Obesity Increases Risk of Sinusitis — Independent of Asthma, Study Finds

There’s a known association between obesity and asthma, and between asthma and chronic sinusitis. However, less is understood about the link between obesity and chronic sinusitis itself. Now, two new studies by Cleveland Clinic physicians make it clear that obesity does increase risk of chronic sinusitis — independent of the asthma connection.

The papers, as well as forthcoming research by the same team, add to our understanding of how obesity impacts different systems of the body, says Mohamad Chaaban, MD, Vice Chair of Research, Cleveland Clinic Otolaryngology – Head and Neck Surgery, and senior author on the studies. He believes the findings could help guide providers in counseling patients about weight management and could also lead to more personalized treatment for chronic sinusitis. The studies, “Association Between Obesity and Chronic Rhinosinusitis: Systematic Review and Meta-analysis,” and “Obesity Increases the Risk of Chronic Rhinosinusitis Independent of Asthma,” were presented at the annual meeting of the American Academy of Otolaryngology-Head and Neck Surgery earlier this year.

An understudied link

Dr. Chaaban says his curiosity was sparked after noticing that chronic sinusitis patients with obesity in his own clinical practice seemed to have a specific type of inflammation, and wondered if their response to treatment would be the same as other patients. After reviewing the literature, he found a wealth of information about the obesity-asthma connection, but almost nothing about obesity and chronic sinusitis.

Researchers first conducted a meta-analysis of existing studies, finding a positive association between overweight/obesity and chronic sinusitis overall, and that these patients were more likely to have chronic sinusitis with nasal polyps.

They then conducted a retrospective study using data from the TriNetX Analytics Global Collaborative Network, comparing data from more than 1.2 million patients with type I and II obesity and chronic sinusitis, with the same number of patients who had chronic sinusitis without obesity. They found that patients with obesity had a higher risk of being diagnosed with chronic sinusitis in the months and years after their obesity diagnosis and that the risk increased over time. Importantly, even after researchers controlled for patients with asthma, “we still found an association,” he says.

“Now, we think it’s not just the asthma linking chronic sinusitis with obesity,” says Dr. Chaaban. “There are different reasons why these conditions are linked.”

Moving toward precision treatment

These findings mean chronic sinusitis can be added to the growing list of diseases known to be linked to obesity — alongside conditions like cardiovascular disease, diabetes, cancer and asthma, he notes. Physicians can include this information when counseling patients about weight concerns.

Providers should also consider the presence of obesity when assessing patients with chronic sinusitis, he adds, noting that these patients may have a specific subtype of the condition that may make them less responsive to certain treatments.

“It’s not one size fits all,” he says. “This is just the beginning, and in future studies, we’ll look into precision medicine approaches for these patients.”

Another question to be explored includes whether obesity interventions at an early age reduces risk later in life. Dr. Chaaban asks, “Can we prevent chronic sinusitis? That will be very important to answer because once you develop chronic sinusitis, you cannot go back.”