From Medscape Medical News CME
Large Waist Size Linked to Asthma in Women CME
News Author: Laurie Barclay, MD
CME Author: Désirée Lie, MD, MSEd
Authors and Disclosures
CME Released: 09/03/2009; Valid for credit through 09/03/2010
* Print This Print This
* Email This Email this
processing....
[ ]
[ ]
CME Information
Target Audience
This article is intended for primary care clinicians, pulmonologists, gynecologists, and other specialists who care for women with obesity or asthma.
Goal
The goal of this activity is to provide medical news to primary care clinicians and other healthcare professionals in order to enhance patient care.
Authors and Disclosures
Laurie Barclay, MD
freelance writer and reviewer, MedscapeCME
Disclosure: Laurie Barclay, MD, has disclosed no relevant financial relationships.
Brande Nicole Martin
is the News CME editor for Medscape Medical News.
Disclosure: Brande Nicole Martin has disclosed no relevant financial information.
Désirée Lie, MD, MSEd
Clinical Professor, Family Medicine, University of California, Orange; Director, Division of Faculty Development, UCI Medical Center, Orange, California
Disclosure: Désirée Lie, MD, MSEd, has disclosed no relevant financial relationships.
Learning Objectives
Upon completion of this activity, participants will be able to:
1. Describe the association between asthma prevalence and body mass index in women.
2. Describe the association between asthma prevalence and severity and waist circumference in women.
Credits Available
Physicians - maximum of 0.25 AMA PRA Category 1 Credit(s)™
Family Physicians - maximum of 0.25 AAFP Prescribed credit(s)
All other healthcare professionals completing continuing education credit for this activity will be issued a certificate of participation.
Physicians should only claim credit commensurate with the extent of their participation in the activity.
Accreditation Statements
For Physicians
MedscapeCME is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
MedscapeCME designates this educational activity for a maximum of 0.25 AMA PRA Category 1 Credit(s)™ . Physicians should only claim credit commensurate with the extent of their participation in the activity. Medscape News CME has been reviewed and is acceptable for up to 300 Prescribed credits by the American Academy of Family Physicians. AAFP accreditation begins September 1, 2009. Term of approval is for 1 year from this date. (This/Each) (element, volume, issue, monograph, tape, web cast, etc) is approved for .25 Prescribed credits. Credit may be claimed for 1 year from the date of (this/each) (issue, webcast, etc.)
Note: Total credit is subject to change based on topic selection and article length.
AAFP Accreditation Questions
Contact This Provider
For questions regarding the content of this activity, contact the accredited provider for this CME/CE activity noted above. For technical assistance, contact CME@medscape.net
CME Released: 09/03/2009; Valid for credit through 09/03/2010
Instructions for Participation and Credit
There are no fees for participating in or receiving credit for this online educational activity. For information on applicability and acceptance of continuing education credit for this activity, please consult your professional licensing board.
This activity is designed to be completed within the time designated on the title page; physicians should claim only those credits that reflect the time actually spent in the activity. To successfully earn credit, participants must complete the activity online during the valid credit period that is noted on the title page.
Follow these steps to earn CME/CE credit*:
1. Read the target audience, learning objectives, and author disclosures.
2. Study the educational content online or printed out.
3. Online, choose the best answer to each test question. To receive a certificate, you must receive a passing score as designated at the top of the test. MedscapeCME encourages you to complete the Activity Evaluation to provide feedback for future programming.
You may now view or print the certificate from your CME/CE Tracker. You may print the certificate but you cannot alter it. Credits will be tallied in your CME/CE Tracker and archived for 6 years; at any point within this time period you can print out the tally as well as the certificates by accessing "Edit Your Profile" at the top of your Medscape homepage.
*The credit that you receive is based on your user profile.
Hardware/Software Requirements
MedscapeCME is accessible using the following browsers: Internet Explorer 6.x or higher, Firefox 2.x or higher, Safari 2.x or higher. Certain educational activities may require additional software to view multimedia, presentation or printable versions of their content. These activities will be marked as such and will provide links to the required software. That software may be: Macromedia Flash, Adobe Acrobat, or Microsoft PowerPoint.
September 3, 2009 — Large waist size is associated with increased asthma prevalence, even among women considered to have normal body weight, according to results from the California Teachers Study cohort reported online in the August 25 issue of Thorax.
"Obesity is a risk factor for asthma, particularly in women, but few cohort studies have evaluated abdominal obesity which reflects metabolic differences in visceral fat known to influence systemic inflammation," write J. Von Behren, MPH, from Northern California Cancer Center in Berkeley, California, and colleagues. "A study was undertaken to examine the relationship between the prevalence of asthma and measures of abdominal obesity and adult weight gain in addition to body mass index (BMI) in a large cohort of female teachers."
Questionnaires were completed in 1995, 1997, 2000, and 2005. Allowing adjustment for age, smoking, and race/ethnicity, multivariable linear modeling was used to calculate prevalence odds ratios (ORs) for current asthma. At baseline, 11,500 (13%) of 88,304 women studied from the cohort were obese, defined as BMI of more than 30 kg/m2, and 1334 were extremely obese, defined as BMI of more than 40 kg/m2.
The adjusted OR for adult-onset asthma was 1.40 (95% confidence interval [CI], 1.31 - 1.49) for overweight women vs those of normal weight and 3.30 (95% CI, 2.85 - 3.82) for extremely obese women. Even among women with normal BMI, large waist circumference (WC; > 88 cm) was linked to increased prevalence of asthma (OR, 1.37; 95% CI, 1.18 - 1.59).
Compared with obese women whose waist was 88 cm or less, obese women who also had abdominal obesity had a greater risk for asthma (OR, 2.36 vs 1.57). The risk for severe asthma episodes, reflected in urgent medical visits and hospital admissions, was also greater in obese and overweight women.
"This study confirms the association between excess weight and asthma severity and prevalence, and showed that a large waist was associated with increased asthma prevalence even among women considered to have normal body weight," the study authors write. "All measures of obesity were strongly associated with increased asthma prevalence. Even being modestly overweight was associated with higher asthma prevalence in this population."
Limitations of this study include lack of data on several recognized risk factors for asthma, mostly cross-sectional data, reliance on self-report for physician diagnosis of asthma, and possible selection bias or participation bias.
"These findings are particularly troubling because a majority of American adults are now overweight or obese," the study authors conclude. "In the next phase of this study we will prospectively ascertain new asthma cases and will be able to evaluate BMI, waist size and weight change as risk factors for incident asthma in women."
The National Cancer Institute supported this study. The study authors have disclosed no relevant financial relationships.
Thorax. Published online August 25, 2009. Abstract
posted by DrR @ 3:54 PM
0 Comments:
Post a Comment
<< Home