J ALLERGY CLIN IMMUNOL

VOLUME 127, NUMBER 2

Abstracts AB153

MONDAY

579 Relationship Between Body Mass Index (BMI) and BaselineCharacteristics in Non-Black and Black Populations WithModerate to Severe Persistent Asthma

S. L. Spector1, T. Uryniak2, U. J. Martin2; 1California Allergy & Asthma

Medical Group, Los Angeles, CA, 2AstraZeneca LP, Wilmington, DE.

RATIONALE: Obesity is more prevalent in black populations

(MMWR.2009;58:740-744) and may be associated with greater asthma im-

pairment (Thorax. 2008;63:14-20). The relationship between BMI and

baseline characteristics was assessed in non-black and black patients

with moderate to severe persistent asthma.

METHODS:Datawere from2double-blind,12-week, randomizedstudieswith

similar inclusion/exclusion criteria conducted in non-black (study I [n5195]:

NCT00652002; Drugs. 2006;66:2235) or self-reported black (study II

[n5307]:NCT00702325)asthmapatients.Baselinecharacteristicsandrun-indi-

ary datawere stratified byBMI (<18.5, 18.5-24.9, 25-29.9, 30-39.9, >_40 kg/m2).

RESULTS:Moreblack (study II) versusnon-black (study I)patients hadBMI>_40 (22.5% vs 8.2%), with similar female/male ratios observed in that cate-

gory (I: 55/14, II: 13/3). In both studies, the percentage of patients receiving

high-dose ICSwas lowest in patients with BMI >_40 (I: 12.5%; II: 20.3%) ver-

sus otherBMIcategories (I: 17.0-35.2%; II: 25.0-39.5%).Comparedwith non-

black patients (I) with BMI >_40, black patients (II) had lower mean percent

predicted forced expiratory volume in 1 second (FEV1) (64.6% vs 70.7%),

morning peak expiratory flow (PEF) (L/min) (296.6 vs 349.8), and evening

PEF (294.8 vs 363.2). Less marked differences were observed between black

(II) and non-black (I) patients across BMI categories for symptoms-related di-

ary variables (rescue medication use, nighttime/daytime asthma symptoms,

symptom-free days, and awakening-free nights).

CONCLUSIONS: In these studies with similar recruitment criteria, there

were substantially more black than non-black patients with BMI >_40 kg/

m2, and findings suggested worse pulmonary function in black versus

non-black patients with BMI >_40 kg/m2.

580 The Association Between Asthma Symptoms And Obesity InAdolescents

K. Yoshida1, I. Masuko1,2, T. Akada3, T. Itazawa4, Y. Adachi4, A. Aka-

sawa2, Y. Ohya1; 1National Center for Child Health and Development, To-

kyo, JAPAN, 2Tokyo Metropolitan Children’s Medical Center, Tokyo,

JAPAN, 3Seishin high school & junior high school, Ibaraki, JAPAN, 4Uni-

versity of Toyama, Toyama, JAPAN.

RATIONALE: Asthma may be more prevalent in obese children. And we

have previously reported an association between obesity and asthma using

ISAAC questionnaire and self- or parent-reported heights and weights in

Japanese school-aged children.

METHODS: To further evaluate the relationship between obesity and

asthma symptoms, we carried out a survey in a private junior & senior

high school. In this school, students with asthma received school-based

asthma education. Subjects included all schoolchildren aged between 12

and18 years. Their heights,weights, and percent body fat (%BF)weremea-

sured in the school. The information of asthma symptoms was obtained us-

ing ISAAC questionnaire. Obese was defined by the two methods: BMI

(>_90th for age and gender) and %BF (>_25% for boys and >_35% for girls).

RESULTS: Of the total number of 1,106 students, 1,099 replied to ISAAC

questionnaire (response rate: 99.4%). The prevalence of obese was 17.6%

(17.6% in boys and 17.6% in girls) in BMI criteria and 9.3% (10.8% in boys

and 7.5% in girls) in%BF criteria. Analysis using BMI criteria, the prevalence

of current wheeze was and 2.6% in obese and 4.6% in non-obese (p50.37).

Analysis using %BF criteria, that of current wheeze was 3.9% in obese and

4.3% in non-obese (p50.87).Analysis using%BFcriteria showed a significant

difference in night cough (8.8% in obese and 4.0% in non-obese) (p50.038).

CONCLUSIONS: In adolescents who received asthma education, there

was no association between obesity and the prevalence of current wheeze.

581 Assessment of The Association of Asthma Status withSelective IgA Deficiency and Common VariableImmunodeficiency: A Population-Based Case-Control Study

Y. Juhn1, H. Yun1,2, S. Urm1,3, Y. Fenta1, K. Yoo1,4, R. Abraham5, J. Ha-

gan6; 1Department of Pediatric and Adolescent Medicine, Mayo Clinic,

Rochester, MN, 2Department of Medicine, Harbor Hospital, Baltimore,

MD, 3Department of Preventive Medicine, Medical College, Inje Univer-

sity, Busan, KOREA, REPUBLIC OF, 4Department of Internal Medicine,

School of Medicine, Konkuk University, Seoul, KOREA, REPUBLIC OF,5Department of Laboratory Medicine, Mayo Clinic, Rochester, MN, 6De-

partment of Medicine, Mayo Clinic, Rochester, MN.

RATIONALE: Asthmatics are at increased risks of bacterial infections but

little is known about the association between asthma and risk of primary im-

munodeficiency diseases such as selective IgAdeficiency (sIgAD) and/or com-

mon variable immunodeficiency (CVID). We conducted a population-based

case-control study using predetermined criteria for sIgAD/CVID and asthma.

METHODS: Cases were from the residents of Olmsted County,

Minnesota in 1984-2007, who met the criteria for the Pan-American

Group for Immunodeficiency and European Society for sIgAD/CVID.

We enrolled two sets of controls: One from the Rochester Epidemiology

Project database (community residents), the other from an immunology

lab database, individuals who had normal results for immunodeficiency

work-up. Each case was matched to four controls (two from the commu-

nity, two from the lab database) with regard to age and gender.

RESULTS:We identified 39 sIgAD/CVID cases; 26 (79%) had sIgAD, re-

maining caseswere CVID. Of these cases, 51.3%weremale and 97.1%were

Caucasians. The mean age at the index date of sIgAD/CVIDwas 34.1 years.

In the entire controls, 15 of 39 IgAD/CVID cases had asthmawhile 20 of 156

controls had asthma (Adjusted OR: 4.1, p50.0016), controlling for co-mor-

bid conditions. In controls from the community alone, 8 of 78 controls had

asthma (adjusted OR: 5.6, p50.003) whereas in controls from the lab data-

base, 12 of 78 controls had asthma (adjusted OR: 3.6, p50.018).

CONCLUSIONS: Patients with sIgAD/CVID are more likely to be asth-

matics. This association may potentially account for increased risks of bac-

terial infections among asthmatics.

582 Effects of Asthma Severity and Medication Use on Prematurityand Intrauterine Growth: A Meta Analysis from Published Data

J. A. Namazy1, V. E. Murphy2, H. Powell3, P. G. Gibson4, C. Chambers5,

M. Schatz6; 1Scripps Clinic, San Diego, CA, 2Center for Asthma and Res-

piratory Diseases, University of Newcastle and Hunter Medical Research

Institute, Newcastle, AUSTRALIA, 3John Hunter Hospital, Newcastle,

AUSTRALIA, 4Center for Asthma and Respiratory Diseases, University

of Newcastle and Hunter Medical Research Institute,John Hunter Hospi-

tal, Newcastle, AUSTRALIA, 5University of California at San Diego,

San Diego, CA, 6Kaiser Permanente Medical Center, San Diego, CA.

RATIONALE: Pregnant women with asthma have been shown to have an

increased risk of preterm birth, lowbirthweight and small for gestational age.

Mechanisms for these adverse perinatal outcomes have not been defined.

METHODS: Electronic databases were searched for the following search

terms: (asthmaorwheeze and (pregnan *or perinat * or obstet *)). Cohort stud-

ies conducted between 1975 and 2009 in which pregnancy outcomes (preterm

delivery, low birth weight, and small for gestational age) in womenwith: exac-

erbations versus no exacerbation, oral corticosteroid use versus no oral cortico-

steroid use, moderate or severe asthma versus mild asthma, and other asthma

medication use(beta-agonist, inhaled corticosteroids and theophylline) were

considered for inclusion in the meta-analysis. Twelve of 103 identified articles

were included in this meta-analysis.

RESULTS:Maternal asthma exacerbations and oral corticosteroid use had a

significant effect on outcomes including: low birth weight (RR3.02, 95%CI

[1.87,4.89]) and (RR 1.41,95%CI[1.04,1.93]), respectively and preterm deliv-

ery (RR 1.54, 95%CI[0.89,2.69]) and (RR 1.51,95%CI[1.15,1.98]), respec-

tively. Moderate to severe asthma during pregnancy was associated with an

increased risk of small for gestational age infants (RR 1.16, 95%CI

[1.01,1.33]). The risk of LBW, preterm delivery and SGA infants was not

higher among those asthmatics using beta-agonists or inhaled corticosteroids.

CONCLUSIONS: These data suggest that asthma severity defined as

moderate to severe asthma, exacerbations, or oral corticosteroid use may

be associated with preterm delivery, low birth weight, and small for gesta-

tional age. Further studies on the effect of maternal asthma control on per-

inatal outcomes are warranted.