Global Disease Burden of Asthma Attributable to High BMI: A Systematic Analysis from 1990–2021

Background Asthma is a chronic inflammatory airway disease that leads to reduced quality of life and premature death. Concurrently, obesity—a complex metabolic disorder—has emerged as a significant contributor to the global burden of noncommunicable diseases. A global burden of disease (GBD) study in 2021 revealed that a high body mass index (BMI) is the most significant modifiable risk factor contributing to the burden of asthma. This study aimed to evaluate the impact of high BMI on the asthma burden from 1990–2021 using data from the GBD 2021. Methods Data from the GBD 2021 were analyzed to assess the asthma burden attributable to high BMI. It covered the period from 1990–2021 and uses the estimated annual percentage change (EAPC) to evaluate time trends. The data were stratified by age, sex, and the sociodemographic index (SDI) to assess disparities among different populations. The age-standardized mortality rate (ASMR) and age-standardized disability-adjusted life year (DALY) rate (ASDR) were calculated to measure the disease burden. Results The results indicated that from 1990–2021, the ASMRs and ASDRs of asthma attributable to high BMI decreased. However, the absolute number of deaths and DALYs significantly increased. The asthma burden was found to be greater in females than in males, with a notable increase among middle-aged and older populations. Regional disparities were evident, with low-income regions such as Oceania and southern sub-Saharan Africa experiencing the highest burden, whereas high-income regions demonstrated relatively effective control. However, the DALY rate in high-income North America significantly increased. There was a negative correlation between the SDI and asthma mortality attributable to high BMI. Conclusion The impact of high BMI on asthma burden exhibits significant heterogeneity across the globe. Tailored asthma management strategies should be developed that consider sex, age, and regional characteristics to mitigate the long-term impact of high BMI on asthma burden.