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Wayne State University researcher seeks to understand link between obesity, flu severity

June 28, 2012

DETROIT — The recent H1N1 flu pandemic was found to be particularly dangerous to obese people, and a Wayne State University researcher is looking for clues as to why.

Emily Martin, Ph.D., assistant professor of pharmacy practice in the Eugene Applebaum College of Pharmacy and Health Sciences, has begun interviewing people hospitalized with influenza to study how weight impacts their illness, response to treatment, and recovery.

“The H1N1 was an unusual flu in that it affected middle-aged adults at higher rates than normal,” Martin said. “Among that group, people with really high weight were more likely to die or have severe outcomes if they got the flu.”

Obesity accounted for five of the six deaths from influenza at Detroit Medical Center (DMC) facilities in the 2010-11 season.

Martin’s project, “Influenza and Obesity: A Prospective Study of Patient Outcomes and Antiviral Resistance,” is supported by a one-year, $10,000 grant from the American Association of Colleges of Pharmacy. She plans to meet with 120 DMC patients 18 years of age and older at all weights who have suffered flu symptoms severe enough to require hospitalization.

The study will monitor progression of their illness, especially pulmonary manifestations, which can land patients on ventilators or in intensive care.
Researchers will take nasal samples to determine specific characteristics of the virus and how it evolves in subjects’ bodies over the first three days in the hospital. Among the characteristics to be examined is the virus’s resistance to oseltamivir, a drug more commonly known as Tamiflu, which is used to treat the flu.

Martin’s team will check the RNA sequence of the flu virus, as well as genetic components of an array other undiagnosed respiratory viruses patients may have.

“Depending on the population being examined, about one-third of the time other viruses are lurking in the background in these patients,” she said. “We still don’t know what kind of impact that has, and we will be looking for correlations among virus types.”

Researchers also will follow up with patients about 30 days after their hospital discharges to assess the number of readmissions or additional medical care visits, duration of symptoms and changes in lifestyle factors.

“We’re trying to see what specifically it is about people with high weight
who get the flu that might be leading them to a really bad outcome from the disease,” Martin said. “We’re also surveying patients to see if there are lifestyle factors that might be influencing this.”

Because hers is a pilot study, Martin doesn’t expect definitive answers. “It should give us some inklings of where the right path is,” she said. “Ideally, if we get a really good clinical picture of why weight increases the number of more drastic outcomes from the flu, then we can start to build treatment pathways especially for this group of patients to counteract that.”

Researchers then can determine whether types of flu treatment drugs or kinds of supportive care need to be modified. On the flip side, Martin said, health care providers can identify if patients with high body mass indexes should be given vaccination priority or can make lifestyle modifications that directly impact their health if infected with the flu.

“The more we understand the virus and the clinical course of people who are severely ill, the more effectively we can guide them when they show up at the hospital,” she said.

Wayne State University is one of the nation’s pre-eminent public research universities in an urban setting. Through its multidisciplinary approach to research and education, and its ongoing collaboration with government, industry and other institutions, the university seeks to enhance economic growth and improve the quality of life in the city of Detroit, state of Michigan and throughout the world. For more information about research at Wayne State University, visit http://www.research.wayne.edu.

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