. [PubMed]
  • von Mutius E, Schwartz J, Neas LM, Dockery D, Weiss ST. Relation of body mass index to asthma and atopy in children: the National Health and Nutrition Examination Study III. Thorax. 2001 Nov;56(11):835–838. [PMC free article] [PubMed]
  • Tantisira KG, Weiss ST. Complex interactions in complex traits: obesity and asthma. Thorax. 2001 Sep;56 (Suppl 2):ii64–ii73. [PMC free article] [PubMed]
  • Schachter LM, Salome CM, Peat JK, Woolcock AJ. Obesity is a risk for asthma and wheeze but not airway hyperresponsiveness. Thorax. 2001 Jan;56(1):4–8. [PMC free article] [PubMed]
  • Chinn S, Burney P, Jarvis D, Luczynska C. Variation in bronchial responsiveness in the European Community Respiratory Health Survey (ECRHS). Eur Respir J. 1997 Nov;10(11):2495–2501. [PubMed]
  • Burney PG, Luczynska C, Chinn S, Jarvis D. The European Community Respiratory Health Survey. Eur Respir J. 1994 May;7(5):954–960. [PubMed]
  • Janson C, Anto J, Burney P, Chinn S, de Marco R, Heinrich J, Jarvis D, Kuenzli N, Leynaert B, Luczynska C, et al. The European Community Respiratory Health Survey: what are the main results so far? European Community Respiratory Health Survey II. Eur Respir J. 2001 Sep;18(3):598–611. [PubMed]
  • Chinn S, Burney P, Sunyer J, Jarvis D, Luczynska C. Sensitization to individual allergens and bronchial responsiveness in the ECRHS. European Community Respiratory Health Survey. Eur Respir J. 1999 Oct;14(4):876–884. [PubMed]
  • Chinn S, Jarvis D, Luczynska C, Burney P. Individual allergens as risk factors for bronchial responsiveness in young adults. Thorax. 1998 Aug;53(8):662–667. [PMC free article] [PubMed]
  • Chinn S, Arossa WA, Jarvis DL, Luczynska CM, Burney PG. Variation in nebulizer aerosol output and weight output from the Mefar dosimeter: implications for multicentre studies. Eur Respir J. 1997 Feb;10(2):452–456. [PubMed]
  • DerSimonian R, Laird N. Meta-analysis in clinical trials. Control Clin Trials. 1986 Sep;7(3):177–188. [PubMed]
  • Quanjer PH, Tammeling GJ, Cotes JE, Pedersen OF, Peslin R, Yernault JC. Lung volumes and forced ventilatory flows. Report Working Party Standardization of Lung Function Tests, European Community for Steel and Coal. Official Statement of the European Respiratory Society. Eur Respir J Suppl. 1993 Mar;16:5–40. [PubMed]
  • Roca J, Burgos F, Sunyer J, Saez M, Chinn S, Antó JM, Rodríguez-Roisin R, Quanjer PH, Nowak D, Burney P. References values for forced spirometry. Group of the European Community Respiratory Health Survey. Eur Respir J. 1998 Jun;11(6):1354–1362. [PubMed]
  • Seidell JC, de Groot LC, van Sonsbeek JL, Deurenberg P, Hautvast JG. Associations of moderate and severe overweight with self-reported illness and medical care in Dutch adults. Am J Public Health. 1986 Mar;76(3):264–269. [PubMed]
  • Chinn S, Rona RJ. Can the increase in body mass index explain the rising trend in asthma in children? Thorax. 2001 Nov;56(11):845–850. [PMC free article] [PubMed]
  • Hauspie R, Susanne C, Alexander F. A mixed longitudinal study of the growth in height and weight in asthmatic children. Hum Biol. 1976 May;48(2):271–283. [PubMed]
  • Kaplan BA, Brush G, Mascie-Taylor CG. The relationship of childhood asthma and wheezy bronchitis with height, weight and body mass index. Hum Biol. 1987 Dec;59(6):921–931. [PubMed]

Articles from Thorax are provided here courtesy of BMJ Group