High Prevalence of Uncontrolled Asthma and Its Association with Obesity and GERD-related symptoms in Syria: A Multicenter Cross-Sectional Study

Introduction: Asthma control remains suboptimal globally, with high rates of partly and uncontrolled disease. Poor asthma control can be attributed to the severity of the disease, ineffective treatment, and the presence of comorbid conditions such as obesity and gastroesophageal reflux disease (GERD). Objective: This cross-sectional study represents the first investigation in Syria to explore the relationship between asthma control status and common asthma comorbidities, namely obesity and gastroesophageal reflux disease (GERD). Methods: This multicenter cross-sectional study interviewed 275 asthma patients from respiratory clinics at four hospitals using questionnaires on sociodemographic, asthma control per Global Initiative for Asthma (GINA) guidelines, symptoms, and management. Body Mass Index (BMI), waist-to-hip (WHR) and waist-to-height ratios (WHtR) were calculated. Associations were assessed between asthma control, obesity markers, GERD symptoms, and other variables. Results: Most patients were women (72%) with a mean age of 41 years. Based on GINA criteria, 60% had uncontrolled, 28.7% partly controlled, and only 11.3% well controlled asthma. Higher BMI associated significantly with worse control (p = 0.006). WHtR also correlated with poorer asthma control (p < 0.001). While GERD diagnosis did not relate significantly to asthma control, symptoms like heartburn, chest pain, and chronic cough did (p < 0.05), as did the lack of GERD treatment (p = 0.002). Additionally, the lack of reflux treatment correlated with poorer asthma control (p = 0.002). Conclusion: There is a marked prevalence of inadequately controlled asthma in Syria. Both obesity and GERD-related symptoms correlate with poorer asthma control, emphasizing the need for a comprehensive management strategy.