Risk of asthma and autoimmune diseases and related conditions in patients hospitalized for obesity

Figures & data

Table I. Number of cases of first hospitalizations for obesity in men and women and number of controls hospitalized for autoimmune and related disorders without prior hospitalization for obesity.

	First hospitalizations for obesity						First hospitalizations for autoimmune and related disorders without obesity
Age at diagnosis (years)	Men		Women		All
	n	%	n	%	n	%	n	%
10–19	816	11.9	1064	4.7	1880	6.3	37443	10.2
20–29	746	10.9	3009	13.2	3755	12.7	36241	9.9
30–39	1378	20.1	6372	27.9	7750	26.1	42321	11.5
40–49	1729	25.2	5926	26.0	7655	25.8	47021	12.8
50–59	1450	21.2	4236	18.6	5686	19.2	58111	15.8
60–69	562	8.2	1595	7.0	2157	7.3	63701	17.3
70–79	136	2.0	491	2.2	627	2.1	57307	15.6
≥80	38	0.6	117	0.5	155	0.5	25314	6.9
All	6855	100.0	22810	100.0	29665	100.0	367459	100.0

Table II. SIR for subsequent autoimmune and related disorders of patients with obesity.

	Follow-up interval (years)
	<1				1–4				5–9				≥10				All
Autoimmune disorders	O	SIR	95% CI		O	SIR	95% CI		O	SIR	95% CI		O	SIR	95% CI		O	SIR	95% CI
Amyotrophic lateral sclerosis	0				2	1.40	0.13	5.14	1	0.53	0.00	3.03	3	0.62	0.12	1.83	6	0.72	0.26	1.57
Ankylosing spondylitis	0				4	2.37	0.62	6.12	7	4.38	1.73	9.07	4	1.59	0.41	4.12	15	2.47	1.38	4.09
Asthma	42	10.66	7.68	14.42	74	2.74	2.15	3.44	101	3.70	3.01	4.49	142	2.98	2.51	3.51	359	3.39	3.05	3.76
Behçet's disease	2	22.22	2.09	81.72	2	3.39	0.32	12.47	3	5.45	1.03	16.15	1	1.82	0.00	10.42	8	4.49	1.92	8.90
Chronic rheumatic heart disease	0				4	1.12	0.29	2.91	5	1.39	0.44	3.28	2	0.33	0.03	1.20	11	0.80	0.40	1.43
Crohn's disease	2	1.59	0.15	5.84	9	1.16	0.53	2.21	14	1.86	1.01	3.13	17	1.36	0.79	2.18	42	1.45	1.04	1.96
Diabetes mellitus type 1	1	3.70	0.00	21.23	7	3.80	1.51	7.88	1	0.85	0.00	4.90	1	2.63	0.00	15.08	10	2.73	1.30	5.04
Graves's, hyperthyroidism	6	2.22	0.80	4.87	15	0.86	0.48	1.42	21	1.25	0.77	1.91	41	1.47	1.05	1.99	83	1.28	1.02	1.58
Hashimoto's/hypothyroidism	11	23.91	11.87	42.93	22	7.10	4.44	10.76	5	1.57	0.50	3.70	16	2.51	1.43	4.08	54	4.12	3.09	5.37
Immune thrombocytopenic purpura	1	6.67	0.00	38.22	2	2.15	0.20	7.91	3	2.97	0.56	8.79	4	1.67	0.44	4.33	10	2.23	1.06	4.12
Multiple sclerosis	3	2.80	0.53	8.30	10	1.51	0.72	2.78	9	1.43	0.65	2.73	16	1.64	0.94	2.67	38	1.60	1.13	2.20
Pernicious anemia	1	6.25	0.00	35.83	1	0.84	0.00	4.82	2	1.59	0.15	5.84	7	3.30	1.31	6.84	11	2.33	1.15	4.18
Polymyalgia rheumatica	2	3.03	0.29	11.14	10	1.97	0.94	3.64	13	2.08	1.10	3.56	23	1.35	0.85	2.02	48	1.65	1.22	2.19
Primary biliary cirrhosis	0				1	2.27	0.00	13.03	1	1.82	0.00	10.42	5	3.57	1.13	8.40	7	2.85	1.13	5.90
Psoriasis	8	10.39	4.44	20.57	28	5.48	3.64	7.93	25	4.96	3.21	7.33	28	3.23	2.14	4.67	89	4.54	3.65	5.59
Rheumatoid arthritis	5	1.79	0.57	4.22	25	1.29	0.83	1.90	29	1.41	0.94	2.03	55	1.36	1.02	1.77	114	1.37	1.13	1.65
Sarcoidosis	1	1.75	0.00	10.06	6	1.63	0.59	3.58	8	2.33	0.99	4.60	16	2.82	1.61	4.59	31	2.32	1.58	3.30
Sjögren's syndrome	0				3	3.85	0.73	11.39	4	4.44	1.16	11.49	3	1.45	0.27	4.29	10	2.59	1.23	4.78
Systemic lupus erythematosus	0				2	0.75	0.07	2.75	0				6	1.45	0.52	3.18	8	0.82	0.35	1.62
Systemic sclerosis	0				4	2.47	0.64	6.38	3	1.79	0.34	5.29	4	1.40	0.37	3.63	11	1.72	0.86	3.10
Ulcerative colitis	3	1.90	0.36	5.62	9	0.91	0.41	1.74	13	1.36	0.72	2.32	18	1.08	0.64	1.71	43	1.14	0.82	1.54
Wegener's granulomatosis	0				2	0.83	0.08	3.05	2	0.77	0.07	2.82	2	0.51	0.05	1.88	6	0.65	0.23	1.42
All of above	88	4.73	3.79	5.83	242	1.95	1.71	2.21	270	2.15	1.90	2.43	414	1.83	1.66	2.02	1014	2.05	1.93	2.18
All of above minus asthma	46	3.14	2.30	4.19	168	1.73	1.48	2.01	169	1.72	1.47	2.00	272	1.52	1.35	1.72	655	1.69	1.56	1.82

Bold type: 95% CI does not include 1.00.

O = observed number of cases; SIR = standardized incidence ratio; CI = confidence interval.

Table III. SIR for subsequent autoimmune and related disorders in obese patients by age at hospitalization; follow-up was started 1 year after last hospitalization for obesity.

	Age at diagnosis of obesity (years)
	<30				30–39				40–49				50–59				≥60
Autoimmune disorders	O	SIR	95% CI		O	SIR	95% CI		O	SIR	95% CI		O	SIR	95% CI		O	SIR	95% CI
Amyotrophic lateral sclerosis	1	2.22	0.00	12.74	1	1.09	0.00	6.23	2	0.97	0.09	3.55	2	0.67	0.06	2.47	0
Ankylosing spondylitis	7	3.70	1.47	7.67	2	1.27	0.12	4.66	4	3.01	0.78	7.78	1	1.30	0.00	7.44	1	4.55	0.00	26.06
Asthma	51	2.89	2.15	3.80	70	4.10	3.20	5.18	73	3.08	2.41	3.87	90	3.44	2.76	4.23	33	1.90	1.31	2.67
Behçet's disease	1	1.75	0.00	10.06	1	3.13	0.00	17.91	1	3.33	0.00	19.11	2	7.41	0.70	27.24	1	4.76	0.00	27.30
Chronic rheumatic heart disease	0				2	1.49	0.14	5.49	1	0.34	0.00	1.97	5	1.05	0.33	2.46	3	0.87	0.16	2.59
Crohn's disease	20	1.92	1.17	2.96	10	1.55	0.74	2.87	6	1.04	0.37	2.28	4	1.05	0.27	2.71	0
Diabetes mellitus type 1	9	2.65	1.20	5.06	0				0				0				0
Graves's, hyperthyroidism	17	1.10	0.64	1.77	16	1.06	0.60	1.73	21	1.52	0.94	2.33	19	1.71	1.03	2.68	4	0.58	0.15	1.50
Hashimoto's/hypothyroidism	4	2.60	0.68	6.72	6	2.84	1.02	6.23	12	4.05	2.08	7.10	9	2.77	1.26	5.28	12	4.29	2.20	7.51
Immune thrombocytopenic purpura	3	3.09	0.58	9.16	1	1.19	0.00	6.82	2	2.04	0.19	7.51	3	3.06	0.58	9.06	0
Multiple sclerosis	14	2.29	1.25	3.85	11	1.61	0.80	2.89	7	1.20	0.48	2.48	2	0.65	0.06	2.40	1	1.27	0.00	7.26
Pernicious anemia	1	4.76	0.00	27.30	2	6.45	0.61	23.73	0				6	4.35	1.56	9.53	1	0.51	0.00	2.91
Polymyalgia rheumatica	1	0.62	0.00	3.56	5	1.87	0.59	4.41	7	1.19	0.47	2.47	18	1.91	1.13	3.02	15	1.70	0.95	2.81
Primary biliary cirrhosis	1	4.35	0.00	24.92	3	6.67	1.26	19.73	2	2.82	0.27	10.36	0				1	3.57	0.00	20.47
Psoriasis	14	3.68	2.01	6.20	18	4.75	2.81	7.52	26	5.20	3.39	7.63	13	3.04	1.61	5.22	10	5.05	2.41	9.32
Rheumatoid arthritis	11	1.40	0.69	2.51	14	1.07	0.58	1.81	35	1.59	1.11	2.21	29	1.20	0.80	1.72	20	1.50	0.92	2.33
Sarcoidosis	12	3.73	1.92	6.53	6	2.17	0.78	4.76	8	2.61	1.11	5.16	4	1.50	0.39	3.87	0
Sjögren's syndrome	1	2.17	0.00	12.46	0				1	0.89	0.00	5.12	4	4.12	1.07	10.66	4	9.52	2.48	24.63
Systemic lupus erythematosus	3	1.31	0.25	3.88	0				1	0.44	0.00	2.55	2	1.14	0.11	4.18	2	2.56	0.24	9.43
Systemic sclerosis	3	2.75	0.52	8.15	3	2.48	0.47	7.34	1	0.63	0.00	3.61	2	1.35	0.13	4.97	2	2.63	0.25	9.68
Ulcerative colitis	11	0.86	0.43	1.54	10	1.18	0.56	2.18	6	0.84	0.30	1.84	11	2.08	1.03	3.74	2	0.82	0.08	3.00
Wegener's granulomatosis	0				0				1	0.66	0.00	3.77	2	0.66	0.06	2.41	3	0.92	0.17	2.73
All of above	185	1.98	1.71	2.29	181	2.03	1.75	2.35	217	1.96	1.71	2.24	228	2.03	1.77	2.31	115	1.63	1.35	1.96
All of above minus asthma	134	1.77	1.48	2.10	111	1.54	1.27	1.86	144	1.66	1.40	1.95	138	1.60	1.35	1.89	82	1.54	1.23	1.92

Bold type: 95% CI does not include 1.00.

O = observed number of cases; SIR = standardized incidence ratio; CI = confidence interval.

Table IV. SIR for subsequent autoimmune and related disorders in obese patients by number of hospitalizations; follow-up was started 1 year after last hospitalization for obesity.

	Number of hospitalizations for obesity
	1				2				≥3
Autoimmune disorders	O	SIR	95% CI		O	SIR	95% CI		O	SIR	95% CI
Amyotrophic lateral sclerosis	3	0.51	0.10	1.51	2	1.46	0.14	5.37	1	1.06	0.00	6.10
Ankylosing spondylitis	12	2.84	1.46	4.97	2	2.08	0.20	7.66	1	1.59	0.00	9.10
Asthma	215	2.89	2.51	3.30	50	3.00	2.22	3.95	52	4.81	3.59	6.31
Behçet's disease	5	3.94	1.24	9.26	0				1	6.25	0.00	35.83
Chronic rheumatic heart disease	5	0.51	0.16	1.20	3	1.41	0.27	4.17	3	2.17	0.41	6.44
Crohn's disease	27	1.32	0.87	1.93	9	2.01	0.91	3.84	4	1.37	0.36	3.54
Diabetes mellitus type 1	5	1.75	0.55	4.11	4	10.81	2.81	27.95	0
Graves's, hyperthyroidism	53	1.17	0.88	1.53	16	1.53	0.87	2.49	8	1.23	0.52	2.43
Hashimoto's/hypothyroidism	26	2.82	1.84	4.13	11	5.16	2.56	9.27	6	4.72	1.70	10.35
Immune thrombocytopenic purpura	4	1.27	0.33	3.28	5	6.85	2.16	16.11	0
Multiple sclerosis	30	1.82	1.23	2.61	3	0.79	0.15	2.35	2	0.81	0.08	2.99
Pernicious anemia	9	2.66	1.21	5.08	1	1.30	0.00	7.44	0
Polymyalgia rheumatica	31	1.51	1.02	2.14	13	2.71	1.44	4.65	2	0.65	0.06	2.40
Primary biliary cirrhosis	4	2.35	0.61	6.08	1	2.38	0.00	13.65	2	7.41	0.70	27.24
Psoriasis	54	3.96	2.97	5.17	14	4.50	2.45	7.57	13	6.22	3.30	10.67
Rheumatoid arthritis	79	1.36	1.08	1.70	18	1.34	0.79	2.11	12	1.33	0.68	2.32
Sarcoidosis	23	2.46	1.56	3.70	4	1.89	0.49	4.88	3	2.27	0.43	6.73
Sjögren's syndrome	6	2.25	0.81	4.92	3	4.69	0.88	13.88	1	2.22	0.00	12.74
Systemic lupus erythematosus	4	0.59	0.15	1.52	3	1.95	0.37	5.77	1	0.99	0.00	5.68
Systemic sclerosis	7	1.58	0.62	3.27	2	1.96	0.18	7.21	2	2.90	0.27	10.66
Ulcerative colitis	32	1.20	0.82	1.70	3	0.52	0.10	1.53	5	1.32	0.42	3.11
Wegener's granulomatosis	5	0.75	0.24	1.77	1	0.68	0.00	3.90	0
All of above	639	1.84	1.70	1.99	168	2.14	1.83	2.49	119	2.35	1.94	2.81
All of above minus asthma	424	1.56	1.41	1.71	118	1.91	1.58	2.29	67	1.68	1.30	2.13

Bold type: 95% CI does not include 1.00.

O = observed number of cases; SIR = standardized incidence ratio; CI = confidence interval.