Heterogeneity of obesity-asthma association disentangled by latent class analysis, the SAPALDIA cohort
Open accessAbstract
Although evidence for the heterogeneity of asthma accumulated, consensus for definitions of asthma phenotypes is still lacking. Obesity may have heterogeneous effects on various asthma phenotypes. We aimed to distinguish asthma phenotypes by latent class analysis and to investigate their associations with different obesity parameters in adults using a population-based Swiss cohort (SAPALDIA). We applied latent class analysis to 959 self-reported asthmatics using information on disease activity, atopy, and age of onset. Associations with obesity were examined by multinomial logistic regression, after adjustments for age, sex, smoking status, educational level, and study centre. Body mass index, percent body fat, waist hip ratio, waist height ratio, and waist circumference were used as obesity measure. Four asthma classes were identified, including persistent multiple symptom-presenting asthma (n = 122), symptom-presenting asthma (n = 290), symptom-free atopic asthma (n = 294), and symptom-free non-atopic asthma (n = 253). Obesity was positively associated with symptom-presenting asthma classes but not with symptom-free ones. Percent body fat showed the strongest association with the persistent multiple symptom-presenting asthma. We observed heterogeneity of associations with obesity across asthma classes, indicating different asthma aetiologies.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Latent class analysis methods are able to identify novel and statistically distinct classes among individuals in a relatively unbiased way, based on measured variables that relate to asthma symptoms and/or biomarkers such as bronchial hyperresponsiveness and atopy.
“Essentially, LCA methods are able to identify novel and statistically distinct classes among individuals in a relatively unbiased way, and are based on measured variables that relate to asthma symptoms (26) and/or biomarkers such as bronchial hyperresponsiveness and atopy (27, 28).”
From Epidemiology of Asthma in Children and Adults (2019) · cites this paper as [28]
Female obesity has been associated with a pauci-eosinophil and non-atopic asthma endotype that is symptom-predominant and less steroid-responsive.
“While this review did not find significant sex-related differences, female obesity has been associated with a pauci-eosinophil and non-atopic asthma endotype that is symptom-predominant and less steroid-responsive in previous cluster and LCA (16, 28).”
From Epidemiology of Asthma in Children and Adults (2019) · cites this paper as [28]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
PAUWELS, R. A., Buist, A. S., CALVERLEY, P. M. A., Jenkins, C. R., & Hurd, S. S. (2001) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/ajrccm.163.5.2101039 · Cited by 6,529 · see citing works
Asthma phenotypes: the evolution from clinical to molecular approaches
Wenzel, S. E. (2012) · Nature Medicine · doi:10.1038/nm.2678 · Cited by 2,423 · see citing works
Identification of Asthma Phenotypes Using Cluster Analysis in the Severe Asthma Research Program
Moore, W. C., Meyers, D. A., Wenzel, S. E., Teague, W. G., Li, H., Li, X., D'Agostino, R., Castro, M., Curran‐Everett, D., Fitzpatrick, A. M., et al. (2009) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.200906-0896oc · Cited by 2,131 · see citing works
A Large-Scale, Consortium-Based Genomewide Association Study of Asthma
Moffatt, M. F., Gut, I. G., Démenais, F., Strachan, D. P., Bouzigon, E., Heath, S. C., von Mutius, E., Farrall, M., Lathrop, M. G., & Cookson, W. (2010) · New England Journal of Medicine · doi:10.1056/nejmoa0906312 · Cited by 2,003 · see citing works
Cluster analysis and clinical asthma phenotypes
Haldar, P., Pavord, I. D., Shaw, D. E., Berry, M. A., Thomas, M., Brightling, C. E., Wardlaw, A. J., & Green, R. H. (2008) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.200711-1754oc · Cited by 1,987 · see citing works
Hagenaars, J. A. P., & McCutcheon, A. L. (2002) · Cambridge University Press eBooks · doi:10.1017/cbo9780511499531 · Cited by 1,983 · see citing works
poLCA : An R Package for Polytomous Variable Latent Class Analysis
Linzer, D. A., & Lewis, J. B. (2011) · Journal of Statistical Software · doi:10.18637/jss.v042.i10 · Cited by 1,649 · see citing works
Overweight, Obesity, and Incident Asthma
Beuther, D. A., & Sutherland, E. R. (2007) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.200611-1717oc · Cited by 1,107 · see citing works
Single prediction equation for bioelectrical impedance analysis in adults aged 20–94 years
Kyle, U. G., Genton, L., Karsegard, L., Slosman, D. O., & Pichard, C. (2001) · Nutrition · doi:10.1016/s0899-9007(00)00553-0 · Cited by 573 · see citing works
Henderson, A. J., Granell, R., Heron, J., Sherriff, A., Simpson, A., Woodcock, A. A., Strachan, D. P., Shaheen, S. O., & Sterne, J. A. C. (2008) · Thorax · doi:10.1136/thx.2007.093187 · Cited by 519 · see citing works
Obesity and asthma: An association modified by age of asthma onset
Holguín, F., Bleecker, E. R., Busse, W. W., Calhoun, W. J., Castro, M., ERZURUM, S. C., Fitzpatrick, A. M., Gaston, B. M., Israel, E., Jarjour, N. N., et al. (2011) · Journal of Allergy and Clinical Immunology · doi:10.1016/j.jaci.2011.03.036 · Cited by 441 · see citing works
Overdiagnosis of asthma in obese and nonobese adults
Aaron, S. D., Vandemheen, K. L., Boulet, L.-P., McIvor, R. A., FitzGerald, J. M., Hernandez, P., Lemiere, C., Sharma, S., Field, S. K., Alvarez, G. G., et al. (2008) · Canadian Medical Association Journal · doi:10.1503/cmaj.081332 · Cited by 400 · see citing works
Obesity and Asthma: An Inflammatory Disease of Adipose Tissue Not the Airway
Sideleva, O., Suratt, B. T., Black, K. E., Tharp, W. G., Pratley, R. E., Forgione, P. M., Dienz, O., Irvin, C. G., & Dixon, A. E. (2012) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.201203-0573oc · Cited by 346 · see citing works
Prevalence of Atopy and Pollinosis in the Adult Population of Switzerland (SAPALDIA Study)
Wüthrich, B., Schindler, C., Leuenberger, P., & Ackermann-Liebrich, U. (2009) · International Archives of Allergy and Immunology · doi:10.1159/000236836 · Cited by 308 · see citing works
Self-citationIdentifying adult asthma phenotypes using a clustering approach
Siroux, V., Basagaña, X., Boudier, A., Pin, I., García‐Aymerich, J., Vesin, A., Slama, R., Jarvis, D., Anto, J. M., Kauffmann, F., et al. (2011) · European Respiratory Journal · doi:10.1183/09031936.00120810 · Cited by 264 · see citing works
Noneosinophilic asthma: A distinct clinical and pathologic phenotype
Haldar, P., & Pavord, I. D. (2007) · Journal of Allergy and Clinical Immunology · doi:10.1016/j.jaci.2007.02.042 · Cited by 263 · see citing works
Observational study of the effect of obesity on lung volumes
Steier, J. S., Lunt, A. C., Hart, N., Polkey, M. I., & Moxham, J. (2014) · Thorax · doi:10.1136/thoraxjnl-2014-205148 · Cited by 213 · see citing works
Distinguishing phenotypes of childhood wheeze and cough using latent class analysis
Spycher, B. D., Silverman, M. A., Brooke, A., Minder, C. E., & Kuehni, C. E. (2008) · European Respiratory Journal · doi:10.1183/09031936.00153507 · Cited by 189 · see citing works
Martin, B. W., Ackermann-Liebrich, U. A., Leuenberger, P., Künzli, N., Stutz, E. Z., Keller, R., Zellweger, J. P., W�thrich, B., Monn, C., Blaser, K., et al. (1997) · Sozial- und Präventivmedizin · doi:10.1007/bf01318136 · Cited by 177 · see citing works
Self-citationAckermann-Liebrich, U. A., Kuna-Dibbert, B., Probst-Hensch, N. M., Schindler, C., Dietrich, D. F., Stutz, E. Z., Bayer-Oglesby, L., Baum, F., Brändli, O., Brutsche, M. H., et al. (2005) · Sozial- und Präventivmedizin · doi:10.1007/s00038-005-4075-5 · Cited by 175 · see citing works
Self-citationEgan, K. B., Ettinger, A. S., & Bracken, M. B. (2013) · BMC Pediatrics · doi:10.1186/1471-2431-13-121 · Cited by 174 · see citing works
Metabolic syndrome and incidence of asthma in adults: the HUNT study
Brumpton, B. M., Camargo, C. A., Romundstad, P., Langhammer, A., Chen, Y., & Mai, X. (2013) · European Respiratory Journal · doi:10.1183/09031936.00046013 · Cited by 171 · see citing works
Brändli, O., Schindler, C., Künzli, N., et al. (1996) · Thorax · doi:10.1136/thx.51.3.277 · Cited by 152 · see citing works
Self-citationAdiposity, asthma, and airway inflammation
McLachlan, C. R., Poulton, R., Car, G., Cowan, J. O., Filsell, S., Greene, J. M., Taylor, D. R., Welch, D., Williamson, A., Sears, M. R., et al. (2006) · Journal of Allergy and Clinical Immunology · doi:10.1016/j.jaci.2006.10.029 · Cited by 148 · see citing works
Newby, C., Heaney, L. G., Menzies-Gow, A. N., et al. (2014) · PLoS ONE · doi:10.1371/journal.pone.0102987 · Cited by 122 · see citing works
Effects of BMI, Fat Mass, and Lean Mass on Asthma in Childhood: A Mendelian Randomization Study
Granell, R., Henderson, A. J., Evans, D. M., Smith, G. D., Ness, A., Lewis, S. J., Palmer, T., & Sterne, J. A. C. (2014) · PLoS Medicine · doi:10.1371/journal.pmed.1001669 · Cited by 119 · see citing works
Todd, D. C., Armstrong, S. W., D’silva, L., Allen, C. J., Hargreave, F. E., & Parameswaran, K. (2007) · Clinical & Experimental Allergy · doi:10.1111/j.1365-2222.2007.02748.x · Cited by 109 · see citing works
Body mass index as predictor for asthma: a cohort study of 118,723 males and females
Hjellvik, V., Tverdal, A., & Furu, K. (2010) · European Respiratory Journal · doi:10.1183/09031936.00192408 · Cited by 76 · see citing works
Genetic heterogeneity of asthma phenotypes identified by a clustering approach
Siroux, V., González, J. R., Bouzigon, E., et al. (2013) · European Respiratory Journal · doi:10.1183/09031936.00032713 · Cited by 72 · see citing works
The role of female sex hormones in the development and severity of allergic and non‐allergic asthma
van den Berge, M., Heijink, H., van Oosterhout, A. J. M., & Postma, D. S. (2009) · Clinical & Experimental Allergy · doi:10.1111/j.1365-2222.2009.03354.x · Cited by 68 · see citing works
Exploring the obesity‐asthma link: do all types of adiposity increase the risk of asthma?
Fenger, R. V., González‐Quintela, A., Vidal, C., Gudé, F., Husemoen, L. L. N., Aadahl, M., Berg, N. D., & Linneberg, A. R. (2012) · Clinical & Experimental Allergy · doi:10.1111/j.1365-2222.2012.03972.x · Cited by 58 · see citing works
Joint effect of obesity andTNFAvariability on asthma: two international cohort studies
Castro-Giner, F., Kogevinas, M., Imboden, M., de Cid, R., Jarvis, D., Mächler, M., Berger, W., Burney, P., Franklin, K. A., González, J. R., et al. (2009) · European Respiratory Journal · doi:10.1183/09031936.00140608 · Cited by 50 · see citing works
Self-citationFenger, R. V., González‐Quintela, A., Vidal, C., Husemoen, L. L. N., Skaaby, T., Thuesen, B. H., Aadahl, M., Madsen, F., & Linneberg, A. R. (2014) · BMC Pulmonary Medicine · doi:10.1186/1471-2466-14-208 · Cited by 42 · see citing works
Re-estimated equations for 5th percentiles of lung function variables
Brändli, O. (2000) · Thorax · doi:10.1136/thorax.55.2.172a · Cited by 41 · see citing works
Gender differences in adult-onset asthma: results from the Swiss SAPALDIA cohort study
Hansen, S. M., Probst-Hensch, N. M., Keidel, D., et al. (2015) · European Respiratory Journal · doi:10.1183/13993003.02278-2014 · Cited by 40 · see citing works
Self-citationDiffering associations of BMI and body fat with asthma and lung function in children
Wang, R., Čustović, A., Simpson, A., Belgrave, D. C. M., Lowe, L. A., & Murray, C. S. (2013) · Pediatric Pulmonology · doi:10.1002/ppul.22927 · Cited by 37 · see citing works
Obesity and pulmonary function testing
Beuther, D. A., & Sutherland, E. W. (2005) · Journal of Allergy and Clinical Immunology · doi:10.1016/j.jaci.2004.12.1141 · Cited by 37 · see citing works
Body weight characteristics of subjects on asthma medication
Hedberg, A., & Rössner, S. (2000) · International Journal of Obesity · doi:10.1038/sj.ijo.0801382 · Cited by 34 · see citing works
Association of General and Central Obesity and Atopic and Nonatopic Asthma in US Adults
Ma, J., & Xiao, L. (2013) · Journal of Asthma · doi:10.3109/02770903.2013.770014 · Cited by 23 · see citing works
Flagged first, then by citations
Research works printed but not linked: 1
- B.D. Ripley, Modern Applied Statistics with S: Springer, 2002.
Cited by
Sorted by citations
Epidemiology of Asthma in Children and Adults
Dharmage, S. C., Perret, J. L., & Custovic, A. (2019) · Frontiers in Pediatrics · doi:10.3389/fped.2019.00246 · Cited by 1,200 · see citing works
- Authors
- Jeong, A., Imboden, M., Hansen, S., Zemp, E., Bridevaux, P.-O., Lovison, G., Schindler, C., & Probst-Hensch, N.
- Affiliations
- Swiss Tropical and Public Health Institute (CH)
- University of Geneva (CH)
- University of Palermo (IT)
- Corresponding author
- Probst-Hensch, Nicole
- ORCID
- Venue
- Respiratory Medicine
- Publisher
- Elsevier BV
- Published
- 2017-04
- Volume
- 125
- Pages
- 25-32
- ISSN
- 0954-6111 (ISSN-L)
- OpenAlex
- W2589720497
- Cited by
- 23
- References
- 39
- Citations by year
- 2026: 3 · 2025: 1 · 2024: 1 · 2023: 1 · 2022: 1 · 2021: 3 · 2020: 3 · 2019: 4 · 2018: 4 · 2017: 2
- FWCI
- 2.63
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Respiratory Medicine (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Nova Science Publishers (Nova Science Publishers, Inc.) (submittedVersion, other-oa)
- INFM-OAR (INFN Catania) (submittedVersion, cc-by-nc-nd)
- Funders
- National Science Foundation
- Freiwillige Akademische Gesellschaft
- Wellcome Trust (084703)
- European Commission (308610, 018996, 018996 (GABRIEL)
- Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung (104283, 104284, 148470, 33CSCO134276/1, 33CSCO, 65896, 134276, 52720, PMPDP3_129021/1, 28099, 108796, 135673, 59302, 42532, 33CS30–148470/1, 018996, no 33CS30-148470/1, 33CS30, PMPDP3_141671/1, 104288)
- Bundesamt für Gesundheit
- Chinese Society of Clinical Oncology
- Lungenliga Schweiz
- Abbott Diagnostics
- Bundesamt für Umwelt
- Topics
- Health Sciences › Medicine › Physiology › Asthma and respiratory diseases
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Chronic Obstructive Pulmonary Disease (COPD) Research
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Occupational exposure and asthma
- Keywords
- obesity, asthma phenotypes, asthma heterogeneity, latent class analysis, SAPALDIA cohort, body mass index, body fat percentage, waist circumference, allergic asthma, non-allergic asthma, persistent asthma, asthma aetiology, age of asthma onset, atopy
- MeSH terms
- Adolescent, Adult, Asthma, Female, Humans, Hypersensitivity, Immediate, Male, Middle Aged, Obesity, Phenotype, Risk Factors, Smoking, Spirometry, Switzerland, Cohort Studies, Body Mass Index, Body Fat Distribution, Waist Circumference, Young Adult, Self Report
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
