Overweight and Obesity Associated with Higher Risk of Asthma in Patients with Chronic Rhinosinusitis

Introduction: Obesity and chronic rhinosinusitis (CRS) are independent risk factors for new-onset asthma, but their combined impact on asthma risk in CRS patients remains underexplored. This study assesses asthma risk among overweight and obese CRS patients compared to healthy-weight controls.

Methods: The TriNetX Analytics U.S. Collaborative Network, a federated research platform that aggregates de-identified electronic health record (EHR) data, was queried to identify CRS patients with EHR-recorded BMI measurements of overweight and obese weight between 2009-2019. These cohorts were then propensity score matched to healthy-weight controls based on demographics and comorbidities. Primary outcomes were new-onset asthma and asthma exacerbations at 1, 2, and 5-year follow-ups.

Results: Compared to healthy-weight CRS patients, overweight CRS patients had modestly increased risks of new-onset asthma (aRR=1.13, 1.13, 1.14) and asthma exacerbations (aRR=1.23, 1.25, 1.25) across 1, 2, and 5 years (all p< 0.0001). Obese CRS patients had significantly elevated risks for new-onset asthma (aRR=1.39, 1.38, 1.38) and asthma exacerbations (aRR=1.62, 1.64, 1.62) at each interval (all p< 0.0001). When comparing obese to overweight CRS patients, obesity was associated with higher risks of new-onset asthma (aRR=1.25, 1.24, 1.22) and exacerbations (aRR=1.35, 1.33, 1.31, all p< 0.0001).

Conclusions: Obesity significantly increases the risk of new-onset asthma and exacerbations in CRS patients, with a dose-dependent effect compared to overweight and healthy-weight individuals. These results propose the importance of weight management as a potential modifiable factor in CRS-associated asthma prevention and management. Further research is needed to elucidate the underlying inflammatory and physiologic mechanisms driving this association and to assess whether targeted interventions can mitigate asthma risk in this high-risk population.