RATIONALE: Asthma, obesity and physical activity (PA) are interrelated. However, longitudinal data with objective PA measures and direct assessment of body composition are still lacking. OBJECTIVE: To study the impact of symptom control on PA and body composition. METHODS: In a longitudinal cohort study of the German Center for Lung Research, we assessed the body composition of 233 asthma patients and 84 healthy controls using bioelectrical impedance analysis. PA (ie average daily steps and time of at least moderate activity, steps/min) was measured by accelerometry for one week. Asthma control was assessed by ACT score, ACQ-5 score and history of severe exacerbations. After two years of follow-up, we studied changes in physical activity and body composition in relation to asthma control. RESULTS: Patients with uncontrolled asthma had increased fat mass and decreased muscle mass compared to patients with controlled asthma or healthy controls. Both fat mass and muscle mass correlated better with asthma control than the body mass index (BMI). In multivariate regressions adjusted for age and sex, asthma control and physical activity were independent predictors of body composition (R(2) = 0.61, p < 0.001). Persistent uncontrolled asthma patients (n=64) had lower physical activity at both baseline (6614 steps/118 min) and follow-up (6195/115). Despite having stable BMI, they also had significant muscle loss (-1.2%, -0.88 kg, p<0.01) and fat accumulation (+1%, +1.1 kg, p<0.01). By contrast, temporarily uncontrolled or controlled asthma patients had higher physical activity at baseline (8670/156) and follow -up (9058/153) with almost unchanged body composition. CONCLUSION: Persistent uncontrolled asthma is associated with sustained physical inactivity and adverse changes in body composition that might be overlooked by relying solely on BMI. Physical activity is an independent predictor of body composition and reliable long-term marker of symptom control.
- Abdo, M.
- Waschki, B.
- Kirsten, A. M.
- Trinkmann, F.
- Biller, H.
- Herzmann, C.
- von Mutius, E.
- Kopp, M.
- Hansen, G.
- Rabe, K. F.
- Bahmer, T.
- Watz, H.
Keywords
- Bmi
- body composition
- fat mass
- muscle mass
- physical activity
- symptom control
- support from Actelion, Berlin Chemie, Boehringer Ingelheim, Chiesi, Novartis,
- Mundipharma and TEVA as well as speaker or consultation fees from AstraZeneca,
- Berlin Chemie, Boehringer Ingelheim, Bristol-Myers Squibb, Chiesi, GlaxoSmithKline,
- Novartis and Roche, Sanofi aventis, all outside the submitted work. Anne-Marie
- Kirsten, Heike biller, Frauke Pedersen and Christian Herzmann report no conflict of
- interest. Erika von Mutius reports personal fees from Pharmaventures, personal fees
- from OM Pharma S. A., personal fees from Springer-Verlag GmbH, personal fees from
- Elsevier GmbH and Elsevier Ltd., personal fees from Peptinnovate Ltd., personal fees
- from Turun Yliopisto, personal fees from Tampereen Yliopisto, personal fees from
- Helsingin Yliopisto, personal fees from European Respiratory Society, personal fees
- from Deutsche Pharmazeutische Gesellschaft e. V., personal fees from Massachusetts
- Medical Society, personal fees from Chinese University of Hongkong, personal fees
- from European Commission, personal fees from Böhringer Ingelheim International GmbH,
- personal fees from Universiteit Utrecht, Faculteit Diergeneeskunde, personal fees
- from Universität Salzburg, personal fees from Georg Thieme Verlag, personal fees
- from Japanese Society of Pediatric Allergy and Clinical Immunology (JSPACI), outside
- the submitted work
- In addition, Dr. von Mutius has a patent LU101064 - Barn dust
- extract for the prevention and treatment of diseases pending, a patent EP2361632:
- Specific environmental bacteria for the protection from and/or the treatment of
- allergic, chronic inflammatory and/or autoimmune disorders with royalties paid to
- ProtectImmun GmbH, a patent EP 1411977: Composition containing bacterial antigens
- used for the prophylaxis and the treatment of allergic diseases licensed to
- ProtectImmun GmbH, a patent number EP1637147: Stable dust extract for allergy
- protection licensed to ProtectImmun GmbH, and a patent EP 1964570: Pharmaceutical
- compound to protect against allergies and inflammatory diseases licensed to
- ProtectImmun GmbH. Matthias V. Kopp, Gesine Hansen, Benjamin Waschki, Klaus F. Rabe
- and Henrik Watz reports no relevant conflict of interest. Thomas Bahmer reports
- grants from BMBF: Unrestricted research grant for the German Center for Lung
- Research (DZL), during the conduct of the study
- personal fees from AstraZeneca,
- personal fees from GlaxoSmithKline, personal fees from Novartis, and personal fees
- from Roche, outside the submitted work. The authors report no other conflicts of
- interest in this work.
