High body mass index and allergies in schoolchildren: the French six cities study

Low-Density Lipoprotein Cholesterol Is Associated with Atopic Dermatitis in Korean Adolescents

INTRODUCTION

Atopic dermatitis (AD) is one of the most common chronic inflammatory skin diseases. Several studies have investigated the relationship between obesity and AD prevalence, but the results have been conflicting. This study investigated the association between obesity and AD in Korean adolescents.

METHODS

We used nationally representative data regarding 1,617 Korean adolescents aged 12-18 years, which were obtained from the cross-sectional Korea National Health and Nutrition Examination Survey 2017-2019. Multiple logistic regression analysis (including age, sex, region of residence, number of household members, economic status, lipid profile, and stress level) was used to evaluate the relationships of obesity and abdominal obesity with doctor-diagnosed AD.

RESULTS

Although the results were not statistically significant, obese adolescents were diagnosed with AD (20.8%) more often than non-obese adolescents (20.8% vs. 14.5%, p = 0.055). This tendency was more prominent in male adolescents than in female adolescents, but the finding was not statistically significant. Body mass index and the prevalence of abdominal obesity did not differ between the AD and non-AD groups. Adolescents with AD had significantly higher total cholesterol and low-density lipoprotein cholesterol (LDL-C) levels, compared with adolescents who did not have AD. In the adjusted model, an LDL-C level ≥130 mg/dL was a risk factor for AD (adjusted odds ratio, 1.03; 95% confidence interval, 1.01-1.05).

CONCLUSIONS

A high LDL-C level may be a risk factor for AD. Proper management of dyslipidemia through lifestyle modification may aid in AD prevention and control. Further large-scale prospective studies are needed to assess the associations of AD with obesity and dyslipidemia.

Link between obesity and atopic dermatitis: Does obesity predispose to atopic dermatitis, or vice versa?

Two serious health conditions, obesity and atopic dermatitis (AD), share some pathological features such as insulin resistance, leptin resistance and inflammation, and a growing body of evidence suggests a link between obesity and AD. Obesity predisposes an individual to and/or worsens AD, whereas AD increases the risk of obesity. Obesity and AD's interactions are mediated by cytokines, chemokines and immune cells. Obese individuals with AD are more resistant to anti-inflammatory therapy, while weight loss can alleviate AD. In this review, we summarize the evidence linking AD and obesity. We also discuss the pathogenic role of obesity in AD, and vice versa. Because of the connection between these two conditions, mitigation of one could possibly prevent the development of or alleviate the other condition. Effective management of AD and weight loss can enhance the wellness of individuals with both of these conditions. However, proper clinical studies are warranted to validate this speculation.

Correlation Between Allergic Rhinitis and Body Mass Index: An Observational Study

Allergic rhinitis is one of the most rampant diseases in the world and many studies have been conducted to find its risk factors. Various studies have shown that there is a correlation between allergic rhinitis and increased Body Mass Index (BMI). Obesity has several effects on the immune system that could play a major role in increasing allergic disease. Allergic rhinitis is known to produce mild eosinophilia. The purpose of this study is to assess the correlation between BMI and allergic rhinitis using the Absolute Eosinophil Count (AEC). Over a period of 6 months, 55 cases of allergic rhinitis were selected. The patients were investigated by Absolute Eosinophil Count and their Body Mass Index values were calculated based on weight and height measurement. There was a positive correlation between Absolute Eosinophil Count and BMI with a p value of < 0.0001 which in turn revealed a positive correlation between BMI and allergy. We conclude that patients with high BMI are more prone to allergic rhinitis and have higher Absolute Eosinophil Counts probably due to the immunological effects of adipose tissue on the progress of the allergic disease.

Foetal exposure to heavy metals and risk of atopic diseases in early childhood

BACKGROUND

Accumulating evidence suggests that in utero exposures can influence the development of the immune system and thus contribute to disease development. Studies investigating the association between prenatal exposures to heavy metals and atopic diseases, however, are scarce.

METHODS

Children from the EDEN birth cohort were prospectively followed up using parental questionnaires with validated questions on asthma, allergic rhinitis, eczema, and food allergy symptoms. The questionnaires were administered every 4 months during the children's first year, and then every year until the age of 5, with a final survey at the age of 8. Serum concentrations of lead (Pb), cadmium (Cd), and manganese (Mn) were assessed in maternal blood samples collected during mid-pregnancy and in cord blood of 651 mother-children pairs. Hazard ratios (HR) for the incidence of each atopic disease in relation to the exposure to metals were calculated using Cox proportional hazard models.

RESULTS

Levels of Cd in cord blood were associated with greater risk of asthma (hazard ratio [95% confidence interval] for upper vs lower quartile: 1.81 [1.00-3.29]), eczema (1.60 [1.09-2.35]), and food allergy (3.17 [1.36-7.38]), while Mn levels in maternal serum were associated with eczema (1.55 [1.05-2.28]). These associations were similar in males and females and were confirmed using log concentrations of metals as exposures.

CONCLUSIONS

Our results support the hypothesis that fetal exposure to heavy metals may affect the development of asthma, eczema, and food allergy in childhood and suggest that timing of exposure in utero may have a role in these associations.

Retinoic Acid Correlates with Reduced Serum IL-10 And TGF-β in Allergic Rhinitis

Background

Retinoic acid (RA) plays a key role in naïve T cell differentiation into FOXP3+ Treg cell in the respiratory airways. The present study aims to investigate RA and Treg-related cytokine serum levels, salivary IgA levels, FOXP3 and IL-4 gene expression, and the relationships between RA serum levels and Treg-related cytokines in allergic rhinitis (AR) patients and healthy controls.

Methods

Salivary IgA and serum IgE, RA, IL-10, and TGF-β concentrations were measured by ELISA in 37 AR patients and 30 age- and sex-matched healthy controls.

Results

IL-10 and TGF-β concentrations were significantly less in AR patients than in healthy controls (p< 0.01 and P< 0.0001, respectively). Salivary IgA was significantly greater in patients than in controls (p< 0.05). RA was not significantly different between patients and controls (p> 0.05); however, a significant positive correlation was found between serum RA and both IL-10 and TGF-β in AR patients.

Conclusion

Our data suggest that RA may influence AR risk via affecting the TGF-β and IL-10 production.

Energy Balance-Related Behaviors and Body Mass Index in Asian School-Aged Children With Congenital Heart Disease

BACKGROUND

Overweight/obesity is a substantial global public health concern, which can be caused by genetic factors and energy balance-related behaviors (EBRBs). If it occurs in children with congenital heart disease (CCHD), it can yield an extra burden on their health. Most studies on CCHD have taken place in Western societies, leaving Asian populations understudied, especially children.

OBJECTIVE

We sought (1) to determine body mass index distribution among school-aged CCHD in Taiwan, (2) to ascertain whether the body mass index of CCHD differs from that of the general population, (3) to describe EBRBs in CCHD, and (4) to identify factors associated with underweight and overweight/obesity among CCHD.

METHODS

In this cross-sectional study, 97 child-parent dyads (53.6% boys; mean age, 9.73 years; 25.8% moderate-to-severe heart conditions) were enrolled. Self-administered questionnaires were used to collect demographics, medical factors, food frequency, physical activity, and sedentary behaviors. Anthropometric measurements were taken in the hospital. Independent predictors of EBRBs and health conditions were calculated through logistic regression analysis.

RESULTS

Among Taiwanese CCHD, 19.6% were underweight and 14.4% were overweight/obese. Children with moderate-to-severe heart defects were more often underweight. Body mass index did not differ between CCHD and children in the general population. More complex heart defects and asthma were associated with being underweight, whereas sedentary behaviors, cardiomegaly, and the New York Heart Association classification II to IV were associated with being overweight/obese.

CONCLUSIONS

Sedentary lifestyle is seemingly the only EBRB correlated with being overweight. Physical activity programs for children may help prevent and treat overweight or obesity in Asian CCHD, similar to Western countries.

Obesity and adiposity indicators in asthma and allergic rhinitis in children

PURPOSE OF REVIEW

The prevalence of obesity and allergic diseases, such as asthma and allergic rhinitis, is increasing worldwide not only in adults, but also in children. Experimental and clinical studies have demonstrated the effect of obesity not only on asthma, but also on other allergic diseases.

RECENT FINDINGS

Allergic diseases, such as asthma and allergic rhinitis, are common chronic inflammatory diseases of the airways. Obesity is an increasingly common pediatric disease and is a risk factor for the development of asthma in that obese patients with asthma tend to have more severe asthma that does not respond well to standard asthma therapy. On the contrary, children with asthma maybe at a high risk of obesity, suggesting that the relationship of asthma and obesity seems to be interrelated. The role of obesity on the development of allergic rhinitis is not well defined, whereas allergic rhinitis may have an impact on obesity.

SUMMARY

Childhood obesity is often considered to be less serious than obesity in adults because of the greater risk of complications in obese adults. In this review, we discuss the allergic confounders of obesity and the impact of allergic diseases on obesity. Proper control of the BMI within the normal range in children with allergic diseases is important.

Role of Obesity in Otorhinolaryngologic Diseases

PURPOSE OF REVIEW

Obesity is a major public health problem associated with various diseases. Improving obesity control and achieving greater patient satisfaction are critical unmet needs. Various otorhinolaryngologic diseases can have negative effects on quality of life or actual health status depending on their type. Over the past decade, the relationship between obesity and otorhinolaryngologic conditions has been investigated. The purpose of this review was to discuss the relationship between obesity and otorhinolaryngological diseases.

RECENT FINDINGS

This is a narrative review on the current state of incidence, effects, and associated mechanisms between obesity and otorhinolaryngologic diseases. In various otologic diseases, otitis media (OM) and hearing loss (HL) are associated with obesity. In rhinologic parts, chronic rhinosinusitis (CRS) and obstructive sleep apnea (OSA) were significantly associated with obesity. Most of these diseases are reported to have higher susceptibility and severity as body mass index (BMI) increases. However, the incidence of head and neck cancer (HNC) was inversely associated with obesity, especially central adiposity. The relevance of obesity in laryngopharyngeal reflux disease (LPR) and allergic rhinitis (AR) has yet to be clarified, and this remains controversial. This review provides a comprehensive overview of the current state of incidence, effects, and associated mechanisms between obesity and otorhinolaryngologic diseases. Various otorhinolaryngological diseases are related to obesity. As obesity can be a negative risk factor in these otorhinolaryngologic diseases, early diagnosis and treatment of these diseases in obese patients will be critical.

The Association Between ENT Diseases and Obesity in Pediatric Population: A Systemic Review of Current Knowledge

Obesity in pediatric population is an important global problem. The prevalence of obesity in children is dramatically rising. According to World Health Organization, about 41 million children under the age of 5 years are obese or overweight worldwide. Overweight and obesity are well-known risk factors for a number of health disorders. Diseases commonly observed in this group of patients are metabolic disorders, type 2 diabetes mellitus, cardiovascular diseases, fatty liver disease, musculoskeletal problems, and many others. The main aim of this study was to present the current knowledge of the association between childhood obesity and common otorhinolaryngological disorders. It is suggested that obese children are more prone to suffer from otorhinolaryngological illnesses than the lean ones. Obesity may predispose to otorhinolaryngological diseases in various ways. It strongly interferes with the immune system (increases serum levels of interleukin 6, tumor necrosis factor, C-reactive protein, and leptin and reduces adiponectin concentration) affecting organs of the upper respiratory tract. Additionally, obesity induces mechanical disorders in the upper airways. According to our review, obesity predisposes to otitis media with effusion, acute otitis media, recurrent otitis media, obstructive sleep apnea, sensorineural hearing loss, adenotonsillar hypertrophy, and post-/perioperative complications after adenotonsillectomy. Obesity in children significantly correlates with both obstructive sleep apnea (OSA) and asthma and constitutes a significant component of "OSA, obesity, asthma" triad.

Allergic rhinitis, rather than asthma, is a risk factor for dental caries

OBJECTIVES

The association between AS (asthma) and dental caries is controversial, while that between allergic rhinitis (AR) and caries has not been established. This study aimed to verify the relationship among AR, AS and dental caries.

DESIGN

Retrospective cohort study.

SETTING

Data from Health Insurance Database of the Taiwan's National Health Insurance Research Database.

PARTICIPANTS

Nine thousand and thirty-eight children born in 2004 were obtained. Their claims data were evaluated from birth to the age of 9 years.

MAIN OUTCOME MEASURES

The frequencies of clinical visits for dental caries were calculated for primary teeth (age 1-5) and for dental transitional period (age 6-9). Differences in the frequencies of clinical visits for caries in AR vs non-AR and AS vs non-AS children were compared. Correlation between AR, AS and caries frequencies was studied, and the influences of AR drugs on the development of caries were evaluated.

RESULTS

After adjusting for confounding factors and AS case, the frequencies of clinical visits for caries were higher in AR (increased by 13%-25% and P<.001 at different age periods). The AR frequencies significantly correlated with caries frequencies in children with AR. Different AR drugs also correlated with caries formation. After adjusting for confounding factors and AR case, there was no relationship between AS and caries in children.

CONCLUSION

Asthma is not associated with dental caries, but AR can increase the frequency of clinical visits for caries. Medications for AR may also play a role in caries formation. Thus, AR may be a risk factor for childhood dental caries.

Growth trajectories and asthma/rhinitis in children: a longitudinal study in Taiwan

Studies have reported the effect of body weight in early childhood on asthma. However, the effect of growth patterns during school age on asthma and rhinitis has yet to be explored. We sought to investigate whether various growth patterns predict incident asthma and rhinitis.We conducted a nationwide longitudinal study (Taiwan Children Health Study) in 14 Taiwanese communities. Body mass index (BMI) z-scores of 4422 children aged 6-11 years were collected annually and distinct growth trajectory classes were identified using a latent generalised mixture model. Pulmonary function and exhaled nitric oxide fraction (F_eNO) levels were also measured. Whether different growth trajectory classes predict incident asthma and rhinitis at age 12, 15 and 18 years was determined using a discrete time hazard model.Four growth trajectory classes were identified. Persistently overweight children exhibited significantly increased risks of asthma and rhinitis at age 12 years. Furthermore, being persistently overweight had a long-term effect on incident asthma (hazard ratio 2.47, 95% CI 1.18-5.12) and rhinitis (hazard ratio 1.44, 95% CI 1.12-1.84) in adolescence and early adulthood. Children in high BMI classes exhibited significantly lower pulmonary functions compared with normal growth children. F_eNO levels were lower in children in the high BMI classes and higher in children showing declining obesity compared with normal growth children.Persistently overweight children exhibited incident asthma and rhinitis in adolescence and early adulthood.

Association of Atopic Dermatitis with Cardiovascular Risk Factors and Diseases

Epidemiological studies suggested an association between atopic dermatitis (AD) and cardiovascular disease. Therefore, we investigate associations and potential underlying pathways of AD and cardiovascular disease in large cohort studies: the AOK PLUS cohort (n = 1.2 Mio), the GINIplus/LISAplus birth cohorts (n = 2,286), and the Cooperative Health Research in the Region of Augsburg (KORA) F4 cohort (n = 2,990). In addition, metabolomics in KORA F4 and established cardiovascular risk loci in genome-wide data on 10,788 AD cases and 30,047 controls were analyzed. Longitudinal analysis of patients with AD in AOK PLUS showed slightly increased risk for incident angina pectoris (adjusted risk ratio 1.17 [95% confidence interval 1.12-1.23]), hypertension (1.04 [1.02-1.06]), and peripheral arterial disease (1.15 [1.11-1.19]) but not for myocardial infarction (1.05 [0.99-1.12]) and stroke (1.02 [0.98-1.07]). In KORA F4 and GINIplus/LISAplus, AD was not associated with cardiovascular risk factors and no differences in metabolite levels were detected. There was no robust evidence for shared genetic risk variants of AD and cardiovascular disease. This study indicates only a marginally increased risk for angina pectoris, hypertension, and peripheral arterial disease and no increased risk for myocardial infarction or stroke in patients with AD. Relevant associations of AD with cardiovascular risk factors reported in US populations could not be confirmed. Likewise, patients with AD did not have increased genetic risk factors for cardiovascular disease.