The Influence of Body Mass Index on Glucocorticoid Insensitivity in Chronic Rhinosinusitis with Nasal Polyps

Yuling Zhang; Shen Shen; Yating Liu; Zaichuan Wang; Qiqi Wang; Yan Li; Chengshuo Wang; Feng Lan; Luo Zhang

doi:10.3390/jpm12111935

The Influence of Body Mass Index on Glucocorticoid Insensitivity in Chronic Rhinosinusitis with Nasal Polyps

J Pers Med. 2022 Nov 21;12(11):1935. doi: 10.3390/jpm12111935.

Authors

Yuling Zhang¹, Shen Shen², Yating Liu¹, Zaichuan Wang¹, Qiqi Wang², Yan Li², Chengshuo Wang^{1

2}, Feng Lan², Luo Zhang^{1

2

3}

Affiliations

¹ Department of Otolaryngology, Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China.
² Beijing Key Laboratory of Nasal Disease, Beijing Institute of Otolaryngology, Beijing 100005, China.
³ Department of Allergy, Beijing Tongren Hospital, Capital Medical University, Beijing 100730, China.

Abstract

Background: Reasons for glucocorticoid (GC) insensitivity in chronic rhinosinusitis with nasal polyps (CRSwNP) are not completely clear. Here, we investigate the influence of body mass index (BMI) on GC insensitivity in eosinophilic CRSwNP (eosCRSwNP) and noneosinophilic CRSwNP (noneosCRSwNP) patients.

Methods: We recruited 699 CRSwNP patients and gave them a course of oral methylprednisolone for 2 weeks (24 mg/day). Patient demographics and clinical features were analyzed in both GC-sensitive and GC-insensitive CRSwNP patients with different BMI levels and phenotypes.

Results: 35.3% of recruited CRSwNP patients were GC-insensitive, and the majority of GC-insensitive patients were males or prone to overweight & obese. Logistic regression analysis further confirmed that being overweight & obese was an independent risk factor for GC-insensitive of CRSwNP patients (odds ratio = 1.584, p = 0.049). Compared to underweight & normal-weight patients, overweight & obese patients were more likely to be GC insensitivity, particularly in the eosCRSwNP group, but not in the noneosCRSwNP group. However, there was no significant difference between the underweight & normal weight and the overweight & obese GC-insensitive eosCRSwNP patients regarding the number of infiltrated eosinophils, neutrophils, and polyp recurrence rate.

Conclusions: Collectively, our findings demonstrate for the first time that BMI contributes to GC insensitivity in eosCRSwNP patients.

Keywords: body mass index; chronic rhinosinusitis with nasal polyps; glucocorticoids.

Grants and funding

This work was supported by the National Nature Science Foundation of China (81970851), the Beijing Nova Program of Science and Technology (Z191100001119117), the Young Top-Notch Talent Program (2018000021223ZK12), the Beijing Hospitals Authority Youth Program (QML20180201), the Beijing Advanced Innovation Center for Food Nutrition and Human Health (Beijing Technology and Business University, 20181045), the CAMS Innovation Fund for Medical Sciences (2019-I2M-5-022), and the Public Welfare Development and Reform Pilot Project (2019-10).