SAN FRANCISCO – Overweight inner-city teenagers with nonobstructive asthma were more likely than their normal-weight peers to report that their asthma was out of control even when spirometry results suggested they were having a relatively good day, a study of 114 teens found.
The study included 102 normal-weight adolescents and 112 overweight adolescents (defined as a body mass index greater than the 85th percentile) who completed the Asthma Control Test and spirometry measures. Observed lung function was similar between the two groups, Iwalola Awoyinka and her associates reported at the annual meeting of the American Academy of Allergy, Asthma, and Immunology.
Ms. Iwalola Awoyinka
Overall, the overweight teenagers were more likely than the normal-weight teenagers to report uncontrolled asthma on the Asthma Control Test. When compared by asthma pattern, however, only teens with nonobstructive asthma were significantly more likely to report uncontrolled asthma (in more than 60%), compared with normal-weight teens with nonobstructive asthma, approximately 50% of whom reported uncontrolled asthma.
Among teens with an obstructive asthma pattern, reports of uncontrolled asthma were statistically similar between the overweight and normal-weight groups, hovering around 60%, said Ms. Awoyinka, a pulmonary function specialist and research coordinator at the University of Wisconsin, Madison.
What some overweight teens perceive as uncontrolled asthma may be a symptom of deconditioning, Ms. Awoyinka suggested. Misperceptions of uncontrolled asthma may lead to overuse of asthma medication. Perhaps prescriptions for overweight teens with asthma should include prescriptions to exercise, she added in an interview.
Uncontrolled asthma, defined as a score of 19 or less on the Asthma Control Test, was reported by 131 adolescents. Spirometry identified 99 teens as having nonobstructive asthma and 115 as having an obstructive asthma pattern, defined as less than 80% of predicted forced expiratory volume in 1 second (FEV1) or a ratio of FEV1 to forced vital capacity (FVC) of less than 0.85.
The analysis was part of a larger study of the use of electronic technology to improve asthma control in 218 inner-city teens on Medicaid, 4 of whom were excluded from the analysis because of a lack of acceptable spirometry results. Previous studies have shown that teens with low socioeconomic status are more likely to be overweight and to have asthma than are more affluent teens.
The National Institutes of Health funded the study. The investigators reported having no relevant conflicts of interest.