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The subject to my talk today
is "Obesity and Asthma."
My name is Dr. Anne Dixon.
I'm Professor of Medicine
and Director
of the Division of Pulmonary
and Critical Care Medicine
at the University of Vermont.
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To outline what
I'm gonna talk about today,
I'm gonna talk about
the epidemiology
linking obesity and asthma.
I will then go on to talk
about how obesity affects
the clinical
presentation of asthma,
and particularly what
it does to asthma control,
and how it affects
response to medications.
I will discuss
the data that we have
regarding the efficacy
of weight loss
for the treatment
of asthma in obesity,
and what that revealed to us
about the phenotypes
of asthma in obesity,
that I think this provides
important insight
into the mechanistic basis
of asthma in patients
who are obese.
Finally, I will discuss the role
of some of the co-morbidities
we see in patients
who are obese
and the effect
that those have on asthma.
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It's well-known that there
is a major obesity epidemic
that is now worldwide.
The slide I'm showing you here
shows data from
the World Health Organization.
Obese women over the age
of 15 are in the top figure,
obese men are
in the bottom figure.
There's clearly an epidemic
particularly affecting
North America and South America,
but is also very common
in the Middle East,
Australia and
the countries of Polynesia.
This is really becoming
a worldwide epidemic.
1:32
It's really not until
the late '90s
that we began to realize
that this obesity epidemic was
affecting patients with asthma.
And the first paper that really
drew widespread attention
to this epidemic was
published by Carlos Camargo
in the Archives
of Internal Medicine in 1999.
This was a large study
which took advantage
of the Nurses' Health Study
in the United States.
And Dr. Camargo
looked at relative risk
of developing new asthma
in about 90,000 women.
So this is incident asthma,
and he looked at it relative
to Body Mass Index.
And using a reference
BMI of 20 to 22.4,
he found that there
was an increasing risk
of developing new asthma
which increased
in relationship to BMI.
This was the first publication
and it was in women.
But there have been
publications in men,
in adults as well
as in children,
really reports from
all over the world
and in all ethnic groups.
It is a little higher risk
for women developing asthma
in the setting of obesity,
but it is true for all
demographic groups.
