1
|
Zhu W, Bai D, Ji W, Gao J. TRP channels associated with macrophages as targets for the treatment of obese asthma. Lipids Health Dis 2024; 23:49. [PMID: 38365763 PMCID: PMC10874053 DOI: 10.1186/s12944-024-02016-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Accepted: 01/10/2024] [Indexed: 02/18/2024] Open
Abstract
Globally, obesity and asthma pose significant health challenges, with obesity being a key factor influencing asthma. Despite this, effective treatments for obese asthma, a distinct phenotype, remain elusive. Since the discovery of transient receptor potential (TRP) channels in 1969, their value as therapeutic targets for various diseases has been acknowledged. TRP channels, present in adipose tissue cells, influence fat cell heat production and the secretion of adipokines and cytokines, which are closely associated with asthma and obesity. This paper aims to investigate the mechanisms by which obesity exacerbates asthma-related inflammation and suggests that targeting TRP channels in adipose tissue could potentially suppress obese asthma and offer novel insights into its treatment.
Collapse
Affiliation(s)
- Wenzhao Zhu
- Chengdu University of Traditional Chinese Medicine, 1166 Liutai Avenue, Wenjiang District, Chengdu, Sichuan, China
| | - Dinxi Bai
- Chengdu University of Traditional Chinese Medicine, 1166 Liutai Avenue, Wenjiang District, Chengdu, Sichuan, China
| | - Wenting Ji
- Chengdu University of Traditional Chinese Medicine, 1166 Liutai Avenue, Wenjiang District, Chengdu, Sichuan, China.
| | - Jing Gao
- Chengdu University of Traditional Chinese Medicine, 1166 Liutai Avenue, Wenjiang District, Chengdu, Sichuan, China.
| |
Collapse
|
2
|
Ramineedu K, Sankaran KR, Mallepogu V, Rendedula DP, Gunturu R, Gandham S, Md SI, Meriga B. Thymoquinone mitigates obesity and diabetic parameters through regulation of major adipokines, key lipid metabolizing enzymes and AMPK/p-AMPK in diet-induced obese rats. 3 Biotech 2024; 14:16. [PMID: 38125651 PMCID: PMC10728404 DOI: 10.1007/s13205-023-03847-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Accepted: 11/02/2023] [Indexed: 12/23/2023] Open
Abstract
The present study was designed to evaluate the anti-obesity and anti-hyperglycemic activity of Thymoquinone (ThyQ) isolated from Nigella sativa seeds. Male Wistar rats were randomly divided into five groups and fed either normal pellet diet or high-fat diet (HFD) for 18 weeks and water ad-libitum. Group I: normal pellet diet (NPD)-fed, Group II: high-fat diet (HFD)-fed, Group III: HFD-fed-ThyQ (20 mg)-treated, Group IV: HFD-fed-ThyQ (40 mg)-treated and Group V: HFD-fed-Orlistat (5 mg)-treated group. Intervention with ThyQ started from 12th week onwards to HFD-fed rats of group III and IV. ThyQ administration significantly (p < 0.01) mitigated body weight gain, blood glucose, insulin level, serum and liver lipids (except HDL) and improved glucose tolerance and insulin sensitivity as evaluated by oral glucose tolerance test (OGTT), homeostasis model assessment-insulin resistance (HOMA-IR) and insulin tolerance test (ITT). Furthermore, ThyQ significantly (p < 0.01) diminished serum aspartate transaminase (AST), alanine transaminase (ALT), acetyl-CoA carboxylase (ACC), plasma leptin, resistin and visfatin levels but enhanced lipoprotein lipase (LPL) and adiponectin levels. RT-PCR analysis demonstrated down-regulated mRNA expression of sterol regulatory element-binding proteins-1c (SREBP-1c), CCAAT/enhancer-binding protein-α (C/EBP-α) and fatty acid synthase (FAS) but upregulation of Insulin receptor substrate-1 (IRS-1).Western blot analysis displayed phosphorylation of adenosine monophosphate activated protein kinase (AMPK) in ThyQ-treated rats. Liver microtome sections of HFD-fed rats showed degenerated hepatocytes with high lipid stores while that of adipose tissue sections displayed large, fat-laden adipocytes, however, these histological changes were considerably attenuated in ThyQ-treated groups. Together these findings demonstrate that ThyQ can be a valuable therapeutic compound to potentially alleviate diet-induced obesity, hyperglycemia and insulin resistance. Supplementary Information The online version contains supplementary material available at 10.1007/s13205-023-03847-x.
Collapse
Affiliation(s)
- Keerthi Ramineedu
- Division of Cell Culture and Molecular Biology, Department of Biochemistry, Sri Venkateswara University, Tirupati, Andhra Pradesh 517502 India
| | - Karunakaran Reddy Sankaran
- Division of Cell Culture and Molecular Biology, Department of Biochemistry, Sri Venkateswara University, Tirupati, Andhra Pradesh 517502 India
| | - Venkataswamy Mallepogu
- Division of Cell Culture and Molecular Biology, Department of Biochemistry, Sri Venkateswara University, Tirupati, Andhra Pradesh 517502 India
| | | | | | - Sreedevi Gandham
- Department of ECE, Siddartha Educational Academy Group of Institutions, Tirupati, AP 517502 India
| | - Shahidul Islam Md
- Department of Biochemistry, School of Life Sciences, University of KwaZulu-Natal, Westville Campus, Durban, 4000 South Africa
| | - Balaji Meriga
- Division of Cell Culture and Molecular Biology, Department of Biochemistry, Sri Venkateswara University, Tirupati, Andhra Pradesh 517502 India
| |
Collapse
|
3
|
Vijverberg SJH, Kampouras A, Nayir Büyükşahin H, Makrinioti H, Petrarca L, Schmidt M, Schreck LD, Urbantat RM, Beydon N, Goutaki M, Lavizzari A, Proesmans M, Schramm D, Stahl M, Zacharasiewicz A, Moeller A, Pijnenburg MW. ERS International Congress 2023: highlights from the Paediatrics Assembly. ERJ Open Res 2024; 10:00853-2023. [PMID: 38410713 PMCID: PMC10895434 DOI: 10.1183/23120541.00853-2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 11/07/2023] [Indexed: 02/28/2024] Open
Abstract
Respiratory health in children is essential for general wellbeing and healthy development in the short and long term. It is well known that many respiratory diseases in adulthood have their origins in early life, and therefore research on prevention of respiratory diseases and management of children with respiratory diseases will benefit patients during the full life course. Scientific and clinical advances in the field of respiratory health are moving at a fast pace. This article summarises some of the highlights in paediatric respiratory medicine presented at the hybrid European Respiratory Society (ERS) International Congress 2023 which took place in Milan (Italy). Selected sessions are summarised by Early Career Members of the Paediatrics Assembly (Assembly 7) under the supervision of senior ERS officers, and cover a wide range of research areas in children, including respiratory physiology and sleep, asthma and allergy, cystic fibrosis, respiratory infection and immunology, neonatology and intensive care, respiratory epidemiology and bronchology.
Collapse
Affiliation(s)
- Susanne J H Vijverberg
- Pulmonary Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Pediatric Pulmonology, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Asterios Kampouras
- Paediatric Pulmonology Department, 424 General Military Hospital, Thessaloniki, Greece
| | - Halime Nayir Büyükşahin
- Division of Pulmonology, Department of Paediatrics, Mardin Training and Research Hospital, Mardin, Turkey
| | - Heidi Makrinioti
- Department of Emergency Medicine, Harvard Medical School, Boston, MA, USA
| | - Laura Petrarca
- Translational and Precision Medicine Department, "Sapienza" University of Rome, Rome, Italy
- Maternal Infantile and Urological Sciences Department, "Sapienza" University of Rome, Rome, Italy
| | - Mehtap Schmidt
- Department of Pediatrics, Teaching Hospital of the University of Vienna, Wilhelminen Hospital, Vienna, Austria
| | - Leonie D Schreck
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Graduate School for Health Sciences, University of Bern, Bern, Switzerland
| | - Ruth M Urbantat
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine and Cystic Fibrosis Center, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- German Center for Lung Research (DZL), associated partner site, Berlin, Germany
- Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Nicole Beydon
- Assistance Publique-Hôpitaux de Paris, Unité Fonctionnelle de Physiologie - Explorations Fonctionnelles Respiratoires et du Sommeil, Hôpital Armand Trousseau, Paris, France
- INSERM, U 938, Centre de Recherche Saint Antoine, Hôpital Saint-Antoine, Paris, France
| | - Myrofora Goutaki
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Anna Lavizzari
- Neonatal Intensive Care Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Marijke Proesmans
- Division of Woman and Child, Department of Pediatrics, University Hospitals Leuven, Leuven, Belgium
| | - Dirk Schramm
- Department of General Pediatrics, Neonatology and Pediatric Cardiology, Medical Faculty, University Hospital Düsseldorf, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany
| | - Mirjam Stahl
- Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine and Cystic Fibrosis Center, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- German Center for Lung Research (DZL), associated partner site, Berlin, Germany
- Berlin Institute of Health at Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Angela Zacharasiewicz
- Department of Pediatrics, Teaching Hospital of the University of Vienna, Wilhelminen Hospital, Vienna, Austria
| | - Alexander Moeller
- Department of Paediatric Pulmonology, University Children's Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Marielle W Pijnenburg
- Department of Paediatrics, Division of Paediatric Respiratory Medicine and Allergology, Erasmus MC - Sophia Children's Hospital, University Medical Centre, Rotterdam, The Netherlands
| |
Collapse
|
4
|
Kian N, Bagheri A, Salmanpour F, Soltani A, Mohajer Z, Samieefar N, Barekatain B, Kelishadi R. Breast feeding, obesity, and asthma association: clinical and molecular views. Clin Mol Allergy 2023; 21:8. [PMID: 37789370 PMCID: PMC10546753 DOI: 10.1186/s12948-023-00189-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 08/28/2023] [Indexed: 10/05/2023] Open
Abstract
Asthma is a chronic condition that affects children worldwide. Accumulating number of studies reported that the prevalence of pediatric obesity and asthma might be altered through breastfeeding. It has been proposed that Leptin, which exists in human milk, is oppositely associated with weight increase in newborns. It may also influence peripheral immune system by promoting TH1 responses and suppressing TH2 cytokines. Leptin influences body weight and immune responses through complex signaling pathways at molecular level. Although previous studies provide explanations for the protective role of breastfeeding against both obesity and asthma, other factors such as duration of breastfeeding, parental, and prenatal factors may confound this relationship which requires further research.
Collapse
Affiliation(s)
- Naghmeh Kian
- Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- USERN Office, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Network of Interdisciplinarity in Neonates and Infants (NINI), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Alireza Bagheri
- USERN Office, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Network of Interdisciplinarity in Neonates and Infants (NINI), Universal Scientific Education and Research Network (USERN), Tehran, Iran
- Department of Genetics, Faculty of Basic Sciences, Shahrekord University, Shahrekord, Iran
| | - Fardis Salmanpour
- USERN Office, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Network of Interdisciplinarity in Neonates and Infants (NINI), Universal Scientific Education and Research Network (USERN), Tehran, Iran
- Student Research Committee, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Afsaneh Soltani
- Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- USERN Office, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Network of Interdisciplinarity in Neonates and Infants (NINI), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Zahra Mohajer
- Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- USERN Office, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Network of Interdisciplinarity in Neonates and Infants (NINI), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Noosha Samieefar
- Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- USERN Office, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Network of Interdisciplinarity in Neonates and Infants (NINI), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Behzad Barekatain
- Division of Neonatology, Department of Pediatrics, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Roya Kelishadi
- Network of Interdisciplinarity in Neonates and Infants (NINI), Universal Scientific Education and Research Network (USERN), Tehran, Iran.
- Child Growth and Development Research Center, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran.
- USERN Office, Research Institute for Primordial Prevention of Non-Communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran.
| |
Collapse
|
5
|
Lucas JA, Marino M, Bailey SR, Hsu A, Datta R, Cottrell E, Kim YJ, Suglia SF, Bazemore A, Heintzman J. Comparison of associations of household-level and neighbourhood-level poverty markers with paediatric asthma care utilisation by race/ethnicity in an open cohort of community health centre patients. Fam Med Community Health 2023; 11:e001760. [PMID: 37524521 PMCID: PMC10391793 DOI: 10.1136/fmch-2022-001760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/02/2023] Open
Abstract
OBJECTIVE The objective of this research was to examine how different measurements of poverty (household-level and neighborhood-level) were associated with asthma care utilisation outcomes in a community health centre setting among Latino, non-Latino black and non-Latino white children. DESIGN, SETTING AND PARTICIPANTS We used 2012-2017 electronic health record data of an open cohort of children aged <18 years with asthma from the OCHIN, Inc. network. Independent variables included household-level and neighborhood-level poverty using income as a percent of federal poverty level (FPL). Covariate-adjusted generalised estimating equations logistic and negative binomial regression were used to model three outcomes: (1) ≥2 asthma visits/year, (2) albuterol prescription orders and (3) prescription of inhaled corticosteroids over the total study period. RESULTS The full sample (n=30 196) was 46% Latino, 26% non-Latino black, 31% aged 6-10 years at first clinic visit. Most patients had household FPL <100% (78%), yet more than half lived in a neighbourhood with >200% FPL (55%). Overall, neighbourhood poverty (<100% FPL) was associated with more asthma visits (covariate-adjusted OR 1.26, 95% CI 1.12 to 1.41), and living in a low-income neighbourhood (≥100% to <200% FPL) was associated with more albuterol prescriptions (covariate-adjusted rate ratio 1.07, 95% CI 1.02 to 1.13). When stratified by race/ethnicity, we saw differences in both directions in associations of household/neighbourhood income and care outcomes between groups. CONCLUSIONS This study enhances understanding of measurements of race/ethnicity differences in asthma care utilisation by income, revealing different associations of living in low-income neighbourhoods and households for Latino, non-Latino white and non-Latino black children with asthma. This implies that markers of family and community poverty may both need to be considered when evaluating the association between economic status and healthcare utilisation. Tools to measure both kinds of poverty (family and community) may already exist within clinics, and can both be used to better tailor asthma care and reduce disparities in primary care safety net settings.
Collapse
Affiliation(s)
- Jennifer A Lucas
- Department of Family Medicine, Oregon Health & Science University, Portland, Oregon, USA
| | - Miguel Marino
- Department of Family Medicine, Oregon Health & Science University, Portland, Oregon, USA
| | - Steffani R Bailey
- Department of Family Medicine, Oregon Health & Science University, Portland, Oregon, USA
| | - Audree Hsu
- California University of Science and Medicine, Colton, California, USA
| | - Roopradha Datta
- Department of Family Medicine, Oregon Health & Science University, Portland, Oregon, USA
| | | | - Ye Ji Kim
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Shakira F Suglia
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | | | - John Heintzman
- Department of Family Medicine, Oregon Health & Science University, Portland, Oregon, USA
- OCHIN Inc, Portland, Oregon, USA
| |
Collapse
|
6
|
Makrinioti H, Zhu Z, Camargo CA, Fainardi V, Hasegawa K, Bush A, Saglani S. Application of Metabolomics in Obesity-Related Childhood Asthma Subtyping: A Narrative Scoping Review. Metabolites 2023; 13:328. [PMID: 36984768 PMCID: PMC10054720 DOI: 10.3390/metabo13030328] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Revised: 02/16/2023] [Accepted: 02/17/2023] [Indexed: 02/25/2023] Open
Abstract
Obesity-related asthma is a heterogeneous childhood asthma phenotype with rising prevalence. Observational studies identify early-life obesity or weight gain as risk factors for childhood asthma development. The reverse association is also described, children with asthma have a higher risk of being obese. Obese children with asthma have poor symptom control and an increased number of asthma attacks compared to non-obese children with asthma. Clinical trials have also identified that a proportion of obese children with asthma do not respond as well to usual treatment (e.g., inhaled corticosteroids). The heterogeneity of obesity-related asthma phenotypes may be attributable to different underlying pathogenetic mechanisms. Although few childhood obesity-related asthma endotypes have been described, our knowledge in this field is incomplete. An evolving analytical profiling technique, metabolomics, has the potential to link individuals' genetic backgrounds and environmental exposures (e.g., diet) to disease endotypes. This will ultimately help define clinically relevant obesity-related childhood asthma subtypes that respond better to targeted treatment. However, there are challenges related to this approach. The current narrative scoping review summarizes the evidence for metabolomics contributing to asthma subtyping in obese children, highlights the challenges associated with the implementation of this approach, and identifies gaps in research.
Collapse
Affiliation(s)
- Heidi Makrinioti
- Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
| | - Zhaozhong Zhu
- Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
| | - Carlos A. Camargo
- Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
| | - Valentina Fainardi
- Clinica Pediatrica, Department of Medicine and Surgery, University of Parma, 43126 Parma, Italy
| | - Kohei Hasegawa
- Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA
| | - Andrew Bush
- National Heart and Lung Institute, Imperial College, London SW7 2AZ, UK
- Centre for Paediatrics and Child Health, Imperial College, London SW7 2AZ, UK
- Royal Brompton Hospital, London SW3 6NP, UK
| | - Sejal Saglani
- National Heart and Lung Institute, Imperial College, London SW7 2AZ, UK
- Centre for Paediatrics and Child Health, Imperial College, London SW7 2AZ, UK
- Royal Brompton Hospital, London SW3 6NP, UK
| |
Collapse
|
7
|
Seyedrezazadeh E, Ghoushouni S, Sharifi A, Zafari V, Zarredar H. Association of the Toll-like receptor 4 and NOX4 gene and protein levels in asthmatic patients with metabolic syndrome: A case–control study. JOURNAL OF RESEARCH IN MEDICAL SCIENCES 2023; 28:11. [PMID: 36974113 PMCID: PMC10039097 DOI: 10.4103/jrms.jrms_860_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 02/17/2022] [Accepted: 04/02/2022] [Indexed: 02/23/2023]
Abstract
Background Understanding the contributing of influence inflammatory biomarkers in asthmatic patients with metabolic syndrome is more important. Whereby, the present study considering the important association of NADPH oxidase4 (NOX4) and Toll- like receptor4 (TLR4) in the respiratory inflammatory responses in asthmatic patients with metabolic syndrome (AS-MetS) and asthmatic (AS) patients. Materials and Methods In this case-control study, 30 AS and 34 AS-MetS patients were enrolled. The Peripheral blood mononuclear cells (PBMCs) mRNA and protein levels of TLR4 and NOX4 were measured by qRT-PCR and western blot, respectively. Then their correlation was evaluated. Results The significant down-regulation of mRNA and protein PBMCs expression levels of TLR4 were observed in the AS-MetS group in comparison to AS one (P=0.03), but the NOX4 expression was non-significant. Additionally, the significant correlation was exhibited between mRNA expression levels of NOX4 and TLR4 in both AS-MetS (r= 0.440, P=0.009) and AS groups (r=0.909, P=0.0001). The association between TLR4 mRNA level and triglyceride in AS-MetS group (r=0.454, P=0.008,) and also white blood cells (WBC) in AS group (r= -0.507, P=0.006,) were significant. Conclusion The metabolic syndrome can significantly influence the expressions of TLR4 in AS-MetS. This study indicated that TLR4 and NOX4 altogether may provide valuable molecular knowledge of their relation with metabolic syndrome criteria for finding major pathways in different phenotype of asthma.
Collapse
|
8
|
Yusuf RA, Rathebe PC, Mbonane TP. Association between Environmental Exposures and Asthma among Children in King Williams Town, South Africa. Diseases 2022; 10:diseases10040123. [PMID: 36547209 PMCID: PMC9777677 DOI: 10.3390/diseases10040123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 11/07/2022] [Accepted: 12/01/2022] [Indexed: 12/12/2022] Open
Abstract
The study aimed to assess the association between environmental exposure and asthma among children between 3 and 12 years old in King Williams Town, South Africa. A quantitative case-control study was conducted at Grey Hospital to assess the association between environmental exposure and asthma among children who reside in King Williams Town. Of the total 566 study participants, 50.5% (286) had asthma while 49.5% did not. Socio-demographic factors associated with asthma in children were being within the age group 9-12 years (OR 1.74, CI 95% 1.09-2.78) and India ethnicity (OR 0.20, CI 95% 0.08-0.48). Factors associated with asthma were weight within 25-35 kg (OR 1.64, CI 95% 1.11-2.42) and BMI within 15-20 (OR 4.80, CI 95% 2.80-8.22). Environmental risk factors associated with asthma were indoor exposure to tobacco smoke from mothers of the participants (OR 5.45, CI 95% 3.08-9.65) and from fathers (OR 4.37; CI 95% 2.77-6.90). Abstaining from eating seafood appeared to be protective from developing asthma (OR 0.01; CI 95% 0.00-0.05). The study found no significant association between outdoor environmental exposures and childhood asthma. The age of participant, weight, BMI, exposure to environmental tobacco smoke (ETS), and eating seafood had significant correlations with childhood asthma. Strengthening the evaluation of children healthcare and encouraging smoking cessation among parents could reduce exposure to environmental asthma triggers among children.
Collapse
|
9
|
Molina MF, Okoniewski W, Puranik S, Aujla S, Celedón JC, Larkin A, Forno E. Severe asthma in children: Description of a large multidisciplinary clinical cohort. Pediatr Pulmonol 2022; 57:1447-1455. [PMID: 35261210 PMCID: PMC9119906 DOI: 10.1002/ppul.25887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Revised: 01/08/2022] [Accepted: 02/21/2022] [Indexed: 11/11/2022]
Abstract
BACKGROUND Children with severe asthma have substantial morbidity and healthcare utilization. Pediatric severe asthma is a heterogeneous disease, and a multidisciplinary approach can improve the diagnosis and management of these children. METHODS We reviewed the electronic health records for patients seen in the Severe Asthma Clinic (SAC) at UPMC Children's Hospital of Pittsburgh between August 2012 and October 2019. RESULTS Of the 110 patients in whom we extracted data, 46% were female, 48% were Black/African American, and 41% had ≥1 admission to the pediatric intensive care unit (PICU) for asthma. Compared to patients without a PICU admission, those with ≥1 PICU admission were more likely to be non-White (64.4% vs. 41.5%, p = 0.031) and more atopic (eosinophil count geometric mean = 673 vs. 319 cells/mm3 , p = 0.002; total IgE geometric mean = 754 vs. 303 KU/L, p = 0.003), and to have lower pre-bronchodilator FEV1 (58.6% [±18.1%] vs. 69.9% [±18.7%], p = 0.002) and elevated FeNO (60% vs. 22%, p = 0.02). In this cohort, 84% of patients were prescribed high-dose ICS/LABA and 36% were on biologics. Following enrollment in the SAC, severe exacerbations decreased from 3.2/year to 2.2/year (p < 0.0001); compared to the year before joining the SAC, in the following year the group had 106 fewer severe exacerbations. CONCLUSIONS This large cohort of children with severe asthma had a high level of morbidity and healthcare utilization. Patients with a history of PICU admissions for asthma were more likely to be nonwhite and highly atopic, and to have lower lung function. Our data support a positive impact of a multidisciplinary clinic on patients with severe childhood asthma.
Collapse
Affiliation(s)
- Maria Forero Molina
- Division of Allergy and Immunology and UPMC Children’s Hospital of Pittsburgh, Pittsburgh, PA
- Division of Pulmonary Medicine, UPMC Children’s Hospital of Pittsburgh, Pittsburgh, PA
| | - William Okoniewski
- Division of Pulmonary Medicine, UPMC Children’s Hospital of Pittsburgh, Pittsburgh, PA
- University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - Sandeep Puranik
- Division of Pediatric Pulmonology, Indiana University School of Medicine, Indianapolis, IN
| | - Shean Aujla
- Division of Pediatric Pulmonology, Medical University of South Carolina, Charleston, SC
| | - Juan C. Celedón
- Division of Pulmonary Medicine, UPMC Children’s Hospital of Pittsburgh, Pittsburgh, PA
- University of Pittsburgh School of Medicine, Pittsburgh, PA
- Pediatric Asthma Center, UPMC Children’s Hospital of Pittsburgh, Pittsburgh, PA
| | - Allyson Larkin
- Division of Allergy and Immunology and UPMC Children’s Hospital of Pittsburgh, Pittsburgh, PA
- Division of Pulmonary Medicine, UPMC Children’s Hospital of Pittsburgh, Pittsburgh, PA
- Pediatric Asthma Center, UPMC Children’s Hospital of Pittsburgh, Pittsburgh, PA
| | - Erick Forno
- Division of Pulmonary Medicine, UPMC Children’s Hospital of Pittsburgh, Pittsburgh, PA
- University of Pittsburgh School of Medicine, Pittsburgh, PA
- Pediatric Asthma Center, UPMC Children’s Hospital of Pittsburgh, Pittsburgh, PA
| |
Collapse
|
10
|
Impact of body mass index on omalizumab response in adults with moderate-to-severe allergic asthma. Ann Allergy Asthma Immunol 2022; 128:553-560. [PMID: 35101644 DOI: 10.1016/j.anai.2022.01.025] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 01/10/2022] [Accepted: 01/11/2022] [Indexed: 11/21/2022]
Abstract
BACKGROUND Effectiveness of asthma treatment, including biologics, may be different in patients with higher body mass index (BMI). OBJECTIVE To evaluate response to omalizumab (dosed by serum immunoglobulin E level and weight) by BMI category. METHODS Pooled data from 2 randomized, double-blind, placebo-controlled studies of adults with moderate-to-severe allergic asthma were analyzed by BMI category (<25 kg/m2 [normal or underweight], n = 397; 25 to <30 kg/m2 [overweight], n = 330; ≥ 30 kg/m2 [obese], n = 268). Placebo-adjusted exacerbation rate reductions were evaluated by Poisson regression modeling. Changes from baseline in forced expiratory volume in 1 second, beclomethasone dipropionate (BDP) dose, Total Asthma Symptom Score, and Asthma Quality of Life Questionnaire were evaluated by analysis of covariance. RESULTS Greater placebo-adjusted exacerbation rate reductions (95% confidence interval) were observed with increasing BMI (normal or underweight, -37.4% [-69.0% to 26.8%]; overweight, -52.7% [-78.4% to 3.7%]; obese, -71.9% [-86.9% to -39.5%]). There were no differences in forced expiratory volume in 1 second improvement between BMI categories at week 16 (normal or underweight, 76.2 [5.3-147.1] mL; overweight, 98.1 [13.9-182.4] mL; obese, 69.1 [-18.9 to 157.2] mL). No differences in BDP dose reduction (µg) were noted between BMI categories (normal or underweight, 23.0 [15.7-30.3]; overweight, 22.5 [13.5-31.5]; obese, 16.6 [5.8-27.3]). Fewer patients in the higher BMI categories eliminated BDP use. There were trends for smaller improvements with higher BMI in Total Asthma Symptom Score (normal/underweight, -0.52 [-0.82 to -0.22]; overweight, -0.50 [-0.80 to -0.20]; obese, -0.39 [-0.77 to 0.00]) and Asthma Quality of Life Questionnaire (normal or underweight, 0.34 [0.16-0.52]; overweight, 0.34 [0.13-0.55]; obese, 0.15 [-0.08 to 0.39]). CONCLUSION Omalizumab provides benefit to patients with moderate-to-severe allergic asthma, regardless of BMI. TRIAL REGISTRATION Studies 008/009 were conducted before clinical trial registration was required, and therefore clinical trial registration numbers are not available.
Collapse
|
11
|
Stevens DR, Rohn MCH, Hinkle SN, Williams AD, Kumar R, Lipsky LM, Grobman W, Sherman S, Kanner J, Chen Z, Mendola P. Maternal body composition and gestational weight gain in relation to asthma control during pregnancy. PLoS One 2022; 17:e0267122. [PMID: 35442986 PMCID: PMC9020691 DOI: 10.1371/journal.pone.0267122] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 04/02/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Poor asthma control is common during pregnancy and contributes to adverse pregnancy outcomes. Identification of risk factors for poor gestational asthma control is crucial. OBJECTIVE Examine associations of body composition and gestational weight gain with asthma control in a prospective pregnancy cohort (n = 299). METHODS Exposures included pre-pregnancy body mass index (BMI), first trimester skinfolds, and trimester-specific gestational weight gain. Outcomes included percent predicted forced expiratory volumes (FEV1, FEV6), forced vital capacity (FVC), peak expiratory flow (PEF), FEV1/FVC, symptoms (activity limitation, nighttime symptoms, inhaler use, and respiratory symptoms), and exacerbations (asthma attacks, medical encounters). Linear and Poisson models examined associations with lung function (β (95% confidence interval (CI)), asthma symptom burden (relative rate ratio (RR (95%CI)), and exacerbations (RR (95%CI)). RESULTS Women with a BMI ≥ 30 had lower percent predicted FVC across pregnancy (βThirdTrimester: -5.20 (-8.61, -1.78)) and more frequent night symptoms in the first trimester (RR: 1.66 (1.08, 2.56)). Higher first trimester skinfolds were associated with lower FEV1, FEV6, and FVC, and more frequent night symptoms and inhaler use across pregnancy. Excessive first trimester gestational weight gain was associated with more frequent activity limitation in the first trimester (RR: 3.36 (1.15, 9.80)) and inhaler use across pregnancy (RRThirdTrimester: 3.49 (1.21, 10.02)). CONCLUSIONS Higher adiposity and first trimester excessive gestational weight gain were associated with restrictive changes in lung function and symptomology during pregnancy.
Collapse
Affiliation(s)
- Danielle R. Stevens
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD, United States of America
| | - Matthew C. H. Rohn
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD, United States of America
| | - Stefanie N. Hinkle
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD, United States of America
| | - Andrew D. Williams
- UND School of Medicine and Health Sciences, University of North Dakota, Grand Forks, ND, United States of America
| | - Rajesh Kumar
- Northwestern University Feinberg School of Medicine, Chicago, IL, United States of America
| | - Leah M. Lipsky
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD, United States of America
| | - William Grobman
- Northwestern University Feinberg School of Medicine, Chicago, IL, United States of America
| | - Seth Sherman
- The Emmes Company, Rockville, MD, United States of America
| | - Jenna Kanner
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD, United States of America
| | - Zhen Chen
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD, United States of America
| | - Pauline Mendola
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD, United States of America
- School of Public Health and Health Professions, University at Buffalo, Buffalo NY, United States of America
| |
Collapse
|
12
|
Persistent overweight or obesity, lung function, and asthma exacerbations in Puerto Rican youth. Ann Allergy Asthma Immunol 2022; 128:408-413.e2. [PMID: 35017083 PMCID: PMC8977258 DOI: 10.1016/j.anai.2022.01.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 12/27/2021] [Accepted: 01/04/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND Whether persistent overweight or obesity affects lung function or asthma morbidity in youth is unclear. OBJECTIVE To evaluate overweight or obesity that persists between school age and adolescence and change in lung function and total immunoglobulin (Ig)E and severe asthma exacerbations in Puerto Rican youth. METHODS Prospective study of 340 Puerto Rican youth assessed at 2 visits, the first at ages 6 to 14 years and the second at ages 9 to 20 years. Persistent overweight or obesity was defined as a body mass index z-score greater than or equal to 85th percentile at both visits. Outcomes of interest were change in percent predicted (%pred) lung function measures and total IgE between study visits and severe asthma exacerbations in the year before visit 2. Logistic or linear regression was used for multivariable analysis. RESULTS In multivariable analysis, persistently overweight or obese subjects had changes in %pred forced expiratory volume in 1 second (FEV1) (β = -5.07%; 95% confidence interval, -1.51% to -8.62%; P < .01) and %pred FEV1 to forced vital capacity (FVC) ratio (β = -2.85%; 95% confidence interval, -0.18% to -5.51%; P = .04) which were lower than those observed in subjects with normal weight at both study visits (control subjects). Compared with control subjects, those who were persistently overweight or obese and those who became overweight or obese at visit 2 had increased odds of more than or equal to 1 severe asthma exacerbation in the year before visit 2. There was no significant association between persistent overweight or obesity and change in %pred FVC or total IgE (P > .20 for both instances). CONCLUSION In a prospective study of Puerto Rican youth, persistently overweight or obese subjects had lower changes in FEV1 or FEV1 to FVC ratio and higher odds of severe asthma exacerbations than subjects of normal weight.
Collapse
|
13
|
Williams EJ, Berthon BS, Stoodley I, Williams LM, Wood LG. Nutrition in Asthma. Semin Respir Crit Care Med 2022; 43:646-661. [PMID: 35272384 DOI: 10.1055/s-0042-1742385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
An emerging body of evidence suggests that diet plays an important role in both the development and management of asthma. The relationship between dietary intake and asthma risk has been explored in epidemiological studies, though intervention trials examining the effects of nutrient intake and dietary patterns on asthma management are scarce. Evidence for diets high in fruits and vegetables, antioxidants, omega-3 fatty acids and soluble fiber such as the Mediterranean diet is conflicting. However, some studies suggest that these diets may reduce the risk of asthma, particularly in young children, and could have positive effects on disease management. In contrast, a Westernized dietary pattern, high in saturated fatty acids, refined grains, and sugars may promote an inflammatory environment resulting in the onset of disease and worsening of asthma outcomes. This review will summarize the state of the evidence for the impact of whole dietary patterns, as well as individual nutrients on the prevalence and management of asthma.
Collapse
Affiliation(s)
- Evan J Williams
- Hunter Medical Research Institute and School of Biomedical Science and Pharmacy, The University of Newcastle, Callaghan, Australia
| | - Bronwyn S Berthon
- Hunter Medical Research Institute and School of Biomedical Science and Pharmacy, The University of Newcastle, Callaghan, Australia
| | - Isobel Stoodley
- Hunter Medical Research Institute and School of Biomedical Science and Pharmacy, The University of Newcastle, Callaghan, Australia
| | - Lily M Williams
- Hunter Medical Research Institute and School of Biomedical Science and Pharmacy, The University of Newcastle, Callaghan, Australia
| | - Lisa G Wood
- Hunter Medical Research Institute and School of Biomedical Science and Pharmacy, The University of Newcastle, Callaghan, Australia
| |
Collapse
|
14
|
Fitzpatrick AM, Mutic AD, Mohammad AF, Stephenson ST, Grunwell JR. Obesity Is Associated with Sustained Symptomatology and Unique Inflammatory Features in Children with Asthma. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY. IN PRACTICE 2022; 10:815-826.e2. [PMID: 34688962 PMCID: PMC8917992 DOI: 10.1016/j.jaip.2021.10.020] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 10/06/2021] [Accepted: 10/07/2021] [Indexed: 01/04/2023]
Abstract
BACKGROUND Obesity complicates the clinical manifestations of asthma in children. However, few studies have examined longitudinal outcomes or markers of systemic inflammation in obese asthmatic children. OBJECTIVE We hypothesized that obese children with asthma would have: (1) poorer clinical outcomes over 12 months, (2) decreased responsiveness to systemic corticosteroid administration, (3) greater markers of systemic inflammation, and (4) unique amino acid metabolites associated with oxidative stress. METHODS Children 6 to 17 years of age (lean, N = 257; overweight, N = 99; obese, N = 138) completed a baseline visit and follow-up visit at 12 months. Outcome measures included asthma control, quality of life, lung function, and exacerbations. A subset received intramuscular triamcinolone and were re-evaluated at 7(+7) days. Leptin, adiponectin, C-reactive protein, total cholesterol, interleukin (IL)-1β, IL-6, IL-17, interferon gamma, tumor necrosis factor alpha, monocyte-chemoattractant protein-1, and amino acid metabolites were also quantified in plasma as potential biomarkers of outcomes in obese children. RESULTS Obesity was associated with more symptoms, poorer quality life, and more exacerbations that persisted over 1 year despite greater medication requirements. Obese children also had minimal clinical improvement in asthma control and lung function after intramuscular triamcinolone. Leptin, C-reactive protein, and amino acid metabolites associated with glutathione synthesis and oxidative stress differed in obese children. Within the obese group, lower concentrations of arginine-related metabolites also distinguished uncontrolled from controlled asthma at 12 months. CONCLUSION Obesity is associated with poorer asthma outcomes and unique systemic inflammatory features that may not be adequately modified with conventional asthma therapies. Novel approaches may be needed given increased symptoms and unique inflammation and oxidative stress in obese children with asthma.
Collapse
Affiliation(s)
- Anne M. Fitzpatrick
- Emory University School of Medicine, Department of Pediatrics, Atlanta, Georgia,Children’s Healthcare of Atlanta, Atlanta, Georgia
| | - Abby D. Mutic
- Emory University Nell Hodgson Woodruff School of Nursing, Atlanta, Georgia
| | - Ahmad F. Mohammad
- Emory University School of Medicine, Department of Pediatrics, Atlanta, Georgia
| | - Susan T. Stephenson
- Emory University School of Medicine, Department of Pediatrics, Atlanta, Georgia
| | - Jocelyn R. Grunwell
- Emory University School of Medicine, Department of Pediatrics, Atlanta, Georgia,Children’s Healthcare of Atlanta, Atlanta, Georgia
| |
Collapse
|
15
|
Billich N, Maugeri I, Calligaro L, Truby H, Davidson ZE. Weight management interventions that include dietary components for young people with chronic health care needs: A systematic review. Nutr Diet 2022; 79:94-109. [PMID: 34369055 DOI: 10.1111/1747-0080.12698] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 06/06/2021] [Accepted: 06/21/2021] [Indexed: 11/30/2022]
Abstract
AIMS To identify and describe weight management interventions that include a dietary component for young people with chronic healthcare needs and overweight or obesity and their effect on body mass index (BMI) or weight. METHODS Six databases were searched in 2017 and 2020 for experimental studies in English: Ovid MEDLINE, Ovid Embase, Ovid AMED, EBSCO CINAHL, Scopus and Cochrane Central Register of Controlled Trials and Database of Systematic Reviews. Two independent reviewers conducted data extraction and quality assessment using the Cochrane Risk of Bias tool. Eligible studies included young people with chronic healthcare needs ≤18 years with overweight or obesity with an intervention that included a dietary component. Eligible outcomes were BMI or weight. Data were synthesised narratively. RESULTS The search identified 15 293 references, 12 studies were included (randomised controlled trials n = 5, before-after comparisons n = 7). Participant diagnoses were neurodevelopmental disabilities (n = 5) and mental illness (n = 1); survivors of cancers or tumours (n = 4); congenital heart disease (n = 1) and; migraine (n = 1). No studies addressed weight management in physical disabilities. Eight studies demonstrated a significant reduction in BMI or weight. Of these, most interventions used dietary counselling or an energy deficit, were family-focused, multicomponent and delivered by a multidisciplinary team including dietitians. A high risk of bias was detected across studies. CONCLUSIONS There is limited high-quality evidence about effective dietary solutions for the management of overweight and obesity for young people with chronic healthcare needs. While more research is required, dietary management appears to be important to manage weight in these populations.
Collapse
Affiliation(s)
- Natassja Billich
- Department of Nutrition, Dietetics and Food, School of Clinical Sciences at Monash Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Victoria, Australia
- Neurology Department, The Royal Children's Hospital, Melbourne, Victoria, Australia
- Weight Management Service, Department of Neurodevelopment and Disability, The Royal Children's Hospital, Melbourne, Victoria, Australia
| | - Isabella Maugeri
- Department of Nutrition, Dietetics and Food, School of Clinical Sciences at Monash Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Victoria, Australia
| | - Lara Calligaro
- Monash School of Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University
| | - Helen Truby
- School of Human Movement and Nutrition Sciences, The University of Queensland, Brisbane, Queensland, Australia
- School of Primary and Allied Health Care Faculty of Medicine, Nursing and Health Sciences, Monash University, Victoria, Australia
| | - Zoe E Davidson
- Department of Nutrition, Dietetics and Food, School of Clinical Sciences at Monash Health, Faculty of Medicine, Nursing and Health Sciences, Monash University, Victoria, Australia
- Neurology Department, The Royal Children's Hospital, Melbourne, Victoria, Australia
- Murdoch Children's Research Institute, Melbourne, Victoria, Australia
| |
Collapse
|
16
|
Shi Z, El-Obeid T, Meftah Z, Alawi A, Said S, Ganji V. Fast food and sweet intake pattern is directly associated with the prevalence of asthma in a Qatari population. Eur J Clin Nutr 2022; 76:428-433. [PMID: 34168291 PMCID: PMC8907074 DOI: 10.1038/s41430-021-00959-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Revised: 05/26/2021] [Accepted: 06/08/2021] [Indexed: 02/06/2023]
Abstract
OBJECTIVE The relationship between dietary patterns and the prevalence of asthma is not well understood. We aimed to investigate the association between dietary patterns and asthma in adults in Qatar. METHODS In this study, cross-sectional data from the Qatar Biobank were used (n = 986). Participants were Qatari or long-term Qatar residents aged ≥20 years old. A food frequency questionnaire was used to collect dietary intakes. Three dietary patterns were identified using factor analysis. Multivariable logistic regression was used to assess the association between dietary patterns scores and asthma. RESULTS Among 986 eligible participants, 6.6% (n = 65) reported that they were diagnosed with asthma. Three dietary patterns were identified. These were (1) "Traditional" (high intake of rice, chicken/meat/fish, and breads); (2) "Prudent" (high intake of fruits, vegetables, and fish); and (3) "Fast Food/Sweets" (high intake of desserts, fast food, and soft drinks). The fast food/sweet dietary pattern was associated with increased likelihood of having asthma [comparing high vs. low tertile, OR for asthma = 1.25; 95% CI (1.02-1.54); p = 0.035]. Traditional and Prudent dietary patterns were not associated with the prevalence of asthma. CONCLUSION The fast food/sweet dietary pattern was directly associated with the prevalence of asthma among adults in Qatar. Reducing the fast foods and sugary-rich foods may be beneficial for respiratory health.
Collapse
Affiliation(s)
- Zumin Shi
- grid.412603.20000 0004 0634 1084Human Nutrition Department, College of Health Sciences, QU Health, Qatar University, P.O. Box 2713, Doha, Qatar
| | - Tahra El-Obeid
- grid.412603.20000 0004 0634 1084Human Nutrition Department, College of Health Sciences, QU Health, Qatar University, P.O. Box 2713, Doha, Qatar
| | - Zainab Meftah
- grid.412603.20000 0004 0634 1084Human Nutrition Department, College of Health Sciences, QU Health, Qatar University, P.O. Box 2713, Doha, Qatar
| | - Amal Alawi
- grid.412603.20000 0004 0634 1084Human Nutrition Department, College of Health Sciences, QU Health, Qatar University, P.O. Box 2713, Doha, Qatar
| | - Suad Said
- grid.412603.20000 0004 0634 1084Human Nutrition Department, College of Health Sciences, QU Health, Qatar University, P.O. Box 2713, Doha, Qatar
| | - Vijay Ganji
- grid.412603.20000 0004 0634 1084Human Nutrition Department, College of Health Sciences, QU Health, Qatar University, P.O. Box 2713, Doha, Qatar
| |
Collapse
|
17
|
Khramova RN, Tush EV, Khramov AA, Ovsyannikov DY, Popov KS, Dolbin IV, Khaletskaya OV, Stroganov AB, Kubysheva NI, Eliseeva TI. Relationship of Nutritional Status and Spirometric Parameters in Children with Bronchial Asthma. Sovrem Tekhnologii Med 2021; 12:12-23. [PMID: 34795975 PMCID: PMC8596246 DOI: 10.17691/stm2020.12.3.02] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Indexed: 12/23/2022] Open
Abstract
The potential mechanisms of bronchial asthma (BA) negative modification under the influence of obesity are currently being actively studied. However, at present, the effect of nutritional status on bronchial obstruction in children with BA cannot be considered established. In this regard, the purpose of this work was to study the relationship of spirometric parameters reflecting bronchial patency with nutritional status in children with asthma.
Collapse
Affiliation(s)
- R N Khramova
- Medical Resident, Department of Hospital Pediatrics; Privolzhsky Research Medical University, 10/1 Minin and Pozharsky Square, Nizhny Novgorod, 603005, Russia
| | - E V Tush
- Associate Professor, Department of Hospital Pediatrics; Privolzhsky Research Medical University, 10/1 Minin and Pozharsky Square, Nizhny Novgorod, 603005, Russia
| | - A A Khramov
- Medical Resident, Department of Hospital Pediatrics; Privolzhsky Research Medical University, 10/1 Minin and Pozharsky Square, Nizhny Novgorod, 603005, Russia
| | - D Yu Ovsyannikov
- Professor, Head of the Department of Children's Diseases; Peoples' Friendship University of Russia, 6 Miklukho-Maklaya St., Moscow, 117198, Russia
| | - K S Popov
- Medical Resident, Department of Hospital Pediatrics; Privolzhsky Research Medical University, 10/1 Minin and Pozharsky Square, Nizhny Novgorod, 603005, Russia
| | - I V Dolbin
- Consultant; City Clinical Hospital No.38, 22 Chernyshevskogo St., Nizhny Novgorod, 603000, Russia
| | - O V Khaletskaya
- Professor, Head of the Department of Hospital Pediatrics; Privolzhsky Research Medical University, 10/1 Minin and Pozharsky Square, Nizhny Novgorod, 603005, Russia
| | - A B Stroganov
- Associate Professor, Department of Faculty Surgery and Transplantology; Privolzhsky Research Medical University, 10/1 Minin and Pozharsky Square, Nizhny Novgorod, 603005, Russia
| | - N I Kubysheva
- Senior Researcher, Research Laboratory "Clinical Linguistics"; Kazan Federal University, 18 Kremlyovskaya St., Kazan, Republic of Tatarstan, 420008, Russia
| | - T I Eliseeva
- Professor, Department of Hospital Pediatrics; Privolzhsky Research Medical University, 10/1 Minin and Pozharsky Square, Nizhny Novgorod, 603005, Russia
| |
Collapse
|
18
|
Niu C, Xu Y, Schuler CL, Gu L, Arora K, Huang Y, Naren AP, Durrani SR, Hossain MM, Guilbert TW. Evaluation of Risk Scores to Predict Pediatric Severe Asthma Exacerbations. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2021; 9:4393-4401.e8. [PMID: 34506966 DOI: 10.1016/j.jaip.2021.08.030] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 08/13/2021] [Accepted: 08/18/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Asthma exacerbations commonly lead to unplanned health care utilization and are costly. Early identification of children at increased risk of asthma exacerbations would allow a proactive management approach. OBJECTIVE We evaluated common asthma risk factors to predict the probability of exacerbation for individual children aged 0-21 years using data from the electronic medical record (EMR). METHODS We analyzed longitudinal EMR data for over 3000 participants with asthma seen at Cincinnati Children's Hospital Medical Center over a 7-year period. The study population was divided into 3 age groups: 0-4, 5-11, and 12-21 years. Each age group was divided into a derivation cohort and a validation cohort, which were used to build a risk score model. We predicted risk of exacerbation in the next 12 months, validated the scores by risk stratum, and developed a clinical tool to determine the risk level based on this model. RESULTS Risk model results were confirmed with validation cohorts by calendar year and age groups. Race, allergic sensitization, and smoke exposure were each important risk factors in the 0-4 age group. Abnormal spirometry and obesity were more sensitive predictors of exacerbation in children >12 years. For each age group, a higher expanded score was associated with a higher predicted probability of an asthma exacerbation in the subsequent year. CONCLUSION This asthma exacerbation prediction model, and the associated clinical tool, may assist clinicians in identifying children at high risk for exacerbation that may benefit from more aggressive management and targeted risk mitigation.
Collapse
Affiliation(s)
- Chao Niu
- Department of Respiratory Medicine, Children's Hospital of Chongqing Medical University, Chongqing, China
| | - Yuanfang Xu
- Division of Oncology, Regeneron Pharmaceuticals, Inc., Basking Ridge, NJ
| | - Christine L Schuler
- Division of Pulmonary and Sleep Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Division of Hospital Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Lijuan Gu
- Division of Pulmonary and Sleep Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Kavisha Arora
- Division of Pulmonary and Sleep Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Yunjie Huang
- Division of Pulmonary and Sleep Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Anjaparavanda P Naren
- Division of Pulmonary and Sleep Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Sandy R Durrani
- Division of Pulmonary and Sleep Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Md M Hossain
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio; Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Theresa W Guilbert
- Division of Pulmonary and Sleep Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio.
| |
Collapse
|
19
|
Salvi SS, Kumar A, Puri H, Bishnoi S, Asaf BB, Ghorpade D, Madas S, Agrawal A, Kumar A. Association between air pollution, body mass index, respiratory symptoms, and asthma among adolescent school children living in Delhi, India. Lung India 2021; 38:408-415. [PMID: 34472517 PMCID: PMC8509169 DOI: 10.4103/lungindia.lungindia_955_20] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Background: Delhi is one of the most polluted cities in the world with annual average ambient PM10 and PM2.5 levels exceeding the World Health Organization standards by over 15 fold. We aimed to study the prevalence of respiratory and allergic symptoms and asthma among adolescent children living in Delhi (D) and compare it with children living in lesser polluted cities of Kottayam (K) and Mysore (M) located in Southern India. Methods: 4361 boys and girls between the age group of 13–14 and 16–17 years from 12 randomly selected private schools from D, K, and M were invited to participate. Modified and expanded International Study for Asthma and Allergies in Children (ISAAC) questionnaires (Q) were filled by the students who also performed spirometry using the ultrasonic flow-sensor-based nDD Spirometer. Results: 3157 students (50.4% boys) completed the Q and performed good quality spirometry. The prevalence of asthma and airflow obstruction among children living in Delhi was 21.7% using the ISAAC Q and 29.4% on spirometry, respectively. This was accompanied by significantly higher rates of self-reported cough, shortness of breath, chest tightness, sneezing, itchy and watery eyes, itchy skin, and eczema among Delhi children (vs. K-M, all P < 0.05). Delhi children were more overweight and obese (39.8% vs. 16.4%, P < 0.0001), and this was the only risk factor that was strongly associated with asthma (odds ratio [OR]: 1.79; confidence interval: 1.49–2.14), with a more pronounced effect in Delhi children (P = 0.04). Forced expiratory volume1 and Forced vital capacity values were significantly higher in Delhi children (vs. K-M P < 0.0001). Preserved ratio impaired spirometry was more common in K-M children (P < 0.0001). Conclusion: Adolescent children living in the polluted city of Delhi had a high prevalence of asthma, respiratory symptoms, allergic rhinitis, and eczema that was strongly associated with a high body mass index (BMI). Our study suggests an association between air pollution, high BMI, and asthma/allergic diseases, which needs to be explored further.
Collapse
Affiliation(s)
| | | | | | | | | | - Deesha Ghorpade
- Pulmocare Research and Education (PURE) Foundation, Pune, Maharashtra, India
| | - Sapna Madas
- Pulmocare Research and Education (PURE) Foundation, Pune, Maharashtra, India
| | - Anurag Agrawal
- CSIR Institute of Genomics and Integrative Biology, New Delhi, India
| | | |
Collapse
|
20
|
Jezioro JR, Gutman SA, Lovinsky-Desir S, Rauh V, Perera FP, Miller RL. A Comparison of Activity Participation between Children with and without Asthma. OPEN JOURNAL OF OCCUPATIONAL THERAPY 2021; 9. [PMID: 34316416 DOI: 10.15453/2168-6408.1813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Background Asthma affects approximately 6 million children in the United States and can greatly impact quality of life and occupational engagement. Although occupational therapists are well-equipped to address participation limitations, insufficient evidence exists to support the role of occupational therapists in asthma treatment. Method The purpose of this study was to further understand the occupational limitations experienced by children with asthma. We also explored a dual diagnosis of asthma and obesity. The participants included children with (n = 84) and without (n = 63) asthma living in New York City. The Child Behavior Checklist, Youth Self Report, Brief Respiratory Questionnaire, and accelerometer data were used to examine occupational participation. Results Although accelerometry data demonstrated that children with asthma were equally as active as their non-asthmatic peers, the participants with asthma perceived themselves as participating more in sedentary occupations and were less likely to be members of sports teams. They also had more missed school days and nights of troubled sleep. The children with both asthma and obesity reported the highest level of activity limitations. Conclusion This study illustrates specific limitations experienced by children with asthma and supports the need for occupational therapy intervention. Future studies are needed to design and assess interventions that will support the addition of occupational therapists to multidisciplinary asthma treatment teams.
Collapse
|
21
|
Lucas JA, Marino M, Giebultowicz S, Fankhauser K, Suglia SF, Bailey SR, Bazemore A, Heintzman J. Mobility and social deprivation on primary care utilisation among paediatric patients with asthma. Fam Med Community Health 2021; 9:fmch-2021-001085. [PMID: 34244305 PMCID: PMC8278882 DOI: 10.1136/fmch-2021-001085] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE Asthma care is negatively impacted by neighbourhood social and environmental factors, and moving is associated with undesirable asthma outcomes. However, little is known about how movement into and living in areas of high deprivation relate to primary care use. We examined associations between neighbourhood characteristics, mobility and primary care utilisation of children with asthma to explore the relevance of these social factors in a primary care setting. DESIGN In this cohort study, we conducted negative binomial regression to examine the rates of primary care visits and annual influenza vaccination and logistic regression to study receipt of pneumococcal vaccination. All models were adjusted for patient-level covariates. SETTING We used data from community health centres in 15 OCHIN states. PARTICIPANTS The sample included 23 773 children with asthma aged 3-17 across neighbourhoods with different levels of social deprivation from 2012 to 2017. We conducted negative binomial regression to examine the rates of primary care visits and annual influenza vaccination and logistic regression to study receipt of pneumococcal vaccination. All models were adjusted for patient-level covariates. RESULTS Clinic visit rates were higher among children living in or moving to areas with higher deprivation than those living in areas with low deprivation (rate ratio (RR) 1.09, 95% CI 1.02 to 1.17; RR 1.05, 95% CI 1.00 to 1.11). Children moving across neighbourhoods with similarly high levels of deprivation had increased RRs of influenza vaccination (RR 1.13, 95% CI 1.03 to 1.23) than those who moved but stayed in neighbourhoods of low deprivation. CONCLUSIONS Movement into and living within areas of high deprivation is associated with more primary care use, and presumably greater opportunity to reduce undesirable asthma outcomes. These results highlight the need to attend to patient movement in primary care visits, and increase neighbourhood-targeted population management to improve equity and care for children with asthma.
Collapse
Affiliation(s)
- Jennifer A Lucas
- Department of Family Medicine, Oregon Health & Science University, Portland, Oregon, USA
| | - Miguel Marino
- Department of Family Medicine, Oregon Health & Science University, Portland, Oregon, USA
| | | | - Katie Fankhauser
- Department of Family Medicine, Oregon Health & Science University, Portland, Oregon, USA
| | - Shakira F Suglia
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Steffani R Bailey
- Department of Family Medicine, Oregon Health & Science University, Portland, Oregon, USA
| | - Andrew Bazemore
- American Board of Family Medicine, Lexington, Kentucky, USA.,Center for Professionalism & Value in Health Care, Washington, DC, USA
| | - John Heintzman
- Department of Family Medicine, Oregon Health & Science University, Portland, Oregon, USA.,OCHIN Inc, Portland, Oregon, USA
| |
Collapse
|
22
|
Chen Y, Zhu Y, Su G, Yang W, Zhao Y, Lu W, Zhang J. KRN7000 Reduces Airway Inflammation via Natural Killer T Cells in Obese Asthmatic Mice. Inflammation 2021; 44:1982-1992. [PMID: 34021838 DOI: 10.1007/s10753-021-01475-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 04/12/2021] [Accepted: 05/03/2021] [Indexed: 12/14/2022]
Abstract
Although natural killer T cells (NKT cells) are altered in obese asthmatic mice, their function remains completely unclear. To further explore the potential mechanism of NKT cells in airway inflammation of obesity-associated asthma, we examined the effects of α-galactosylceramide (KRN7000) on airway inflammation in obese asthmatic mice. Male C57BL/6J mice were divided into five groups: (1) control; (2) asthma; (3) A + KRN, asthma with KRN7000; (4) obese asthma; and (5) OA + KRN, obese asthma with KRN7000. Cytometric bead array (CBA) was used to detect interleukin-4 (IL-4), IL-10, tumor necrosis factor-α (TNF-α), and interferon-γ (IFN-γ) in the serum. Flow cytometry was used to detect NKT cells and CD69+ NKT cells. Airway inflammation was observed in pathological sections, and calmodulin (CaM) expression was observed by immunohistochemistry in lung tissues. Airway inflammation in the obese asthma group was more severe than that of the asthma group. Airway inflammation of the OA + KRN group was reduced more than that of the A + KRN group. CD69+ NKT cells were only significantly reduced in the OA + KRN group. The levels of serum IFN-γ and TNF-α increased more in the OA + KRN group than in the A + KRN group. CaM is widely expressed in the cytoplasm of the lung tissues and was sharply decreased in the OA + KRN group. KRN7000 can significantly reduce airway inflammation in obesity-associated asthma by regulating NKT cell cytokine secretion and intracellular calcium. These results may contribute to the development of novel therapeutic approaches.
Collapse
Affiliation(s)
- Yiping Chen
- The Affiliated Minzu Hospital of Guangxi Medical University/Guangxi Minzu Hospital, Nanning, Guangxi, 530001, People's Republic of China
| | - Yiping Zhu
- The Affiliated Minzu Hospital of Guangxi Medical University/Guangxi Minzu Hospital, Nanning, Guangxi, 530001, People's Republic of China
| | - Geng Su
- The Affiliated Minzu Hospital of Guangxi Medical University/Guangxi Minzu Hospital, Nanning, Guangxi, 530001, People's Republic of China
| | - Wei Yang
- Guangdong Lewwin Pharmaceutical Research Institute Co., Ltd, Guangzhou, Guangdong, 510990, People's Republic of China
| | - Yanying Zhao
- The Affiliated Minzu Hospital of Guangxi Medical University/Guangxi Minzu Hospital, Nanning, Guangxi, 530001, People's Republic of China
| | - Weiwei Lu
- The Affiliated Minzu Hospital of Guangxi Medical University/Guangxi Minzu Hospital, Nanning, Guangxi, 530001, People's Republic of China
| | - Jinghong Zhang
- The Second Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, 530001, People's Republic of China.
| |
Collapse
|
23
|
Stevens DR, Grobman W, Kumar R, Lipsky LM, Hinkle SN, Chen Z, Williams A, Rohn MCH, Kanner J, Sherman S, Mendola P. Gestational and Postpartum Weight Trajectories Among Women With and Without Asthma. Am J Epidemiol 2021; 190:744-754. [PMID: 33169142 DOI: 10.1093/aje/kwaa248] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 10/06/2020] [Accepted: 11/04/2020] [Indexed: 11/14/2022] Open
Abstract
Asthma leads to increased weight gain in nonpregnant populations, but studies have not examined this association within the context of pregnancy. The association between asthma and perinatal weight trajectories was examined in the Breathe-Wellbeing, Environment, Lifestyle, and Lung Function Study (2015-2019). Multilevel linear spline models were adjusted for age, race/ethnicity, income, marital status, education, cigarette smoking, parity, study site, and prepregnancy body mass index were used to examine differences in perinatal weight trajectories between women with (n = 299) and without (n = 101) asthma. Secondary analyses were conducted to assess whether associations differed by asthma phenotypes. At 40 weeks' gestation, women with asthma gained 16.2 kg (95% confidence interval (CI): 14.6, 17.7) and women without asthma gained 13.1 kg (95% CI: 10.9, 15.4). At 3 months postpartum, women with asthma retained 10.4 kg (95% CI: 8.9, 11.9) and women without asthma retained 8.0 kg (95% CI: 5.9, 10.2). Among women with asthma, exercise-induced asthma and step 3 asthma medications were associated with excess gestational weight gain. These study findings suggest women with asthma gain and retain more weight during pregnancy and postpartum than do women without asthma.
Collapse
|
24
|
Parental Feeding, Child Eating and Physical Activity: Differences in Children Living with and without Asthma. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18073452. [PMID: 33810395 PMCID: PMC8036624 DOI: 10.3390/ijerph18073452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 03/18/2021] [Accepted: 03/23/2021] [Indexed: 11/29/2022]
Abstract
This study aimed to establish the differences in parental attitudes toward feeding and activity, as well as child eating and activity levels, between families of children living with and without asthma. Parents of children and young people aged between 10 and 16 years living both with asthma (n = 310) and without asthma (n = 311) completed measures for parental feeding, parental attitudes toward child exercise, child eating, child activity level and asthma control. Children living with asthma had a significantly higher BMIz (BMI standardised for weight and age) score, were significantly more likely to emotionally overeat and desired to drink more than their peers without asthma. Parents of children with asthma reported greater use of food to regulate emotions, restriction of food for weight control, monitoring of child activity, pressure to exercise and control over child activity. When asthma symptoms were controlled, parental restriction of food for weight management predicted greater child BMIz scores, and higher child activity predicted lower child BMIz scores. These relationships were not found to be significant for children with inadequately controlled asthma. Differences in parental attitudes toward feeding and exercise, and child eating and exercise behaviors, between families may help to explain the increased obesity risk for children with asthma.
Collapse
|
25
|
Dragomir AI, Boucher VG, Bacon SL, Gemme C, Szczepanik G, Corace K, Campbell TS, Vallis MT, Garber G, Rouleau C, Rabi D, Diodati JG, Ghali W, Lavoie KL. An international Delphi consensus study to define motivational communication in the context of developing a training program for physicians. Transl Behav Med 2021; 11:642-652. [PMID: 32145022 PMCID: PMC7963284 DOI: 10.1093/tbm/ibaa015] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Poor health behaviors (e.g., smoking, poor diet, and physical inactivity) are major risk factors for noncommunicable chronic diseases (NCDs). Evidence supporting traditional advice-giving approaches to promote behavior change is weak or short lived. Training physicians to improve their behavior change counseling/communication skills is important, yet the evidence for the efficacy and acceptability of existing training programs is lacking and there is little consensus on the core competencies that physicians should master in the context of NCD management. The purpose of this study is to generate an acceptable, evidence-based, stakeholder-informed list of the core communication competencies that physicians should master in the context of NCD management. Using a modified Delphi process for consensus achievement, international behavior change experts, physicians, and allied health care professionals completed four phases of research, including eight rounds of online surveys and in-person meetings over 2 years (n = 13-17 participated in Phases I, III, and IV and n = 39-46 in Phase II). Eleven core communication competencies were identified: reflective listening, expressing empathy, demonstrating acceptance, tolerance, and respect, responding to resistance, (not) negatively judging or blaming, (not) expressing hostility or impatience, eliciting "change-talk"/evocation, (not) being argumentative or confrontational, setting goals, being collaborative, and providing information neutrally. These competencies were used to define a unified approach for conducting behavior change counseling in medical settings: Motivational Communication. The results may be used to inform and standardize physician training in behavior change counseling and communication skills to reduce morbidity and mortality related to poor health behaviors in the context of NCD prevention and management.
Collapse
Affiliation(s)
- Anda I Dragomir
- Montreal Behavioural Medicine Centre, Centre Intégré Universitaire de santé et services sociaux du Nord-de-l’Ile-de-Montréal (CIUSSS-NIM), Hôpital du Sacré-Coeur de Montréal, Montreal, Canada
- Department of Psychology, Université du Québec à Montréal, Montreal, Canada
| | - Vincent Gosselin Boucher
- Montreal Behavioural Medicine Centre, Centre Intégré Universitaire de santé et services sociaux du Nord-de-l’Ile-de-Montréal (CIUSSS-NIM), Hôpital du Sacré-Coeur de Montréal, Montreal, Canada
- Department of Psychology, Université du Québec à Montréal, Montreal, Canada
| | - Simon L Bacon
- Montreal Behavioural Medicine Centre, Centre Intégré Universitaire de santé et services sociaux du Nord-de-l’Ile-de-Montréal (CIUSSS-NIM), Hôpital du Sacré-Coeur de Montréal, Montreal, Canada
- Department of Health, Kinesiology and Applied Physiology, Concordia University, Montreal, Canada
| | - Claudia Gemme
- Montreal Behavioural Medicine Centre, Centre Intégré Universitaire de santé et services sociaux du Nord-de-l’Ile-de-Montréal (CIUSSS-NIM), Hôpital du Sacré-Coeur de Montréal, Montreal, Canada
- Department of Psychology, Université du Québec à Montréal, Montreal, Canada
| | - Geneviève Szczepanik
- Montreal Behavioural Medicine Centre, Centre Intégré Universitaire de santé et services sociaux du Nord-de-l’Ile-de-Montréal (CIUSSS-NIM), Hôpital du Sacré-Coeur de Montréal, Montreal, Canada
| | - Kimberly Corace
- Department of Psychiatry, University of Ottawa, Ottawa, Canada
| | - Tavis S Campbell
- TotalCardiology Rehabilitation, Calgary, AB, Canada
- Department of Psychology, University of Calgary, Calgary Canada
| | - Michael T Vallis
- Department of Family Medicine, Dalhousie University, Halifax, Canada
| | - Gary Garber
- Department of Medicine, University of Ottawa, Ottawa, Canada
- Department of Medicine, University of Toronto, Toronto, Canada
- Public Health Ontario, Ontario Agency for Health Protection and Promotion, Toronto, Canada
| | - Codie Rouleau
- TotalCardiology Rehabilitation, Calgary, AB, Canada
- Department of Psychology, University of Calgary, Calgary Canada
| | - Doreen Rabi
- Department of Community Health Sciences, University of Calgary, Calgary, Canada
| | - Jean G Diodati
- Montreal Behavioural Medicine Centre, Centre Intégré Universitaire de santé et services sociaux du Nord-de-l’Ile-de-Montréal (CIUSSS-NIM), Hôpital du Sacré-Coeur de Montréal, Montreal, Canada
| | - William Ghali
- Department of Community Health Sciences, University of Calgary, Calgary, Canada
| | - Kim L Lavoie
- Montreal Behavioural Medicine Centre, Centre Intégré Universitaire de santé et services sociaux du Nord-de-l’Ile-de-Montréal (CIUSSS-NIM), Hôpital du Sacré-Coeur de Montréal, Montreal, Canada
- Department of Psychology, Université du Québec à Montréal, Montreal, Canada
| |
Collapse
|
26
|
Childhood Obesity and Respiratory Diseases: Which Link? CHILDREN-BASEL 2021; 8:children8030177. [PMID: 33669035 PMCID: PMC7996509 DOI: 10.3390/children8030177] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 02/16/2021] [Accepted: 02/18/2021] [Indexed: 12/14/2022]
Abstract
Prevalence of childhood obesity is progressively increasing, reaching worldwide levels of 5.6% in girls and of 7.8% in boys. Several evidences showed that obesity is a major preventable risk factor and disease modifier of some respiratory conditions such as asthma and Obstructive Sleep Apnea Syndrome (OSAS). Co-occurrence of asthma and obesity may be due to common pathogenetic factors including exposure to air pollutants and tobacco smoking, Western diet, and low Vitamin D levels. Lung growth and dysanapsis phenomenon in asthmatic obese children play a role in impaired respiratory function which appears to be different than in adults. Genes involved in both asthma and obesity have been identified, though a gene-by-environment interaction has not been properly investigated yet. The identification of modifiable environmental factors influencing gene expression through epigenetic mechanisms may change the natural history of both diseases. Another important pediatric respiratory condition associated with obesity is Sleep-Disordered Breathing (SDB), especially Obstructive Sleep Apnea Syndrome (OSAS). OSAS and obesity are linked by a bidirectional causality, where the effects of one affect the other. The factors most involved in the association between OSAS and obesity are oxidative stress, systemic inflammation, and gut microbiota. In OSAS pathogenesis, obesity's role appears to be mainly due to mechanical factors leading to an increase of respiratory work at night-time. However, a causal link between obesity-related inflammatory state and OSAS pathogenesis still needs to be properly confirmed. To prevent obesity and its complications, family education and precocious lifestyle changes are critical. A healthy diet may lead to an improved quality of life in obese children suffering from respiratory diseases. The present review aimed to investigate the links between obesity, asthma and OSAS, focusing on the available evidence and looking for future research fields.
Collapse
|
27
|
Terry D, Peck B, Kloot K, Hutchins T. Pediatric emergency asthma presentations in Southwest Victoria: a retrospective cross-sectional study 2017 to 2020. J Asthma 2020; 59:264-272. [PMID: 33143500 DOI: 10.1080/02770903.2020.1845725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVES Australia has one of the highest prevalence of asthma globally, and accessible emergency asthma presentation data remains vital, however, is currently underreported in regional and rural areas. Utilizing the Rural Acute Hospital Data Register (RAHDaR) which includes previously non-reported data, the aim of the study is to provide a more accurate understanding of asthma emergency presentation events, while investigating the factors associated with these presentations. METHODS A retrospective cross-sectional study collected de-identified emergency asthma presentation data from nine health services in regional Victoria for children aged 0 to 14 years between 2017 and 2020. Demographic and presentation data were collated along with government datasets. Asthma emergency presentations incidence rates and predictor variables were analyzed using hierarchical multiple regression after adjusting for smoking and sex. Significance was determined at p < 0.05. RESULTS Of the 1090 emergency asthma presentations, n = 369 occurred at health services who did not previously report data. This represents a 33.86% increase in our understanding of emergency asthma presentations and demonstrating a rate of 16.06 presentations per 1000 children per year. Key factors such as age, population density, and private health insurance were associated with asthma emergency presentation events among both sexes, while socioeconomic status and rurality were not predictive. CONCLUSIONS Although some findings are consistent with current research, the study highlights previously unrecognized specific factors that are predictive of asthma among 0-14-year-old children. These findings provide more accurate insights for healthcare workers and policymakers as they seek to support people with asthma and accurately address health inequities.
Collapse
Affiliation(s)
- Daniel Terry
- School of Health, Federation University, Ballarat, Victoria, Australia
| | - Blake Peck
- School of Health, Federation University, Ballarat, Victoria, Australia
| | - Kate Kloot
- Center for Rural Emergency Medicine, School of Medicine, Deakin University, Warrnambool, Victoria, Australia
| | | |
Collapse
|
28
|
Hawkins MAW, Clawson AH, Smith CE, Stout ME, Keirns NG, Ruppe NM. Psychological distress and substance use among young adults with comorbid asthma and obesity. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2020; 68:914-921. [PMID: 31373892 DOI: 10.1080/07448481.2019.1643353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Revised: 10/31/2018] [Accepted: 07/05/2019] [Indexed: 06/10/2023]
Abstract
This study examined psychosocial distress and substance use in young adults with asthma (A), obesity (O), comorbid asthma and obesity (AO), or neither (controls). Participants: Eight hundred eighty-one young adults were included in the A, O, AO, or control group. Methods: ANCOVA and logistic regression analyses were performed to compare responses to screeners for psychological distress and substance use among the four groups. Results: Levels of depressive symptoms, worry, nonsuicidal self-injury, emotion dysregulation, and chronic pain symptoms differed across groups, with the A and AO groups showing greater psychological distress than the O and control groups. The AO group exhibited the highest levels of cigarette and smokeless tobacco use, while the O group exhibited the least frequent binge drinking behaviors. Conclusions: Individuals with asthma or comorbid asthma and obesity appear to experience the poorest psychosocial functioning and highest use of tobacco products. Potential mechanisms and implications of these relationships are discussed.
Collapse
Affiliation(s)
- Misty A W Hawkins
- Department of Psychology, Oklahoma State University, Stillwater, Oklahoma, USA
| | - Ashley H Clawson
- Department of Psychology, Oklahoma State University, Stillwater, Oklahoma, USA
| | - Caitlin E Smith
- Department of Psychology, Oklahoma State University, Stillwater, Oklahoma, USA
| | - Madison E Stout
- Department of Psychology, Oklahoma State University, Stillwater, Oklahoma, USA
| | - Natalie G Keirns
- Department of Psychology, Oklahoma State University, Stillwater, Oklahoma, USA
| | - Nicole M Ruppe
- Department of Psychology, Oklahoma State University, Stillwater, Oklahoma, USA
| |
Collapse
|
29
|
Abstract
Childhood obesity is an epidemic in the US. This article discusses the evolution, prevention, and associated physical and psychosocial consequences of and interventions for obesity in the pediatric population.
Collapse
|
30
|
Saelee R, Gazmararian JA, Haardörfer R, Suglia SF. Associations between the Neighborhood Social Environment and Obesity Among Adolescents: Do Physical Activity, Screen Time, and Sleep Play a Role? Health Place 2020; 64:102380. [PMID: 32831579 PMCID: PMC7434044 DOI: 10.1016/j.healthplace.2020.102380] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
This study examines: (1) the association between the neighborhood social environment and obesity among adolescents, (2) whether physical activity, screen time, and short sleep mediates this association, and (3) examine sex differences. Participants (n=12,692; age 11-19 years old) came from Waves I and II of the National Longitudinal Study of Adolescent to Adult Health. Neighborhood social disorganization and socioeconomic status (NSES) measures were associated with obesity adjusting for sex, race, age, parental education, and urbanicity. Screen time mediated NSES and obesity. Very short sleep duration (<6 hours) mediated social disorganization and obesity among females only. Findings suggest improving neighborhood social conditions may reduce the risk for obesity.
Collapse
Affiliation(s)
- Ryan Saelee
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Julie A. Gazmararian
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Regine Haardörfer
- Department of Behavioral Sciences and Health Education , Rollins School of Public Health, Emory University, Atlanta, GA
| | - Shakira F Suglia
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
| |
Collapse
|
31
|
Mikalsen IB, Byberg K, Forman MR, Øymar K. Adipokines in adolescence; the associations with lung function and atopy - A cross-sectional study. Respir Med 2020; 170:106063. [PMID: 32705985 DOI: 10.1016/j.rmed.2020.106063] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 06/07/2020] [Accepted: 06/08/2020] [Indexed: 12/31/2022]
Abstract
Both inflammatory and mechanical effects have been proposed to explain the increased risk of asthma and reduced lung function observed in obese children and adults. The evidence regarding the potential role of obesity in the aetiology of atopy and allergy is more conflicting. The adipokines leptin and adiponectin are inflammatory markers of fat metabolism which may be involved in explaining the increased risk of asthma and reduced lung function in obese children and adults. In this cross-sectional study, we aimed to study how adiponectin and leptin were associated with lung function and atopic sensitisation in adolescents. The study included 384 children at mean age 12.9 years with measurements of adiponectin, leptin, lung function and atopic sensitisation. Adiponectin and leptin levels were measured in serum, lung function was measured by spirometry and atopic sensitisation was measured by serum specific Immunoglobulin E. In linear regression models, leptin was negatively associated with forced vital capacity (FVC) (Beta: -4.13; 95% Confidence Interval: -5.83, -2.44, P < 0.001) and forced expiratory volume in the first second (FEV1) (-3.74; -5.39, -2.09, P < 0.001) after adjusting for body mass index (BMI) and other covariates. No associations were observed between adiponectin and lung function or between leptin or adiponectin and atopic sensitisation. In this cross-sectional analysis of adolescents in all weight classes, leptin was negatively associated with FEV1 and FVC independent of BMI, but no associations were found between adiponectin and lung function. The results suggest that leptin may have a functional role in the airways of healthy children.
Collapse
Affiliation(s)
- Ingvild Bruun Mikalsen
- Department of Pediatrics, Stavanger University Hospital, Stavanger, Norway; Department of Clinical Science, University of Bergen, Norway.
| | - Kristine Byberg
- Department of Pediatrics, Stavanger University Hospital, Stavanger, Norway
| | - Michele R Forman
- Department of Nutritional Sciences, Purdue University, West Lafayette, IN, USA
| | - Knut Øymar
- Department of Pediatrics, Stavanger University Hospital, Stavanger, Norway; Department of Clinical Science, University of Bergen, Norway
| |
Collapse
|
32
|
Weight Loss for Children and Adults with Obesity and Asthma. A Systematic Review of Randomized Controlled Trials. Ann Am Thorac Soc 2020; 16:613-625. [PMID: 30605347 DOI: 10.1513/annalsats.201810-651sr] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Background: Asthma and obesity are major public health problems, affecting hundreds of millions of people worldwide. Obesity is associated with increased asthma risk and severity, and lower asthma-related quality of life. Objective: In this systematic review, we aimed to evaluate whether weight loss in subjects with obesity and asthma leads to improvement in asthma-related outcomes. Data Sources and Extraction: We searched PubMed and Google Scholar for all studies in English published January 2000-December 2018. Studies were included if they were randomized, controlled clinical trials (RCTs) for overweight/obese children or adults with asthma, with sufficient data to assess outcomes and study quality. Non-randomized and non-controlled studies were excluded, as well as those in subjects without overweight/obesity, or with non-asthmatic controls. Synthesis: We identified four RCTs involving children (total n = 246) and six involving adults (n = 502). All interventions were designed for weight loss and varied from dietary restrictions to multifactorial interventions with exercise training and cognitive behavioral therapy; the duration of intervention ranged from 8 weeks to 18 months. All RCTs reported successful improvements in weight or body mass index (-0.14 standard deviation scores to -15.9% BMI reduction in children, 1.8%-14.5% weight loss in adults). RCTs generally reported improvements in asthma-related quality of life and, to some degree, asthma control. RCTs involving adults also reported improvements in lung function (FEV1, FVC, TLC), while RCTs in children showed less consistent results. Conclusions: These findings suggest that weight loss in subjects with obesity and asthma may improve asthma outcomes. However, there was wide variability in populations studied, baseline and post-intervention assessments, follow-up length, outcome definition and reporting, and statistical approaches, which hindered the ability to compare studies, perform a pooled analysis, or assess generalizability. Primary Source of Funding: U.S. National Institutes of Health (NIH).
Collapse
|
33
|
Mensink-Bout SM, Santos S, van Meel ER, Oei EHG, de Jongste JC, Jaddoe VWV, Duijts L. General and Organ Fat Assessed by Magnetic Resonance Imaging and Respiratory Outcomes in Childhood. Am J Respir Crit Care Med 2020; 201:348-355. [PMID: 31597047 DOI: 10.1164/rccm.201905-0942oc] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Rationale: Obesity has been implicated as a pathogenic factor in asthma, but the underlying role of general and organ fat is unclear.Objectives: We hypothesized that organ fat, rather than the total fat mass, increases the risk of asthma.Methods: In a population-based prospective cohort study among 5,421 children aged 10 years, we measured general fat including body mass index and fat mass index by dual-energy X-ray absorptiometry, and organ fat including subcutaneous fat index, visceral fat index, pericardial fat index, and liver fat fraction by magnetic resonance imaging. Lung function was measured by spirometry. Current asthma was assessed by questionnaire.Measurements and Main Results: Higher body mass index and fat mass index were associated with higher FEV1 (z-score difference [95% confidence interval (CI)], 0.16 [0.14 to 0.19] and z-score difference [95% CI], 0.06 [0.03 to 0.09] per SD score increase, respectively), higher FVC (z-score difference [95% CI], 0.19 [0.17 to 0.22] and z-score difference [95% CI], 0.07 [0.04 to 0.10]), and lower FEV1/FVC ratio (z-score difference [95% CI], -0.07 [-0.10 to -0.05] and z-score difference [95% CI], -0.03 [-0.06 to -0.00]) but not with forced expiratory flow after exhaling 75% of FVC or asthma. Higher visceral fat index, independent of fat mass index, was associated with higher FVC (z-score difference [95% CI], 0.07 [0.03 to 0.10]), lower FEV1/FVC (z-score difference [95% CI], -0.05 [-0.09 to -0.01]), and higher risk of asthma (odds ratio, 1.20; 95% CI, 1.01 to 1.43 per SD score increase). No other organ fat measures were independently associated with lung function or asthma.Conclusions: The obesity-asthma link is driven mainly by visceral fat, independent of total fat mass; therefore, abdominal fat might contribute to asthma development.
Collapse
Affiliation(s)
- Sara M Mensink-Bout
- The Generation R Study Group.,Division of Respiratory Medicine and Allergology and
| | - Susana Santos
- The Generation R Study Group.,Department of Pediatrics, and
| | - Evelien R van Meel
- The Generation R Study Group.,Division of Respiratory Medicine and Allergology and
| | - Edwin H G Oei
- Department of Radiology and Nuclear Medicine, Erasmus Medical Center, University Medical Center, Rotterdam, the Netherlands
| | | | | | - Liesbeth Duijts
- Division of Respiratory Medicine and Allergology and.,Division of Neonatology
| |
Collapse
|
34
|
Hsu CY, Lehman HK, Wood BL, Benipal J, Humayun Q, Miller BD. Comorbid Obesity and Depressive Symptoms in Childhood Asthma: A Harmful Synergy. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2020; 8:2689-2697. [PMID: 32304840 DOI: 10.1016/j.jaip.2020.03.036] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Revised: 03/03/2020] [Accepted: 03/19/2020] [Indexed: 01/22/2023]
Abstract
BACKGROUND Overweight/obesity (OV/OB) and depression have each been separately associated with worsened childhood asthma severity and control. Pathways by which these factors may jointly affect childhood asthma have not been elucidated. OBJECTIVE To examine the interrelationship of OV/OB and depressive symptoms with childhood asthma and explore associated psychobiologic pathways. The present study investigated whether comorbid OV/OB and depressive symptoms are associated with impaired baseline lung function and increased airway resistance during emotional stress, and to assess whether such effects may be mediated by autonomic nervous system (ANS) dysregulation, specifically through predominance of vagal over sympathetic reactivity (vagal bias). METHODS A total of 250 children with asthma, aged 7 to 17, were assessed for OV/OB using body mass index, depressive symptoms using the Children's Depression Inventory (CDI), and asthma severity using National Asthma Education and Prevention Program Expert Panel Report 3 criteria. Baseline pulmonary function (forced expiratory volume in 1 second [FEV1]) was assessed. The film "E.T. the Extra-Terrestrial" was used in a laboratory paradigm to evoke emotional stress/arousal. Airway resistance (Rint) was measured before and after the film to determine changes in airway function. ANS reactivity was assessed by measuring parasympathetic/vagal and sympathetic reactivity throughout the film. RESULTS In OV/OB children with asthma, depressive symptoms predicted lower baseline FEV1 (β = -0.67, standard error [SE] = 0.24, P = .008), CDI predicted vagal bias under emotion stress/arousal (β = 0.27, SE = 0.09, P = .009), and vagal bias predicted increased Rint (β = 3.55, SE = 1.54, P = .023). CONCLUSION This study is the first to link OV/OB and depressive symptoms in their relationship to childhood asthma. In OV/OB children with asthma, depression may potentiate airway compromise, mediated by vagal bias. Use of antidepressant and anticholinergic therapies should be studied in this subgroup of patients.
Collapse
Affiliation(s)
- Chiun Yu Hsu
- Neuroscience Program, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY; Child and Family Asthma Studies Center, Oishei Children's Hospital, Buffalo, NY
| | - Heather K Lehman
- Child and Family Asthma Studies Center, Oishei Children's Hospital, Buffalo, NY; Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY; Allergy & Immunology, Oishei Children's Hospital, Buffalo, NY
| | - Beatrice L Wood
- Neuroscience Program, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY; Child and Family Asthma Studies Center, Oishei Children's Hospital, Buffalo, NY; Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY; Department of Psychiatry, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY
| | - Jaspreet Benipal
- Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY
| | - Quratulain Humayun
- Child and Family Asthma Studies Center, Oishei Children's Hospital, Buffalo, NY
| | - Bruce D Miller
- Neuroscience Program, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY; Child and Family Asthma Studies Center, Oishei Children's Hospital, Buffalo, NY; Department of Pediatrics, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY; Department of Psychiatry, Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, Buffalo, NY.
| |
Collapse
|
35
|
Wark PAB. Contemporary Concise Review 2019: Asthma. Respirology 2020; 25:651-656. [PMID: 32133761 DOI: 10.1111/resp.13794] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Accepted: 02/20/2020] [Indexed: 12/13/2022]
Affiliation(s)
- Peter A B Wark
- Centre for Healthy Lungs, Hunter Medical Research Institute, The University of Newcastle, Newcastle, NSW, Australia
| |
Collapse
|
36
|
Lai L, Zhang T, Zeng X, Tan W, Cai L, Chen Y. Association between Physician-Diagnosed Asthma and Weight Status among Chinese Children: The Roles of Lifestyle Factors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17051599. [PMID: 32121663 PMCID: PMC7084854 DOI: 10.3390/ijerph17051599] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/07/2019] [Revised: 02/12/2020] [Accepted: 02/18/2020] [Indexed: 02/07/2023]
Abstract
Childhood asthma and obesity have posed a parallel epidemic over the past few decades. However, whether asthma diagnosis is associated with obesity, and what the roles of lifestyle factors play in this relationship, remained unclarified. This study aimed to investigate the association between asthma and weight status in Chinese children and explore the potential mediating and/or modifying roles of lifestyle factors in the association. In this cross-sectional study, 16,837 children aged 6–12 years were recruited from Guangzhou, China. Participants’ information on physician-diagnosed asthma was collected from parents, and data on physical activity, screen time, and sleeping were reported in a validated questionnaire. Height and weight were objectively measured, and weight status was classified by body mass index (BMI). Multiple logistic regression analysis and mediation analysis were used. Results showed that asthmatic children were at significantly higher risk of obesity (odds ratio (OR) 1.51, 95% confidence interval (CI) 1.03, 2.21) compared with non-asthmatic children. More importantly, this increased risk was even greater in children with moderate-to-vigorous physical activity <60 min/d and children with screen time >2 h/d (both Pinteraction < 0.05). Also, a positive relationship of asthma with overweight was found in children with screen time >2 h/d (OR 3.92, 95% CI 1.56, 9.88), while a negative association was observed between asthma and underweight in children aged 9–12 years (OR 0.23, 95% CI 0.06, 0.92). Mediation analysis indicated that these associations were not mediated by physical activity, screen time, or sleeping. The findings suggested that physician-diagnosed asthma was associated with higher risks of overweight and obesity, and these risks might be exacerbated by insufficient physical activity and prolonged screen time.
Collapse
Affiliation(s)
- Lijuan Lai
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; (L.L.); (X.Z.)
| | - Ting Zhang
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China;
| | - Xia Zeng
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; (L.L.); (X.Z.)
| | - Weiqing Tan
- Health Promotion Centre for Primary and Secondary Schools of Guangzhou Municipality, Guangzhou 510020, China;
| | - Li Cai
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; (L.L.); (X.Z.)
- Correspondence: (Y.C.); (L.C.); Tel.: +86-020-8733-4627 (Y.C.); Fax: +86-020-8733-0446 (Y.C.)
| | - Yajun Chen
- Department of Maternal and Child Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; (L.L.); (X.Z.)
- Correspondence: (Y.C.); (L.C.); Tel.: +86-020-8733-4627 (Y.C.); Fax: +86-020-8733-0446 (Y.C.)
| |
Collapse
|
37
|
van der Plaat DA. Mendelian randomisation supports causal link between obesity and asthma. Thorax 2020; 75:194-195. [PMID: 31915306 DOI: 10.1136/thoraxjnl-2019-214164] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/20/2019] [Indexed: 02/06/2023]
|
38
|
Associations between obesity, asthma and physical activity in children and adolescents. APUNTS SPORTS MEDICINE 2020. [DOI: 10.1016/j.apunsm.2020.02.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
|
39
|
Lucas JA, Marino M, Fankhauser K, Bailey SR, Ezekiel-Herrera D, Kaufmann J, Cowburn S, Suglia SF, Bazemore A, Puro J, Heintzman J. Oral corticosteroid use, obesity, and ethnicity in children with asthma. J Asthma 2019; 57:1288-1297. [PMID: 31437069 DOI: 10.1080/02770903.2019.1656228] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objective: Comorbid asthma and obesity leads to poorer asthma outcomes, partially due to decreased response to controller medication. Increased oral steroid prescription, a marker of uncontrolled asthma, may follow. Little is known about this phenomenon among Latino children. Our objective was to determine whether obesity is associated with increased oral steroid prescription for children with asthma, and to assess potential disparities in these associations between Latino and non-Hispanic white children.Methods: We examined electronic health record data from the ADVANCE national network of community health centers. The sample included 16,763 children aged 5-17 years with an asthma diagnosis and ≥1 ambulatory visit in ADVANCE clinics across 22 states between 2012 and 2017. Poisson regression analysis was used to examine the rate of oral steroid prescription overall and by ethnicity controlling for potential confounders.Results: Among Latino children, those who were always overweight/obese at study visits had a 15% higher rate of receiving an oral steroid prescription than those who were never overweight/obese [rate ratio (RR) = 1.15, 95% CI 1.05-1.26]. A similar effect size was observed for non-Hispanic white children, though the relationship was not statistically significant (RR = 1.10, 95% CI: 0.92-1.33). The interactions between body mass index and ethnicity were not significant (sometimes overweight/obese p = 0.95, always overweight/obese p = 0.58), suggesting a lack of disparities in the association between obesity and oral steroid prescription by ethnicity.Conclusions: Children with obesity received more oral steroid prescriptions than those at a healthy weight, which may be indicative of worse asthma control. We did not observe significant ethnic disparities.
Collapse
Affiliation(s)
- Jennifer A Lucas
- Department of Family Medicine, Oregon Health and Science University, Portland, OR, USA
| | - Miguel Marino
- Department of Family Medicine, Oregon Health and Science University, Portland, OR, USA.,Division of Biostatistics, School of Public Health, Oregon Health and Science University, Portland State University, Portland, OR, USA
| | - Katie Fankhauser
- Department of Family Medicine, Oregon Health and Science University, Portland, OR, USA
| | - Steffani R Bailey
- Department of Family Medicine, Oregon Health and Science University, Portland, OR, USA
| | - David Ezekiel-Herrera
- Department of Family Medicine, Oregon Health and Science University, Portland, OR, USA
| | - Jorge Kaufmann
- Department of Family Medicine, Oregon Health and Science University, Portland, OR, USA
| | | | - Shakira F Suglia
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Andrew Bazemore
- The Robert Graham Center for Policy Studies, Washington, DC, USA
| | | | - John Heintzman
- Department of Family Medicine, Oregon Health and Science University, Portland, OR, USA.,OCHIN, Inc, Portland, OR, USA
| |
Collapse
|
40
|
Omega-3 Fatty Acids for Obesity and Asthma: Is the Good Fat Not Quite Good Enough? Ann Am Thorac Soc 2019; 16:542-544. [PMID: 31042092 DOI: 10.1513/annalsats.201901-049ed] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
|
41
|
Association of Obesity with Quantitative Chest CT Measured Airway Wall Thickness in WTC Workers with Lower Airway Disease. Lung 2019; 197:517-522. [PMID: 31254057 DOI: 10.1007/s00408-019-00246-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Accepted: 06/24/2019] [Indexed: 11/27/2022]
Abstract
BACKGROUND We previously reported that wall area percent (WAP), a quantitative CT (QCT) indicator of airway wall thickness and, presumably, inflammation, is associated with adverse longitudinal expiratory flow trajectories in WTC workers, but that obesity and weight gain also seemed to be independently predictive of the latter. Previous studies have reported no association between WAP and obesity, so we investigated that association in nonsmoking WTC-exposed individuals and healthy unexposed controls. METHODS We assessed WAP using the Chest Imaging Platform QCT system in a segmental bronchus in 118 former WTC workers, and 89 COPDGene® WTC-unexposed and asymptomatic subjects. We used multiple regression to model WAP vs. body mass index (BMI) in the two groups, adjusting for important subject and CT image characteristics. RESULTS Unadjusted analyses revealed significant differences between the two groups with regards to WAP, age, gender, scan pixel spacing and slice interval, but not BMI or total lung capacity. In adjusted analysis, there was a significant interaction between BMI and WTC exposure on WAP. BMI was significantly and positively associated with WAP in the WTC group, but not in the COPDGene® group, but stratified analyses revealed that the effect was significant in WTC subjects with clinical evidence of lower airway disease (LAD). DISCUSSION Unlike non-diseased subjects, BMI was significantly associated with WAP in WTC workers and, in stratified analyses, the association was significant only among those with LAD. Our findings suggest that this adverse effect of obesity on airway structure and inflammation may be confined to already diseased individuals.
Collapse
|
42
|
Ma C, Wang Y, Xue M. Correlations of severity of asthma in children with body mass index, adiponectin and leptin. J Clin Lab Anal 2019; 33:e22915. [PMID: 31152468 PMCID: PMC6642295 DOI: 10.1002/jcla.22915] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2019] [Revised: 04/12/2019] [Accepted: 04/25/2019] [Indexed: 01/27/2023] Open
Abstract
Background This study aims to investigate the correlations of asthma in children with body mass index (BMI), adiponectin, and leptin. Methods A total of 122 children with asthma in our hospital from January 2017 to February 2018 were randomly selected and divided into control group (normal) and observation group (BMI > 28 kg/m2) according to BMI. BMI, adiponectin, and leptin levels between the two groups were measured and compared, and correlations of disease grade with BMI, adiponectin, or leptin were analyzed. Moreover, risk factors for asthma in children were also identified. Results Body mass index, leptin level, forced vital capacity (FVC), FVC%, and forced expiratory volume in 1s (FEV1)/FVC in observation group were significantly higher than those in control group (P < 0.05), while the adiponectin level, forced expiratory capacity in 1s (FEC1), and FEV1% in observation group were significantly lower than those in control group (P < 0.05). The amount of severe patients in observation group was much larger than that in control group. The severity of disease was positively correlated with BMI and leptin and negatively correlated with adiponectin. BMI, adiponectin, and leptin were identified as risk factors for asthma in children. Conclusion Adiponectin, leptin, and BMI are involved in the pathogenesis of asthma in children, suggesting they might be therapeutic targets for clinical treatment.
Collapse
Affiliation(s)
- Chunli Ma
- Department of Pediatrics, Baoji People's Hospital, Baoji, China
| | - Yujun Wang
- Department of Integrated Traditional Chinese and Western Medicine, Children's Hospital Affiliated to Xi'an Jiaotong University (Xi'an Children's Hospital), Xi'an, China
| | - Man Xue
- Department of Pediatrics, Baoji People's Hospital, Baoji, China
| |
Collapse
|
43
|
Strömberg Celind F, Wennergren G, Vasileiadou S, Alm B, Åberg N, Goksör E. Higher parental education was associated with better asthma control. Acta Paediatr 2019; 108:920-926. [PMID: 30304579 PMCID: PMC6587735 DOI: 10.1111/apa.14610] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Revised: 09/17/2018] [Accepted: 10/05/2018] [Indexed: 11/30/2022]
Abstract
Aim Inhaled corticosteroids have resulted in the improved control of asthma and a reduced need for hospitalisation. This study aimed to examine the prevalence of uncontrolled asthma and factors that affect asthma control. Methods The data came from a longitudinal cohort study of children. The parents answered questionnaires from age 6 months to 12 years. The response rate at age 12 years was 76% (3637/4777) and doctor‐diagnosed asthma was reported in 6.4% (n = 233). Asthma control was examined with the Asthma Control Test (ACT), where scores below 20 denote uncontrolled asthma. Results Of the children with asthma at age 12 years, 15% had an ACT value below 20, that is uncontrolled asthma. Independent risk factors for uncontrolled asthma were wheeze triggered by exercise (adjusted OR, aOR 5.6; 1.9–16.6), cat at home (aOR 3.5; 1.2–10.0) and current doctor‐diagnosed rhinitis (aOR 2.8; 95% CI 1.1–7.0). A higher education in the parents reduced the risk of uncontrolled asthma (aOR 0.3; 95% CI 0.1–0.8). Only six children (i.e. 2.6%) reported hospitalisation due to asthma during the last year. Conclusion Of the children with asthma, 15% had uncontrolled asthma. Higher education in the parents was associated with better asthma control in the children.
Collapse
Affiliation(s)
- Frida Strömberg Celind
- Department of Paediatrics University of Gothenburg Queen Silvia Children's Hospital Gothenburg Sweden
| | - Göran Wennergren
- Department of Paediatrics University of Gothenburg Queen Silvia Children's Hospital Gothenburg Sweden
| | - Styliana Vasileiadou
- Department of Paediatrics University of Gothenburg Queen Silvia Children's Hospital Gothenburg Sweden
| | - Bernt Alm
- Department of Paediatrics University of Gothenburg Queen Silvia Children's Hospital Gothenburg Sweden
| | - Nils Åberg
- Department of Paediatrics University of Gothenburg Queen Silvia Children's Hospital Gothenburg Sweden
| | - Emma Goksör
- Department of Paediatrics University of Gothenburg Queen Silvia Children's Hospital Gothenburg Sweden
| |
Collapse
|
44
|
Milanese M, Miraglia Del Giudice E, Peroni DG. Asthma, exercise and metabolic dysregulation in paediatrics. Allergol Immunopathol (Madr) 2019; 47:289-294. [PMID: 30789156 DOI: 10.1016/j.aller.2018.03.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Accepted: 03/27/2018] [Indexed: 02/06/2023]
Abstract
Asthma is the most frequent chronic disease in childhood. Chest tightness, cough, wheezing and dyspnoea during or after exercise may be unique manifestations of asthma in up to 90% of subjects. Physical activity may be reduced by uncontrolled asthma symptoms and parental beliefs, impairing physical fitness of asthmatic children. Clinicians working in the field of allergy are aware of evidence supporting the benefits of physical activity for patients with asthma. Treatment of asthma is required in order to obtain its control and to avoid any limitation in sports and active play participation. As exercise performance in children with controlled asthma is not different from that of healthy controls, any exercise limitation cannot be accepted. Overweight and obesity may interfere with asthma and exercise, leading to dyspnoea symptoms. Evidences on the effect of insulin resistance on airway smooth muscle and on bronchial hyperactivity are presented. CONCLUSION: Exercise is part of the strategy to obtain the best control of asthma in childhood, but we have to optimise the asthma control therapy before starting exercise programming. Furthermore, it is crucial to give best attention on the effects of obesity and insulin resistance, because they could in turn influence patients' symptoms.
Collapse
Affiliation(s)
- Manlio Milanese
- Division of Respiratory Diseases, Azienda Sanitaria Locale 2 Savonese, Savona, Italy
| | - Emanuele Miraglia Del Giudice
- Department of Women, Child and General and Special Surgery, Università della Campania Luigi Vanvitelli, Naples, Italy
| | - Diego G Peroni
- Department of Clinical and Experimental Medicine, Section of Paediatric, University of Pisa, Pisa, Italy.
| |
Collapse
|
45
|
Longo C, Bartlett G, Schuster T, Ducharme FM, MacGibbon B, Barnett TA. Influence of weight status in the response to Step-2 maintenance therapies in children with asthma. BMJ Open Respir Res 2019; 6:e000401. [PMID: 31179003 PMCID: PMC6530505 DOI: 10.1136/bmjresp-2019-000401] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Revised: 02/26/2019] [Indexed: 11/24/2022] Open
Abstract
Introduction Overweight children with asthma may display impaired response to inhaled corticosteroids (ICS), possibly due to non-eosinophilic inflammation or weight-related lung compression; these mechanisms may differentially affect response to ICS and leukotriene receptor antagonists (LTRAs). We assessed whether weight status modified the response to low-dose ICS and LTRA Step-2 monotherapy. Methods A historical cohort study from clinical data linked to administrative databases was conducted among children aged 2–18 years with specialist-diagnosed asthma who were initiating or continuing a Step-2 monotherapy from 2000 to 2007 at the Montreal Children’s Hospital Asthma Centre. The outcome was time-to-management failure defined as any step-up in therapy, acute care visit, hospitalisation or oral corticosteroids for asthma, whichever occurred first. The independent and joint effects of weight status (body mass index [BMI] percentile) and time-varying treatment on time-to-management failure were estimated with marginal structural Cox models. The likelihood ratio test (LRT) and relative excess risk due to interaction (RERI) were computed to assess treatment effect modification by weight status on the multiplicative and additive scales. Results Of the 433 and 85 visits with a low-dose ICS and LTRA prescription, respectively, 388 management failures occurred over 14 529 visit-weeks of follow-up. Children using LTRA compared with low-dose ICS tended to have an overall higher risk of early management failure (HR 1.52; 95% CI 0.72 to 3.22). Irrespective of treatment, the hazard of management failure increased by 5% (HR 1.05; 95% CI 1.01 to 1.10) for every 10-unit increase in BMI percentile. An additional hazard reduction of 17% (HR 0.83; 95% CI 0.70 to 0.99) was observed for every 10-unit increase in BMI percentile among LTRA users, but not for ICS (HR 0.95; 95% CI 0.86 to 1.04). The LRT indicated a departure from exact multiplicativity (p<0.0001), and the RERIs for ICS and LTRA were −0.05 (95% CI −0.14 to 0.05) and −0.52 (95% CI −1.76 to 0.71). Conclusions Weight status was associated with earlier time-to-management failure in children prescribed Step-2 therapy. This hypothesis-generating study suggests that LTRA response increases in children with higher BMI percentiles, although further research is warranted to confirm findings.
Collapse
Affiliation(s)
- Cristina Longo
- Family Medicine, McGill University, Montreal, Québec, Canada.,Respiratory Medicine, Academic Medical Center, Amsterdam, The Netherlands
| | | | - Tibor Schuster
- Family Medicine, McGill University, Montreal, Québec, Canada
| | - Francine M Ducharme
- Pediatrics and Social and Preventive Medicine, Université de Montréal, Montreal, Québec, Canada.,Pediatrics, Centre de recherche du CHU Sainte-Justine, Montreal, Québec, Canada
| | | | - Tracie A Barnett
- Pediatrics, Centre de recherche du CHU Sainte-Justine, Montreal, Québec, Canada.,Epidemiology and Biostatistics, INRS-Institut Armand-Frappier, Laval, Québec, Canada
| |
Collapse
|
46
|
Palo SK, Swain S, Priyadarshini S, Behera B, Pati S. Epidemiology of obesity and its related morbidities among rural population attending a primary health centre of Odisha, India. J Family Med Prim Care 2019; 8:203-208. [PMID: 30911507 PMCID: PMC6396592 DOI: 10.4103/jfmpc.jfmpc_255_18] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Context: Overweight and obesity has become a major contributor to global burden of chronic diseases and disability. Obesity among rural India is emerging as a major health problem because of change in lifestyle and food habits, thereby increases the risk of multiple morbid conditions among rural population. Aims: This study aims to find out the association of overweight/obesity with different socio-demographic factors and explore the co-morbidities among overweight and obese in a rural setting. Settings and Design: A cross-sectional study was done in a randomly selected primary health centre of Khurda district, Odisha for 4 months. Materials and Methods: This study was done among 183 patients aged >20 years with BMI >25 kg/m2 after taking their consent. Anthropometric measurements were done and data were collected using a semi-structured questionnaire. Statistical Analysis Used: Descriptive statistics such as proportion, mean and standard deviation were calculated and inferential statistics such as Chi-square test, univariate and multivariate regression was done using the SPSS version 20.0. Results: Mean age of participants was 45.7 (±13.8) years. About 93.4% were Grade II obese while 51.9% were at risk according to their waist–hip ratio. Around 53.6% of participants had multi-morbidity. Age, occupation and number of children were significantly associated with obesity. Morbidity was significantly associated with age, occupation, marital status and number of children. Increased grade in obesity the more is the probability of having morbidity. Conclusions: There is an urgent need to screen for obesity at rural health facility and early management for prevention from co-morbidities.
Collapse
Affiliation(s)
| | - Swagatika Swain
- Technical Assistant Nursing, ICMR-RMRC, Bhubaneswar, Odisha, India
| | | | | | | |
Collapse
|
47
|
Neffen H, Chahuàn M, Hernández DD, Vallejo-Perez E, Bolivar F, Sánchez MH, Galleguillos F, Castaños C, S Silva R, Giugno E, Pavie J, Contreras R, Lamarao F, Moraes Dos Santos F, Rodriguez C, Tobler J, Viana K, Vieira C, Soares C. Key factors associated with uncontrolled asthma - the Asthma Control in Latin America Study. J Asthma 2019; 57:113-122. [PMID: 30915868 DOI: 10.1080/02770903.2018.1553050] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Objective: This study aimed to estimate asthma control at specialist treatment centers in four Latin American countries and assess factors influencing poor asthma control.Methods: Patients aged ≥12 years with an asthma diagnosis and asthma medication prescription, followed at outpatient specialist centers in Argentina, Chile, Colombia, and Mexico, were included. The study received all applicable ethical approvals. The Asthma Control Test (ACT) was used to classify patients as having controlled (ACT 20-25) or uncontrolled (ACT ≤19) asthma. Frequency and statistical tests were used to assess the association between hospital admissions/exacerbations/emergency department (ED) visits and uncontrolled asthma; multivariate logistic regression was used to assess the association of uncontrolled asthma with clinical/demographic variables.Results: A total of 594 patients were included. Overall controlled-asthma prevalence was 43.4% (95% confidence interval [CI]: 39.0, 47.4). Patients with uncontrolled asthma were more likely to be women (adjusted odds ratio [aOR]: 1.85; p = 0.003), non-white (aOR: 2.14; p < 0.001), obese (aOR: 1.71; p = 0.036), to have a low monthly family income (aOR: 1.75; p = 0.004), to have severe asthma (aOR:1.59; p = 0.26), and, compared with patients with controlled asthma, to have a higher likelihood of asthma exacerbations (34.5% vs. 15.9%; p < 0.001), hospital admissions (6.9% vs. 3.1%; p = 0.042), and ED visits (34.5% vs. 15.9%; p < 0.001) due to asthma.Conclusions: Even in specialist ambulatory services, fewer than half of patients were classified as having controlled asthma. The proportion of uncontrolled patients varied according to clinical and demographic variables.
Collapse
Affiliation(s)
- Hugo Neffen
- Centro de Alergia e Inmunología-Santa Fe, Santa Fe, Argentina
| | | | | | | | - Fabio Bolivar
- Instituto Neumologico del Oriente, Santander, Colombia
| | - Marco H Sánchez
- Unidad de Investigación en Salud de Chihuahua SC, San Felipe, Mexico
| | | | - Claudio Castaños
- Hospital Nacional de Pediatría Garrahan, Buenos Aires, Argentina
| | - Rafael S Silva
- Facultad Ciencias de la Salud Universidad Autónoma de Chile, Talca, Chile
| | - Eduardo Giugno
- Centro de Investigacion Clinica Belgrano, Buenos Aires, Argentina
| | - Juana Pavie
- Centro Investigaciones Médicas Integrales, Quillota, Chile
| | | | | | | | | | | | | | | | | |
Collapse
|
48
|
Pediatric asthma - moving ahead faster than ever. Curr Opin Allergy Clin Immunol 2019; 17:96-98. [PMID: 28225363 DOI: 10.1097/aci.0000000000000353] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
|
49
|
Han YY, Forno E, Celedón JC. Health risk behaviors, violence exposure, and current asthma among adolescents in the United States. Pediatr Pulmonol 2019; 54:237-244. [PMID: 30614209 PMCID: PMC7032019 DOI: 10.1002/ppul.24236] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Accepted: 11/27/2018] [Indexed: 12/17/2022]
Abstract
BACKGROUND Asthma may worsen during adolescence, due to both health risk behaviors and psychosocial stressors commonly encountered during this life stage. METHODS Cross-sectional study of 24 612 high school students who participated in the 2009 and 2011 National Youth Risk Behavior Survey. Multivariable logistic regression was used to examine the relation between self-reported health risk behaviors or psychosocial stressors and current asthma. Mediation analysis was performed to assess whether depressive symptoms or suicidal behavior contribute to the link between psychosocial stressors and asthma. RESULTS Current asthma was reported by 13.1% of the study participants. In a multivariable analysis, female sex, obesity, shorter sleep duration, frequent soda/pop consumption, and marijuana use were each significantly associated with 14-36% increased odds of asthma. Any violent behavior (adjusted odds ratio [OR] = 1.12, 95% confidence interval [CI] = 1.02-1.24), any victimization (OR = 1.43, 95%CI = 1.29-1.58), any suicidal behavior (OR = 1.41, 95%CI = 1.22-1.64) and having felt sad or hopeless in the past year (OR = 1.57, 95%CI = 1.40-1.75) were each associated with current asthma. In a mediation analyses, having felt sad/hopeless and suicidal behaviors accounted for 21% and 14%, respectively, of the victimization-asthma association. CONCLUSION Potentially modifiable risk factors, including obesity, short sleep duration, frequent soda/pop consumption, and psychosocial stressors are associated with asthma in US adolescents. Promoting healthier lifestyles, as well as screening for violence exposure and treating depressive symptoms, could help reduce asthma burden in this population.
Collapse
Affiliation(s)
- Yueh-Ying Han
- Division of Pediatric Pulmonary Medicine, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Erick Forno
- Division of Pediatric Pulmonary Medicine, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Juan C Celedón
- Division of Pediatric Pulmonary Medicine, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh, Pittsburgh, Pennsylvania
| |
Collapse
|
50
|
Jago R, Salway RE, Ness AR, Shield JPH, Ridd MJ, Henderson AJ. Associations between physical activity and asthma, eczema and obesity in children aged 12-16: an observational cohort study. BMJ Open 2019; 9:e024858. [PMID: 30662005 PMCID: PMC6340420 DOI: 10.1136/bmjopen-2018-024858] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Revised: 10/19/2018] [Accepted: 11/27/2018] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVES To compare the physical activity of adolescents with three common long-term conditions (asthma, eczema and obesity) with adolescents without these conditions. DESIGN Cross-sectional and longitudinal analyses of adolescents at ages 12, 14 and 16 in a large UK cohort study. SETTING The Avon Longitudinal Study of Parents and Children. PARTICIPANTS 6473 adolescents with complete accelerometer data at at least one time point. METHODS Mean minutes of moderate to vigorous intensity physical activity (MVPA) and sedentary time per day were derived from accelerometer-based measurements at ages 12, 14 and 16. Obesity was defined at each time point from height and weight measurements. Parents reported doctor-assessed asthma or eczema. Cross-sectional and longitudinal regression models examined any differences in MVPA or sedentary time for adolescents with asthma, eczema or obesity compared with those without. RESULTS In longitudinal models, boys engaged in an average of 69.7 (95% CI 67.6 to 71.7) min MVPA at age 12, declining by 3.1 (95% CI 2.6 to 3.6) min/year while girls' average MVPA was 47.5 (95% CI 46.1 to 48.9) min at age 12, declining by 1.8 (95% CI 1.5 to 2.1) min/year. There was no strong evidence of differences in physical activity patterns of those with and without asthma or eczema. Obese boys engaged in 11.1 (95% CI 8.7 to 13.6) fewer minutes of MVPA, and obese girls in 5.0 (95% CI 3.3 to 6.8) fewer minutes than their non-obese counterparts. Cross-sectional models showed comparable findings. CONCLUSIONS Mean minutes of MVPA per day did not differ between adolescents with asthma or eczema and those without, but obese adolescents engaged in fewer minutes of MVPA. Findings reinforce the need for strategies to help obese adolescents be more active but suggest no need to develop bespoke physical activity strategies for adolescents with mild asthma or eczema.
Collapse
Affiliation(s)
- Russell Jago
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol, UK
- National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care West (CLAHRC West) at University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Ruth E Salway
- Centre for Exercise, Nutrition and Health Sciences, School for Policy Studies, University of Bristol, Bristol, UK
| | - Andy R Ness
- NIHR Biomedical Research Centre at the University Hospitals Bristol NHS Foundation Trust and the University of Bristol, Bristol, UK
- Bristol Dental School, University of Bristol, Bristol, UK
| | - Julian P Hamilton Shield
- NIHR Biomedical Research Centre at the University Hospitals Bristol NHS Foundation Trust and the University of Bristol, Bristol, UK
| | - Matthew J Ridd
- Centre for Academic Primary Care, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - A John Henderson
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| |
Collapse
|