The association between body size and chronic upper airway disorders

Background: Excess weight can contribute to chronic, systemic inflammation and is a major risk factor for chronic disease. Chronic upper airway disorders such as allergic rhinitis (AR) and chronic rhinosinusitis (CRS), are prevalent sinonasal disorders considered to be perpetuated by significant inflammatory pathways. The objective of this epidemiological study was to determine whether body size was associated with chronic sinonasal disease from a national population survey. Methods: A cross-sectional study of 17,248 respondents from the Australian National Health Survey 2017/18 was performed. Respondents reporting symptoms of chronic sinonasal disease (AR or CRS) for 6 months prior to being surveyed were included. Body mass index (BMI) was categorized as underweight (<18.5), healthy (18.5–24.9), overweight (25.0–29.9) or obese (≥30.0). Waist circumference (WC) was measured in centimeters [females—healthy (<80 cm), increased (≥80 and <88 cm), substantially increased (≥88 cm); males—healthy (<94 cm), increased (≥94 and <102 cm), substantially increased (≥102 cm)]. Additional co-variates included age, gender, ethnicity, cigarette smoking, and alcohol consumption. Results: The prevalence of sinonasal disease symptoms was 31.3%, consisting of 21.5% reporting symptoms of AR and 9.8% reporting symptoms of CRS. After controlling for age, gender, ethnicity, cigarette smoking and alcohol consumption, respondents classified as obese or with a substantially increased WC were significantly more likely to report symptoms of CRS than healthy counterparts [obese—OR 1.3 (1.1–1.5), P<0.001; substantially increased WC—OR 1.3 (1.1–1.6), P<0.001]. After adjustment, AR symptoms were not associated with increased BMI or enlarged WC. Conclusions: Body size is associated with symptoms of CRS. Individuals with CRS symptoms are more likely to be obese and have a substantially increased waist circumference. Future research is warranted to investigate the mechanisms contributing to CRS symptoms and if pro-inflammatory conditions or comorbid conditions, such as gastrointestinal reflux, coexist.