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Qu J, Liang Y, Rao Y, Pei Y, Li D, Zhang Y, Chen Y, Sun Y. Causal relationship between frailty and chronic obstructive pulmonary disease or asthma: A two sample bidirectional Mendelian randomization study. Arch Gerontol Geriatr 2024; 118:105310. [PMID: 38128266 DOI: 10.1016/j.archger.2023.105310] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Revised: 12/06/2023] [Accepted: 12/09/2023] [Indexed: 12/23/2023]
Abstract
BACKGROUND Observational studies have established a strong association between frailty and obstructive lung diseases. However, the causal nature of this association remains unclear. To address this gap, we conducted a bidirectional Mendelian randomization (MR) study to investigate the causal relationship between frailty, as measured by the frailty index (FI), and chronic obstructive pulmonary disease (COPD) or asthma. METHODS The latest meta-analysis of genome-wide association studies for FI, which included individuals of European ancestry from UK Biobank and TwinGene (N = 175,226), yielded the genetic instruments for frailty and outcome summary statistics. The genetic instrument for COPD and asthma, as well as the outcome summary data, were derived from the GWAS conducted on individuals of European ancestry from the FinnGen, with a sample size of 16,410 cases and 283,589 controls for COPD, and 37,253 cases and 187,112 controls for asthma. The analysis of MR was conducted employing the inverse-variance weighted (IVW) method, complemented by the weighted median method, MR-Egger regression, and MR pleiotropy residual sum and outlier (MR-PRESSO) test. RESULTS Our results showed that genetically predicted higher FI was significantly associated with increased risk of COPD (odds ratio [OR] 1.75, 95 % confidence interval [CI] 1.29-2.36) and asthma (OR 2.10, 95 % CI 1.44-3.16). In the reverse direction analysis, genetic liability to both COPD (beta 0.06, 95 % CI 0.01-0.10) and asthma (beta 0.08, 95 % CI 0.06-0.11) showed significant associations with a higher FI. CONCLUSIONS Our research has reinforced the existing evidence supporting a reciprocal causal relationship between frailty and obstructive lung diseases. A deeper comprehension of this interconnection is imperative for the prevention and treatment of obstructive lung diseases.
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Affiliation(s)
- Jingge Qu
- Department of Respiratory and Critical Care Medicine, Research Center for Chronic Airway Diseases, Peking University Third Hospital, Peking University Health Science Center, 49 North Garden Road, Haidian District, Beijing, PR China
| | - Ying Liang
- Department of Respiratory and Critical Care Medicine, Research Center for Chronic Airway Diseases, Peking University Third Hospital, Peking University Health Science Center, 49 North Garden Road, Haidian District, Beijing, PR China
| | - Yafei Rao
- Department of Respiratory and Critical Care Medicine, Research Center for Chronic Airway Diseases, Peking University Third Hospital, Peking University Health Science Center, 49 North Garden Road, Haidian District, Beijing, PR China
| | - Yuqiang Pei
- Department of Respiratory and Critical Care Medicine, Research Center for Chronic Airway Diseases, Peking University Third Hospital, Peking University Health Science Center, 49 North Garden Road, Haidian District, Beijing, PR China
| | - Danyang Li
- Department of Respiratory and Critical Care Medicine, Research Center for Chronic Airway Diseases, Peking University Third Hospital, Peking University Health Science Center, 49 North Garden Road, Haidian District, Beijing, PR China
| | - Yue Zhang
- Department of Respiratory and Critical Care Medicine, Research Center for Chronic Airway Diseases, Peking University Third Hospital, Peking University Health Science Center, 49 North Garden Road, Haidian District, Beijing, PR China
| | - Yahong Chen
- Department of Respiratory and Critical Care Medicine, Research Center for Chronic Airway Diseases, Peking University Third Hospital, Peking University Health Science Center, 49 North Garden Road, Haidian District, Beijing, PR China
| | - Yongchang Sun
- Department of Respiratory and Critical Care Medicine, Research Center for Chronic Airway Diseases, Peking University Third Hospital, Peking University Health Science Center, 49 North Garden Road, Haidian District, Beijing, PR China.
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Kozioł-Kozakowska A, Januś D, Stępniewska A, Szczudlik E, Stochel-Gaudyn A, Wójcik M. Beyond the Metabolic Syndrome: Non-Obvious Complications of Obesity in Children. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1905. [PMID: 38136107 PMCID: PMC10742254 DOI: 10.3390/children10121905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 11/24/2023] [Accepted: 12/06/2023] [Indexed: 12/24/2023]
Abstract
Obesity is currently one of the most significant public health challenges worldwide due to the continuous increase in obesity rates among children, especially younger children. Complications related to obesity, including serious ones, are increasingly being diagnosed in younger children. A search was performed from January 2023 to September 2023 using the PubMed, Cochrane Library, Science Direct, MEDLINE, and EBSCO databases. The focus was on English-language meta-analyses, systematic reviews, randomized clinical trials, and observational studies worldwide. Four main topics were defined as follows: disorders of glucose metabolism; liver disease associated with childhood obesity; the relationship between respiratory disorders and obesity in children; and the effects of obesity on the hypothalamic-pituitary-gonadal axis and puberty. Understanding potential complications and their underlying mechanisms can expedite the diagnostic process and enhance the effectiveness of treatment. We aspire that this study will bring insight into the often-overlooked complications associated with obesity.
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Affiliation(s)
- Agnieszka Kozioł-Kozakowska
- Department of Pediatrics, Gastroenterology and Nutrition, Institute of Pediatrics, Jagiellonian University Medical College, 31-008 Cracow, Poland; (A.K.-K.); (A.S.-G.)
- Interclinical Center for the Treatment of Childhood Obesity, University Children’s Hospital of Krakow, 30-663 Kraków, Poland; (A.S.); (E.S.)
| | - Dominika Januś
- Department of Pediatric and Adolescent Endocrinology, Pediatric Institute, Jagiellonian University Medical College, 31-008 Kraków, Poland;
| | - Anna Stępniewska
- Interclinical Center for the Treatment of Childhood Obesity, University Children’s Hospital of Krakow, 30-663 Kraków, Poland; (A.S.); (E.S.)
- Department of Pediatric and Adolescent Endocrinology, Pediatric Institute, Jagiellonian University Medical College, 31-008 Kraków, Poland;
| | - Ewa Szczudlik
- Interclinical Center for the Treatment of Childhood Obesity, University Children’s Hospital of Krakow, 30-663 Kraków, Poland; (A.S.); (E.S.)
- Department of Pediatric and Adolescent Endocrinology, Pediatric Institute, Jagiellonian University Medical College, 31-008 Kraków, Poland;
| | - Anna Stochel-Gaudyn
- Department of Pediatrics, Gastroenterology and Nutrition, Institute of Pediatrics, Jagiellonian University Medical College, 31-008 Cracow, Poland; (A.K.-K.); (A.S.-G.)
| | - Małgorzata Wójcik
- Interclinical Center for the Treatment of Childhood Obesity, University Children’s Hospital of Krakow, 30-663 Kraków, Poland; (A.S.); (E.S.)
- Department of Pediatric and Adolescent Endocrinology, Pediatric Institute, Jagiellonian University Medical College, 31-008 Kraków, Poland;
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Tuvel AL, Winiger EA, Ross JM. A Review of the Effects of Adolescent Cannabis Use on Physical Health. Psychiatr Clin North Am 2023; 46:719-739. [PMID: 37879834 DOI: 10.1016/j.psc.2023.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2023]
Abstract
The current review highlights the available research related to cannabis and indicators of physical health in a variety of domains. Various studies have found associations between cannabis use with pulmonary, cardiovascular, gastrointestinal, and endocrine function as well as body mass index and sleep. At this time, more research is needed to understand the influence of cannabis use on physical health, particularly among adolescent samples.
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Affiliation(s)
- Abigail L Tuvel
- Department of Psychology and Neuroscience, University of Colorado Boulder, 1777 Exposition Drive, Boulder, CO 80301
| | - Evan A Winiger
- Department of Psychiatry, School of Medicine, University of Colorado Anschutz Medical Campus, 1890 N Revere Court, Aurora, CO, 80045
| | - J Megan Ross
- Department of Psychiatry, Division of Addiction Sciences, Treatment and Prevention, University of Colorado Anschutz Medical Campus, 1890 N Revere Court, Aurora, CO, 80045.
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Lin D, Chen D, Huang J, Li Y, Wen X, Ou P, Shi H. Breastfeeding is associated with reduced risks of central obesity and hypertension in young school-aged children: a large, population-based study. Int Breastfeed J 2023; 18:52. [PMID: 37697319 PMCID: PMC10496387 DOI: 10.1186/s13006-023-00581-1] [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: 11/25/2021] [Accepted: 08/04/2023] [Indexed: 09/13/2023] Open
Abstract
BACKGROUND Previous studies examined the effects of breastfeeding on measured values of body circumferences or blood pressure during childhood. However, limited data are available for the association between child feeding and a specific disease diagnosed as central obesity or hypertension. Hence, we aimed to examine whether the type and duration of breastfeeding are associated with obesity/central obesity or hypertension in young school-aged children. METHODS We matched the data obtained from a cross-sectional survey in 2019 with retrospective breastfeeding information recorded in the database. Heights, weights, waist circumferences, and blood pressures of 8480 children in first grade of primary schools in Shanghai, China were measured to diagnose obesity, central obesity, and hypertension. Data on child feeding was collected retrospectively from clinical records. Associations between the type/duration of breastfeeding and children's measured values of body mass index, waist circumference, and blood pressure were analysed by linear regression. Associations between the type/duration of breastfeeding and risks of obesity, central obesity, and hypertension were analysed by generalised linear models. RESULTS Breastfeeding duration was inversely associated with blood pressure values in children in the first grade. Each month's increase in the duration of any breastfeeding was associated with a 0.07 mmHg decrease in systolic blood pressure (P < 0.01) and a 0.05 mmHg decrease in diastolic blood pressure (P < 0.01). Any breastfeeding > one month was associated with a reduced risk of hypertension (adjusted risk ratio 0.84; 95% CI 0.73, 0.96, P = 0.01). Exclusive breastfeeding > one month was associated with a reduced risk of central obesity (adjusted risk ratio 0.76; 95% CI: 0.60, 0.96, P = 0.02). Any breastfeeding > 12 months was linked with a lower risk of hypertension (adjusted risk ratio 0.83; 95% CI 0.70, 0.98, P = 0.03). CONCLUSIONS Lack of breastfeeding is associated with higher risks of central obesity and hypertension during middle childhood. As a potential component of the public health strategy to reduce population levels of metabolic and cardiovascular diseases, breastfeeding could be a vital prevention strategy.
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Affiliation(s)
- Dan Lin
- Fujian Maternity and Child Health Hospital, Fuzhou, China
- Department of Maternal, Child and Adolescent Health, School of Public Health, Fudan University, Shanghai, China
| | - Didi Chen
- Minhang Center of Disease Control and Prevention, Shanghai, China
- Minhang Branch, School of Public Health, Fudan University, Shanghai, China
| | - Jun Huang
- Minhang Maternal and Child Health Centre, Shanghai, China
| | - Yun Li
- Minhang Maternal and Child Health Centre, Shanghai, China
| | - Xiaosa Wen
- Minhang Center of Disease Control and Prevention, Shanghai, China
- Minhang Branch, School of Public Health, Fudan University, Shanghai, China
| | - Ping Ou
- Fujian Maternity and Child Health Hospital, Fuzhou, China
| | - Huijing Shi
- Department of Maternal, Child and Adolescent Health, School of Public Health, Fudan University, Shanghai, China.
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Brero M, Meyer CL, Jackson-Morris A, Spencer G, Ludwig-Borycz E, Wu D, Espinosa De Candido AF, Ferre Eguiluz MI, Bonvecchio Arenas A, Jewell J, Nugent R. Investment case for the prevention and reduction of childhood and adolescent overweight and obesity in Mexico. Obes Rev 2023; 24:e13595. [PMID: 37464960 DOI: 10.1111/obr.13595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 04/11/2023] [Accepted: 05/21/2023] [Indexed: 07/20/2023]
Abstract
Despite efforts to curb the rise in Mexico's child and adolescent overweight and obesity rates, prevalence in Mexico has grown by 120% since 1990 to 43.3% in 2022. This investment case identifies policies that will produce the largest returns for Mexico. The investment case model builds beyond a cost-of-illness analysis by predicting the health and societal economic impact of implementing child and adolescent overweight and obesity interventions in a cohort aged 0-19 from 2025 to 2090. The Markov model's impacts include healthcare expenditures, years of life lost, and reduced wages and productivity. We projected and compared costs in a status quo scenario to an intervention scenario to estimate cost savings and calculate return-on-investment (ROI). Total lifetime health and economic costs amount to USD 1.8 trillion-USD 30 billion on average per year. Implementing five interventions can reduce lifetime costs by approximately 7%. Each intervention has a low cost per disability-adjusted life year averted over 30-year, 50-year, and lifetime horizons. The findings demonstrate that a package of interventions mitigating child and adolescent overweight and obesity offers a strong ROI. The novel investment case methods should be applied to other countries, particularly low- and middle-income countries.
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Affiliation(s)
| | - Christina L Meyer
- Center for Global Noncommunicable Diseases, RTI International, Research Triangle Park, North Carolina, USA
| | - Angela Jackson-Morris
- Center for Global Noncommunicable Diseases, RTI International, Research Triangle Park, North Carolina, USA
| | - Garrison Spencer
- Center for Global Noncommunicable Diseases, RTI International, Research Triangle Park, North Carolina, USA
| | | | - Daphne Wu
- Center for Global Noncommunicable Diseases, RTI International, Research Triangle Park, North Carolina, USA
| | | | | | - Anabelle Bonvecchio Arenas
- Directora de Investigación en Políticas y Programas de Nutrición, Centro de Investigación en Nutrición y Salud, Instituto Nacional de Salud Pública, Cuernavaca, Mexico
| | | | - Rachel Nugent
- Center for Global Noncommunicable Diseases, RTI International, Research Triangle Park, North Carolina, USA
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Konjevod M, Sreter KB, Popovic-Grle S, Lampalo M, Tudor L, Jukic I, Nedic Erjavec G, Bingulac-Popovic J, Safic Stanic H, Nikolac Perkovic M, Markeljevic J, Samarzija M, Pivac N, Svob Strac D. Platelet Serotonin (5-HT) Concentration, Platelet Monoamine Oxidase B (MAO-B) Activity and HTR2A, HTR2C, and MAOB Gene Polymorphisms in Asthma. Biomolecules 2023; 13:biom13050800. [PMID: 37238670 DOI: 10.3390/biom13050800] [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: 04/06/2023] [Revised: 05/05/2023] [Accepted: 05/06/2023] [Indexed: 05/28/2023] Open
Abstract
The complex role of the serotonin system in respiratory function and inflammatory diseases such as asthma is unclear. Our study investigated platelet serotonin (5-HT) levels and platelet monoamine oxidase B (MAO-B) activity, as well as associations with HTR2A (rs6314; rs6313), HTR2C (rs3813929; rs518147), and MAOB (rs1799836; rs6651806) gene polymorphisms in 120 healthy individuals and 120 asthma patients of different severity and phenotypes. Platelet 5-HT concentration was significantly lower, while platelet MAO-B activity was considerably higher in asthma patients; however, they did not differ between patients with different asthma severity or phenotypes. Only the healthy subjects, but not the asthma patients, carrying the MAOB rs1799836 TT genotype had significantly lower platelet MAO-B activity than the C allele carriers. No significant differences in the frequency of the genotypes, alleles, or haplotypes for any of the investigated HTR2A, HTR2C and MAOB gene polymorphisms have been observed between asthma patients and healthy subjects or between patients with various asthma phenotypes. However, the carriers of the HTR2C rs518147 CC genotype or C allele were significantly less frequent in severe asthma patients than in the G allele carriers. Further studies are necessary to elucidate the involvement of the serotonergic system in asthma pathophysiology.
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Affiliation(s)
- Marcela Konjevod
- Rudjer Boskovic Institute, Division of Molecular Medicine, Bijenicka Cesta 54, 10000 Zagreb, Croatia
| | - Katherina B Sreter
- Department of Clinical Immunology, Pulmonology and Rheumatology, University Hospital Centre "Sestre Milosrdnice", 10000 Zagreb, Croatia
| | - Sanja Popovic-Grle
- Clinic for Lung Diseases Jordanovac, University Hospital Centre Zagreb, 10000 Zagreb, Croatia
- School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Marina Lampalo
- Clinic for Lung Diseases Jordanovac, University Hospital Centre Zagreb, 10000 Zagreb, Croatia
| | - Lucija Tudor
- Rudjer Boskovic Institute, Division of Molecular Medicine, Bijenicka Cesta 54, 10000 Zagreb, Croatia
| | - Irena Jukic
- Croatian Institute of Transfusion Medicine, 10000 Zagreb, Croatia
- Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia
| | - Gordana Nedic Erjavec
- Rudjer Boskovic Institute, Division of Molecular Medicine, Bijenicka Cesta 54, 10000 Zagreb, Croatia
| | | | | | - Matea Nikolac Perkovic
- Rudjer Boskovic Institute, Division of Molecular Medicine, Bijenicka Cesta 54, 10000 Zagreb, Croatia
| | - Jasenka Markeljevic
- Department of Clinical Immunology, Pulmonology and Rheumatology, University Hospital Centre "Sestre Milosrdnice", 10000 Zagreb, Croatia
- School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Miroslav Samarzija
- Clinic for Lung Diseases Jordanovac, University Hospital Centre Zagreb, 10000 Zagreb, Croatia
- School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Nela Pivac
- Rudjer Boskovic Institute, Division of Molecular Medicine, Bijenicka Cesta 54, 10000 Zagreb, Croatia
- University of Applied Sciences "Hrvatsko Zagorje Krapina", 49000 Krapina, Croatia
| | - Dubravka Svob Strac
- Rudjer Boskovic Institute, Division of Molecular Medicine, Bijenicka Cesta 54, 10000 Zagreb, Croatia
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Paw M, Wnuk D, Madeja Z, Michalik M. PPARδ Agonist GW501516 Suppresses the TGF-β-Induced Profibrotic Response of Human Bronchial Fibroblasts from Asthmatic Patients. Int J Mol Sci 2023; 24:ijms24097721. [PMID: 37175437 PMCID: PMC10178673 DOI: 10.3390/ijms24097721] [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: 02/27/2023] [Revised: 03/30/2023] [Accepted: 04/21/2023] [Indexed: 05/15/2023] Open
Abstract
The airway wall remodeling observed in asthma is associated with subepithelial fibrosis and enhanced activation of human bronchial fibroblasts (HBFs) in the fibroblast to myofibroblast transition (FMT), induced mainly by transforming growth factor-β (TGF-β). The relationships between asthma severity, obesity, and hyperlipidemia suggest the involvement of peroxisome proliferator-activated receptors (PPARs) in the remodeling of asthmatic bronchi. In this study, we investigated the effect of PPARδ ligands (GW501516 as an agonist, and GSK0660 as an antagonist) on the FMT potential of HBFs derived from asthmatic patients cultured in vitro. This report shows, for the first time, the inhibitory effect of a PPARδ agonist on the number of myofibroblasts and the expression of myofibroblast-related markers-α-smooth muscle actin, collagen 1, tenascin C, and connexin 43-in asthma-related TGF-β-treated HBF populations. We suggest that actin cytoskeleton reorganization and Smad2 transcriptional activity altered by GW501516 lead to the attenuation of the FMT in HBF populations derived from asthmatics. In conclusion, our data demonstrate that a PPARδ agonist stimulates antifibrotic effects in an in vitro model of bronchial subepithelial fibrosis. This suggests its potential role in the development of a possible novel therapeutic approach for the treatment of subepithelial fibrosis during asthma.
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Affiliation(s)
- Milena Paw
- Department of Cell Biology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Gronostajowa 7, 30-387 Kraków, Poland
| | - Dawid Wnuk
- Department of Cell Biology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Gronostajowa 7, 30-387 Kraków, Poland
| | - Zbigniew Madeja
- Department of Cell Biology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Gronostajowa 7, 30-387 Kraków, Poland
| | - Marta Michalik
- Department of Cell Biology, Faculty of Biochemistry, Biophysics and Biotechnology, Jagiellonian University, Gronostajowa 7, 30-387 Kraków, Poland
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Elish P, Boedeker P, Lash TL, Gazmararian J. Longitudinal weight status and academic achievement in elementary schoolchildren in the United States. Int J Obes (Lond) 2023:10.1038/s41366-023-01309-1. [PMID: 37085587 PMCID: PMC10119509 DOI: 10.1038/s41366-023-01309-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 04/03/2023] [Accepted: 04/05/2023] [Indexed: 04/23/2023]
Abstract
BACKGROUND/OBJECTIVES Childhood overweight and obesity have a well-established negative impact on children's health. Overweight and obesity might also negatively impact children's academic performance, but existing literature on this association is inconclusive. This study uses a longitudinal design in a large, diverse elementary school sample to rigorously test the association between longitudinal weight status and academic achievement. Analyses also investigate modification by sex, race/ethnicity, and cardiorespiratory fitness (CRF). SUBJECTS/METHODS In a large suburban school district in the United States, 4936 Grade 4 students were recruited. Demographic, course grade, and standardized test data were collected from school records for Grades 3-5, and body mass index and CRF were assessed each year. Students wore accelerometers during the school day for up to 15 days across three semesters (Grade 4 Fall and Spring, Grade 5 Fall) to objectively measure physical activity. Multiple imputation addressed missing data and multilevel analyses controlled for student demographics and clustering within schools. RESULTS Unadjusted multilevel models found small negative associations between persistent obesity and course grades and standardized test scores, but these associations largely disappeared when controlling for demographic characteristics. Residual associations for math and writing course grades were attenuated when controlling for CRF, though some marginal negative associations for math and writing remained for students who developed obesity during follow-up. There was also evidence of marginal negative associations with course grades for students who developed overweight/obesity. There was no evidence of modification by sex or race/ethnicity. CONCLUSIONS Results suggest very small associations between weight status and academic achievement that were largely explained by sociodemographic factors and CRF. Evidence of an association between weight status and achievement was stronger among students who developed overweight/obesity. Interventions promoting healthy weight and high CRF remain critical for schools given the link between student health and achievement.
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Affiliation(s)
- Paul Elish
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Peter Boedeker
- Department of Education, Innovation and Technology, Baylor College of Medicine, Houston, TX, USA
| | - Timothy L Lash
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Julie Gazmararian
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
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Kim JG, Kang J, Lee JH, Koo HK. Association of rheumatoid arthritis with bronchial asthma and asthma-related comorbidities: A population-based national surveillance study. Front Med (Lausanne) 2023; 10:1006290. [PMID: 36968830 PMCID: PMC10036351 DOI: 10.3389/fmed.2023.1006290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 02/20/2023] [Indexed: 03/12/2023] Open
Abstract
BackgroundThe aim of this study was to investigate the impact of rheumatoid arthritis (RA) on the prevalence of bronchial asthma and asthma-related comorbidities. We also aimed to identify the influence of RA on interrelationship between asthma and asthma-related comorbidities.MethodsFrom the Korean National Health and Nutrition Examination Survey, participants >40 years of age who completed questionnaires and spirometry tests were enrolled. Patient data on RA, asthma, allergic rhinitis, atopic dermatitis, chronic obstructive pulmonary disease (COPD), sinusitis, otitis media, and body mass index (BMI) were collected. Logistic regression and network analyses were performed.ResultsA total of 14,272 subjects were enrolled, among which, 334 (2.4%) had RA. RA was significantly associated with asthma (OR 2.32; 95% CI 1.51–3.57), allergic rhinitis (OR 1.51; 95% CI 1.08–2.10), and sinusitis (OR 1.64; 95% CI 1.08–2.50). The network analysis of total patients revealed a positive interrelationship between asthma and allergic rhinitis, sinusitis, otitis media, atopic dermatitis, BMI, and RA. The interrelationship between asthma and sinusitis was stronger in the RA group. Of note, the relationship between asthma and BMI was distinctively found only in the RA group (r = 0.214, P < 0.05). In patients with asthma, the prevalence of obesity was 64% in the presence of RA, and 40% in the absence of RA (P = 0.034).ConclusionThis study supports the positive association of RA with asthma, allergic rhinitis, and sinusitis. Our analysis suggests a notable interrelationship between the presence of asthma and higher BMI values in patients with RA, indicating that asthma is more obesity-related in patients with RA.
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Affiliation(s)
- Jung Gon Kim
- Division of Rheumatology, Department of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine, Goyang-si, Republic of Korea
| | - Jiyeon Kang
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine, Goyang-si, Republic of Korea
| | - Joo-Hyun Lee
- Division of Rheumatology, Department of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine, Goyang-si, Republic of Korea
| | - Hyeon-Kyoung Koo
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Ilsan Paik Hospital, Inje University College of Medicine, Goyang-si, Republic of Korea
- *Correspondence: Hyeon-Kyoung Koo,
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10
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Shanmugasundaram K, Bade G, Sampath M, Talwar A. Effect of Obesity on Airway Mechanics. Indian J Endocrinol Metab 2023; 27:161-166. [PMID: 37292068 PMCID: PMC10245307 DOI: 10.4103/ijem.ijem_363_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 01/15/2023] [Accepted: 01/27/2023] [Indexed: 06/10/2023] Open
Abstract
Background Obesity is known to induce lung function impairment. Previous studies of decline in lung function associated with obesity are well established. Materials and Methods In this cross-sectional study, to evaluate the effects of different obesity indices on lung mechanics, healthy subjects (males-23 and females-22) were recruited. Anthropometric parameters like body mass index (BMI), waist circumference (WC), hip circumference (HC) and neck circumference (NC) were measured and waist-hip ratio (WHR) was derived. Spirometry, impulse oscillometry (IOS) and fractional exhaled nitric oxide (FeNO) measurements were performed to assess lung function. Subgroups were divided and analysed. Results In males, increased WHR is associated with increased total airway resistance (R5). BMI correlates positively with R5, R5% predicted, resistance at 20 Hz (R20) and R20% predicted; likewise, WHR shows a positive correlation with R5. In females, increased WHR has significantly higher R5, R5% predicted, R20, R20% predicted, area of reactance (Ax), resonant frequency (Fres) and decreased reactance at 5 Hz (X5), reactance at 20 Hz (X20), X20% predicted. The female group with higher WC shows significantly increased R5, R5% predicted, R20, R20% predicted, Ax, Fres and lower fixed ratio of forced expiratory volume in 1 s (FEV1)/forced vital capacity (FVC), X5, X20, X20% predicted. The group with higher NC has a lower FEV1/FVC ratio. WHR positively correlated with R5% predicted and Fres while WC correlated positively with R5, R5% predicted, Ax and Fres; same way, NC with X5% predicted. Conclusion Obesity/overweight causes significant changes in lung volumes, capacity and airway mechanics, Higher WC and WHR are associated with significant changes in lung mechanics, which are more prominent in females than in males. NC is not associated with changes in lung mechanics.
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Affiliation(s)
| | - Geetanjali Bade
- Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
| | - Meghashree Sampath
- Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
| | - Anjana Talwar
- Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
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Rosal MC, Lemon SC, Borg A, Lopez-Cepero A, Sreedhara M, Silfee V, Pbert L, Kane K, Li W. The Healthy Kids & Families study: Outcomes of a 24-month childhood obesity prevention intervention. Prev Med Rep 2023; 31:102086. [PMID: 36820371 PMCID: PMC9938323 DOI: 10.1016/j.pmedr.2022.102086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 11/30/2022] [Accepted: 12/01/2022] [Indexed: 12/12/2022] Open
Abstract
Socioeconomically disadvantaged children experience a high burden of obesity but few interventions address obesity prevention in this population subgroup. The Healthy Kids & Families study tested the effect of a parent-focused community health worker (CHW)-delivered lifestyle intervention to prevent childhood obesity. Participants were child-parent/guardian (Kindergarten to 6th grade at baseline) dyads (n = 247) recruited through schools located in socioeconomically disadvantaged neighborhoods in Worcester, MA, USA. Using a quasi-experimental design, the study tested the impact of Healthy Kids & Families, a theory-based, low-intensity, parent-focused, CHW-delivered intervention to improve children's weight, healthy eating and physical activity. The attention-control comparison condition was a positive parenting intervention. The primary outcome was change in child body mass index (BMI) z-score at 24 months. Secondary outcomes included number of positive child and parent changes in selected diet and physical activity behaviors targeted by the intervention and change in parent BMI. Outcomes were assessed following the intent-to-treat principle and using multivariable generalized linear mixed models. Compared to the attention-control comparison condition, the Healthy Kids & Families intervention led to a greater reduction in children's BMI z-score (β = -0.17, 95 %CI: -1.92 to -0.36; p = 0.057) and a greater number of positive behavior changes among children (β = 0.57, 95 %CI: 0.08-1.06; p = 0.02) at 24 months. There was no significant change in parent outcomes. The Healthy Kids & Families intervention shows promise for obesity prevention among children in socioeconomically disadvantaged communities.
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Affiliation(s)
- Milagros C. Rosal
- Division of Preventive and Behavioral Medicine, Department of Population & Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA, USA
| | - Stephenie C. Lemon
- Division of Preventive and Behavioral Medicine, Department of Population & Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA, USA
| | - Amy Borg
- Division of Preventive and Behavioral Medicine, Department of Population & Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA, USA
| | - Andrea Lopez-Cepero
- Division of Preventive and Behavioral Medicine, Department of Population & Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA, USA
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Meera Sreedhara
- Division of Preventive and Behavioral Medicine, Department of Population & Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA, USA
| | - Valerie Silfee
- Division of Preventive and Behavioral Medicine, Department of Population & Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA, USA
- Weight Watchers International, NY, USA
| | - Lori Pbert
- Division of Preventive and Behavioral Medicine, Department of Population & Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, MA, USA
| | - Kevin Kane
- Health Statistics and Geography Lab, Center for Health Statistics and Department of Public Health, Zuckerberg College of Health Sciences, University of Massachusetts, Lowell, MA, USA
| | - Wenjun Li
- Health Statistics and Geography Lab, Center for Health Statistics and Department of Public Health, Zuckerberg College of Health Sciences, University of Massachusetts, Lowell, MA, USA
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Abstract
The current review highlights the available research related to cannabis and indicators of physical health in a variety of domains. Various studies have found associations between cannabis use with pulmonary, cardiovascular, gastrointestinal, and endocrine function as well as body mass index and sleep. At this time, more research is needed to understand the influence of cannabis use on physical health, particularly among adolescent samples.
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Affiliation(s)
- Abigail L Tuvel
- Department of Psychology and Neuroscience, University of Colorado Boulder, 1777 Exposition Drive, Boulder, CO 80301
| | - Evan A Winiger
- Department of Psychiatry, School of Medicine, University of Colorado Anschutz Medical Campus, 1890 N Revere Court, Aurora, CO, 80045
| | - J Megan Ross
- Department of Psychiatry, Division of Addiction Sciences, Treatment and Prevention, University of Colorado Anschutz Medical Campus, 1890 N Revere Court, Aurora, CO, 80045.
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13
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Sánchez-Ortega H, Jiménez-Cortegana C, Novalbos-Ruiz JP, Gómez-Bastero A, Soto-Campos JG, Sánchez-Margalet V. Role of Leptin as a Link between Asthma and Obesity: A Systematic Review and Meta-Analysis. Int J Mol Sci 2022; 24:ijms24010546. [PMID: 36613991 PMCID: PMC9820321 DOI: 10.3390/ijms24010546] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 12/13/2022] [Accepted: 12/19/2022] [Indexed: 12/31/2022] Open
Abstract
Asthma and obesity are considered as highly prevalent diseases with a great impact on public health. Obesity has been demonstrated to be an aggravating factor in the pathogenesis of asthma. Adipose tissue secretes proinflammatory cytokines and mediators, including leptin, which may promote the development and severity of asthma in obese patients. This study is a systematic review and a meta-analysis based on the relationship between leptin and asthma during obesity. MEDLINE, Cochrane, EMBASE and CINAHL databases were used. Data heterogeneity was analyzed using Cochran’s Q and treatment effect with the DerSimonian and Laird method. Random effect analyses were carried out to test data sensitivity. Asymmetry was estimated using Begg’s and Egger’s tests. All studies showed significant differences in leptin levels. The effect of the measures (p < 0.001), data sensitivity (p < 0.05) and data asymmetry were statistically significant, as well as tBegg’s test (p = 0.010) and Egge’s test (p < 0.001). Despite the existing limiting factors, the results of this study support the relevant role of leptin in the pathophysiology of asthma in obese subjects. Nevertheless, further studies are needed to obtain better insight in the relationship between leptin and asthma in obesity.
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Affiliation(s)
- Helena Sánchez-Ortega
- Medicine Laboratory Service, Department of Medical Biochemistry and Molecular Biology and Immunology, Medical School, Virgen Macarena University Hospital, University of Seville, Av. Dr. Fedriani 3, 41009 Seville, Spain
| | - Carlos Jiménez-Cortegana
- Medicine Laboratory Service, Department of Medical Biochemistry and Molecular Biology and Immunology, Medical School, Virgen Macarena University Hospital, University of Seville, Av. Dr. Fedriani 3, 41009 Seville, Spain
| | - José P. Novalbos-Ruiz
- Department of Biomedicine, Biotechnology and Public Health, Medical School, University of Cadiz, 11003 Cádiz, Spain
| | - Ana Gómez-Bastero
- Pneumology Service, Virgen Macarena University Hospital, University of Seville, 41009 Seville, Spain
| | - José G. Soto-Campos
- Pneumology Service, Jerez University Hospital, University of Cadiz, 11003 Cádiz, Spain
| | - Víctor Sánchez-Margalet
- Medicine Laboratory Service, Department of Medical Biochemistry and Molecular Biology and Immunology, Medical School, Virgen Macarena University Hospital, University of Seville, Av. Dr. Fedriani 3, 41009 Seville, Spain
- Correspondence:
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14
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Patel D, Butzer D, Williams BD, Dev DA, Horm D, Finneran D, Lowery B, Campbell JE, Sisson SB. Food Waste, Preference, and Cost: Perceived Barriers and Self-Reported Food Service Best Practices in Family Child Care Homes. Child Obes 2022; 18:548-555. [PMID: 35333611 DOI: 10.1089/chi.2021.0251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Background: Family Child Care Homes (FCCHs) are a setting where providers care for children at their own residence. FCCHs face unique challenges and children may not always receive optimal nutrition and have higher risk of obesity compared to other programs. The objective of this study was to determine differences in food service best practices scores between FCCHs who did/did not perceive barriers to serving healthy meals. Methods: FCCHs (n = 167) self-reported demographics, and perceived barriers to serving healthy foods. Nutrition and Physical Activity Self-Assessment for Child Care was used to assess food served with 1 (indicating poor practice) to 4 (indicating best practice). Means, standard deviations, and t-tests were conducted to determine differences in scores between FCCHs with and without perceived barriers. Adjusted alpha was 0.013. Results: FCCHs perceiving food waste as a barrier had significantly lower scores for total food and beverage (p = 0.006, 3.2 ± 0.3 vs. 3.4 ± 0.3); fruits and vegetables (p = 0.003, 3.1 ± 0.5 vs. 3.3 ± 0.5), whole fruits (p = 0.048, 3.1 ± 1.2 vs. 3.4 ± 0.9), and nonstarchy vegetables (p = 0.007, 2.8 ± 0.9 vs. 3.2 ± 0.9). Providers perceiving food preferences as a barrier had significantly lower scores compared to those who did not (p = 0.008, 2.9 ± 0.9 vs. 3.3 ± 0.9). No significant differences found in best practices among providers with vs. without perceived barrier of food costs. Conclusion: Food waste is an understudied barrier in FCCHs to serve healthy meals. Research is needed to explore these perceived barriers in FCCHs to improve best practices around meals.
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Affiliation(s)
- Divya Patel
- Department Nutritional Sciences, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Daisy Butzer
- Department Nutritional Sciences, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Bethany D Williams
- Department Nutritional Sciences, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.,Department of Nutrition and Exercise Physiology, Washington State University Health Sciences Spokane, Spokane, WA, USA
| | - Dipti A Dev
- Department of Child, Youth, and Family studies, University of Nebraska-Lincoln, Lincoln, NE, USA
| | - Diane Horm
- Instructional Leadership and Academic Curriculum, and University of Oklahoma, Norman, OK, USA
| | - Denise Finneran
- Department Speech Pathology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Bryce Lowery
- Department of Regional and City Planning, University of Oklahoma, Norman, OK, USA
| | - Janis E Campbell
- Department of Biostatistics and Epidemiology, Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Susan B Sisson
- Department Nutritional Sciences, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
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15
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Haynes-Maslow L, Ray S, Giombi K. Perceptions of sugar-sweetened beverages among adolescents in North Carolina. Front Public Health 2022; 10:943295. [PMID: 36249251 PMCID: PMC9557148 DOI: 10.3389/fpubh.2022.943295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 09/05/2022] [Indexed: 01/21/2023] Open
Abstract
Introduction Sugar-sweetened beverage (SSB) consumption among adolescents contributes to diet-related chronic disease including obesity, type 2 diabetes, and poor oral health. Objective To better understand adolescents' perceptions, attitudes, and consumption behaviors around SSBs by conducting virtual workshop discussions with adolescents in NC. Materials and methods Adolescents ages 11-17 in communities with a high proportion of Supplemental Nutrition Assistance Program (SNAP) eligible households were selected to participate in a series of virtual group workshops during summer 2021. A semi-structured discussion guide was used by a workshop facilitator. Workshop discussions centered around general health perceptions, SSB perceptions, and consumption behaviors. A thematic analysis was used to summarize knowledge, beliefs, attitudes, and perceptions around SSBs. Results Approximately 36 adolescents participated across four group workshops. Parents and caregivers influenced adolescents most when it came to making beverage choices. Positive SSB perceptions included liking the taste and the association with special times and social events. Negative opinions focused on associated health risks (diet-related chronic disease and poor oral health). Some adolescents acknowledged SSBs were not healthy but suggested they could be consumed occasionally. Very few participants mentioned any benefits from SSBs; those that mentioned benefits stated they provided energy, replaced electrolytes, and tasted good. Conclusion Findings provide several key insights that can contribute to the development of messages aimed at curbing SSB consumption among adolescents. For example, messages that focus on catching adolescents' attention and sharing short- and long-term health consequences of high SSB consumption resonated with adolescents, but because occasional SSB intake was not seen as consequential, messages that suggest abstinence from SSBs may not be helpful in reducing consumption.
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Affiliation(s)
- Lindsey Haynes-Maslow
- Department of Agricultural and Human Sciences, North Carolina State University, Raleigh, NC, United States,*Correspondence: Lindsey Haynes-Maslow
| | - Sarah Ray
- Center for Communication Science, RTI International, Atlanta, GA, United States
| | - Kristen Giombi
- Health Economics Program, RTI International, Research Triangle Park, NC, United States
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16
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Mirra D, Cione E, Spaziano G, Esposito R, Sorgenti M, Granato E, Cerqua I, Muraca L, Iovino P, Gallelli L, D’Agostino B. Circulating MicroRNAs Expression Profile in Lung Inflammation: A Preliminary Study. J Clin Med 2022; 11:jcm11185446. [PMID: 36143090 PMCID: PMC9500709 DOI: 10.3390/jcm11185446] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 09/08/2022] [Accepted: 09/12/2022] [Indexed: 11/29/2022] Open
Abstract
Background: Bronchial asthma is an inflammatory airway disease with an ever-increasing incidence. Therefore, innovative management strategies are urgently needed. MicroRNAs are small molecules that play a key role in lungs cellular functions and are involved in chronic inflammatory diseases, such as bronchial asthma. This study aims to compare microRNA serum expression between subjects with asthma, obesity, the most common co-morbidity in asthma, and healthy controls to obtain a specific expression profile specifically related to lung inflammation. Methods: We collected serum samples from a prospective cohort of 25 sex-matched subjects to determine circulating miRNAs through a quantitative RT-PCR. Moreover, we performed an in silico prediction of microRNA target genes linked to lung inflammation. Results: Asthmatic patients had a significant lower expression of hsa-miR-34a-5p, 181a-5p and 146a-5p compared to both obese and healthy ones suggesting microRNAs’ specific involvement in the regulation of lungs inflammatory response. Indeed, using in silico analysis, we identified microRNAs novel target genes as GATA family, linked to the inflammatory-related pathway. Conclusions: This study identifies a novel circulating miRNAs expression profile with promising potentials for asthma clinical evaluations and management. Further and larger investigations will be needed to confirm the potential role of microRNA as a clinical marker of bronchial asthma and eventually of pharmacological treatment response.
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Affiliation(s)
- Davida Mirra
- Department of Environmental Biological and Pharmaceutical Sciences and Technologies University of Campania “Luigi Vanvitelli”, 81100 Caserta, Italy
| | - Erika Cione
- Department of Pharmacy, Health and Nutritional Sciences-Department of Excellence 2018–2022, University of Calabria, 87036 Rende, CS, Italy
| | - Giuseppe Spaziano
- Department of Environmental Biological and Pharmaceutical Sciences and Technologies University of Campania “Luigi Vanvitelli”, 81100 Caserta, Italy
| | - Renata Esposito
- Department of Environmental Biological and Pharmaceutical Sciences and Technologies University of Campania “Luigi Vanvitelli”, 81100 Caserta, Italy
| | - Mario Sorgenti
- Respiratory Diseases in Primary Care, ASP Catanzaro, 88100 Catanzaro, Italy
| | - Elisabetta Granato
- Department of Pharmacy, School of Medicine and Surgery, University of Naples Federico II, 80138 Naples, Italy
| | - Ida Cerqua
- Department of Pharmacy, School of Medicine and Surgery, University of Naples Federico II, 80138 Naples, Italy
| | - Lucia Muraca
- Department of Primary Care, ASP Catanzaro, 88100 Catanzaro, Italy
| | - Pasquale Iovino
- Department of Environmental Biological and Pharmaceutical Sciences and Technologies University of Campania “Luigi Vanvitelli”, 81100 Caserta, Italy
| | - Luca Gallelli
- Clinical Pharmacology and Pharmacovigilance Unit, Department of Health Sciences, Mater Domini Hospital, University of Catanzaro, 88100 Catanzaro, Italy
- Correspondence:
| | - Bruno D’Agostino
- Department of Environmental Biological and Pharmaceutical Sciences and Technologies University of Campania “Luigi Vanvitelli”, 81100 Caserta, Italy
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17
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Wangberg H, Mortazavi D, Kitsen J, Sanni A, Leibel S, Geng B. Dose-dependent association between inhaled corticosteroid use and risk of obesity and metabolic syndrome in asthma. Allergy Asthma Proc 2022; 43:446-453. [PMID: 36065107 DOI: 10.2500/aap.2022.43.220027] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Background: Inhaled corticosteroids (ICS) are widely prescribed medications. Some studies have reported that ICS may suppress the hypothalamic-pituitary-adrenal axis and induce systemic effects. Objective: To explore the possibility of a dose-dependent association between the long-term use of ICS and the risk of obesity and other markers of metabolic syndrome. Methods: A 5-year retrospective two-arm cohort study explored patients on asthma and not on ICS relative to patients with asthma who were on varying doses of ICS (low, medium, and high) and attributes such as body mass index (BMI) trajectory and prescription of antihypertensive, antidiabetic, and cholesterol-lowering medications. Results: A total of 229 subjects with asthma were in the control cohort, and 215 subjects with asthma were in the ICS cohort. The ICS cohort was subdivided into individuals on low- (n = 88), medium- (n = 107), or high- (n = 20) dose ICS throughout the 5-year study period. For every 1-year increase in time, the BMI in the high-dose ICS group increased at a rate of 0.25 kg/m² when compared with the subjects in the control group after controlling for age and gender. Also, for every 1-year increase in time, the BMI of those on medium-dose ICS increased by 0.06 kg/m² compared with those in the control group after controlling for age and gender. The subjects on ICS also had a statistically increased risk of being prescribed antihypertensive, antidiabetic, and cholesterol-lowering medications. Conclusion: ICS use in the subjects with asthma was associated with a dose-dependent risk of increasing BMI trajectories over time and an increased requirement for antidiabetic and cholesterol-lowering medications. One possible conclusion from this study is that long-term medium- and high-dose ICS have the potential to induce systemic effects.
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Affiliation(s)
- Hannah Wangberg
- From the Department of Allergy, Asthma, and Immunology, Scripps Health, San Diego, California; and
| | - Diba Mortazavi
- Department of Allergy and Immunology, University of California San Diego and Rady Children's Hospital, San Diego, California
| | - Jessica Kitsen
- Department of Allergy and Immunology, University of California San Diego and Rady Children's Hospital, San Diego, California
| | - Adepeju Sanni
- Department of Allergy and Immunology, University of California San Diego and Rady Children's Hospital, San Diego, California
| | - Sydney Leibel
- Department of Allergy and Immunology, University of California San Diego and Rady Children's Hospital, San Diego, California
| | - Bob Geng
- Department of Allergy and Immunology, University of California San Diego and Rady Children's Hospital, San Diego, California
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18
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Com G, Amin R, Gunnett M, Antonetti C. Patient Characteristics and Caregiver Asthma Knowledge of Children with Well-Controlled and Poorly Controlled Asthma. J Asthma Allergy 2022; 15:793-802. [PMID: 35721305 PMCID: PMC9199526 DOI: 10.2147/jaa.s361135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 05/05/2022] [Indexed: 12/02/2022] Open
Abstract
Purpose To describe the socio-demographics and clinical characteristics of children in a pulmonology clinic or admitted to a children’s hospital with well-controlled and poorly controlled asthma, and to assess caregiver knowledge of asthma pathogenesis, treatment, and self-management. Patients and Methods A cohort of 132 children aged 2–18 years and their caregivers seen in a pediatric pulmonology clinic with a diagnosis of asthma (n=112) or admitted to the hospital with a diagnosis of asthma exacerbation (n=20) were invited to participate in a cross-sectional study. Caregivers completed a survey, which healthcare providers then used to tailor asthma education to the patient and caregiver. Two-tail t-tests and Chi-square tests were used to compare demographics and clinical characteristics of children with well-controlled vs poorly controlled asthma. Results Of 132 children, 111 children in this cohort had poorly controlled asthma (84%). Medicaid insurance was associated with poorly controlled asthma versus well-controlled asthma (63% vs 35% p=0.01). Asthma action plans (AAP) had previously been given to 113 caregivers (86%), but caregivers of children with both well-controlled and poorly controlled asthma still reported misconceptions about asthma pathology and management, such as stopping daily medications when asthma is controlled. Conclusion This study contributes to the existing evidence that socio-demographics have a significant impact on asthma prevalence and proper management. Our study suggests that caregivers of children with asthma need comprehensive asthma education beyond the AAP focusing on asthma-related misconceptions.
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Affiliation(s)
- Gulnur Com
- Department of Pediatric Pulmonology, University of Florida, Ascension Sacred Heart, Pensacola, FL, USA
| | - Raid Amin
- Department of Mathematics & Statistics, University of West Florida, Pensacola, FL, USA
| | - Mohini Gunnett
- Department of Pediatric Pulmonology, University of Alabama, Birmingham, AL, USA
| | - Callah Antonetti
- Department of Pediatrics, University of Florida, Ascension Sacred Heart, Pensacola, FL, USA
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19
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Wang X, Ammerman A, Orr CJ. Family‐based interventions for preventing overweight or obesity among preschoolers from racial/ethnic minority groups: A scoping review. Obes Sci Pract 2022; 8:371-386. [PMID: 35664252 PMCID: PMC9159561 DOI: 10.1002/osp4.578] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 11/10/2021] [Accepted: 11/21/2021] [Indexed: 11/11/2022] Open
Abstract
Objective This scoping review aimed to synthesize the published literature on family‐based childhood obesity prevention interventions from 2015 to 2021 that focused on children 2–5 years of age from racial and/or ethnic minority households. Methods A PICOS (population, intervention, comparison, outcome, and setting) framework was used to guide the development of the research question, search strategy, and inclusion/exclusion criteria. To be included, the study must have been a randomized controlled trial or quasi‐experimental trial that enrolled participants 2–5 years of age and their caregivers who identified as being from a racial and/or ethnic minority group in the United States. The study must have also examined a family‐based intervention that incorporated components to prevent childhood obesity (i.e., fruits and vegetable intake, parental responsive feeding, physical activity), be conducted in a remote (i.e., online, text, mail), home, community, primary care setting, or early childhood education institution setting, and report on body mass index (BMI, kg/m2), BMI z‐score, anthropometric measures (weight, waist circumference, fat mass, etc.), changes in health behaviors, or increase in nutritional knowledge. Results Fourteen individual studies were identified. Most interventions used multiple components for promoting nutritional knowledge and behavioral changes among families. Eight interventions included culturally tailored components targeting four aspects: (1) language barriers, (2) food choices, (3) relationships between family members, and (4) rapport building. Conclusions There is limited research in this field focusing on children from racial and/or ethnic minority groups. Future efforts should invest in developing culturally appropriate interventions for these groups.
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Affiliation(s)
- Xiran Wang
- Department of Nutrition University of North Carolina at Chapel Hill Gillings School of Public Health Chapel Hill North Carolina USA
| | - Alice Ammerman
- Health Promotion and Disease Prevention University of North Carolina at Chapel Hill Chapel Hill North Carolina USA
| | - Colin J. Orr
- Department of Pediatrics University of North Carolina at Chapel Hill School of Medicine Chapel Hill North Carolina USA
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20
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Experiences of exercise in patients with asthma: qualitative analysis of discussions in a UK asthma online community. BJGP Open 2022; 6:BJGPO.2021.0162. [PMID: 35487580 DOI: 10.3399/bjgpo.2021.0162] [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: 09/06/2021] [Revised: 12/28/2021] [Accepted: 01/31/2022] [Indexed: 10/31/2022] Open
Abstract
BACKGROUND Engagement with exercise in adults with asthma is suboptimal. Limited information is available regarding factors affecting engagement with exercise. AIM To explore experiences of exercise and linked unmet needs in adults with asthma. DESIGN & SETTING Qualitative thematic analysis of posts in a UK asthma online community, written between 2015 and 2020. METHOD Posts were identified using keywords searches. Posts in the 'Exercise' topic section were additionally included. Thematic analysis of posts was undertaken. RESULTS 143 relevant posts were analysed. 92 participants were identified through posts (11M, 33F, 48 gender not stated, aged 26-73 years). Emerging themes included: fear of experiencing asthma symptoms during exercise, lack of information about how to deal with symptoms, external barriers, emotional response, and involvement of healthcare providers. Environmental factors, concomitant life stressors, distrust of healthcare professionals and embarrassment of displaying asthma symptoms during exercise were barriers to engagement. Facilitators included experiencing positive health outcomes following exercise and positive discussions regarding exercise with healthcare professionals. Strategies participants developed to enable exercise were warming up, increasing reliever and preventer inhalers when exercising and finding exercises felt as enjoyable. CONCLUSION Future interventions to address fears of exercise-induced physical symptoms, and clear instructions on the use of inhalers when exercising are needed. Exploring patients' attitudes to exercise in clinical consultations, especially in primary care, may be beneficial.
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21
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Carman K, O'Neal LJ, Byrd-Bredbenner C, Olfert MD, Shelnutt KP. HomeStyles-2 for SNAP-Ed families with children in middle childhood: Cluster randomized trial protocol. Contemp Clin Trials 2022; 117:106771. [PMID: 35489646 DOI: 10.1016/j.cct.2022.106771] [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: 12/22/2021] [Revised: 04/08/2022] [Accepted: 04/22/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND Childhood obesity prevention efforts are needed in the United States, especially for families with low income. The purpose of this study is to determine whether HomeStyles-2, a nutrition education and childhood obesity prevention program for families with children in middle childhood (ages 6 to 11 years), motivates parents to re-shape their home environments and weight-related lifestyle practices to be more supportive of meeting national nutrition and physical activity recommendations and weight status of their children more so than those in the control condition. METHODS A research-practice partnership with Florida's Supplemental Nutrition Assistance Program-Education (SNAP-Ed) program was formed to conduct a cluster randomized trial to evaluate the HomeStyles-2 intervention. SNAP-Ed-eligible individuals who are parents/caregivers of children aged 6-11 living in the study catchment area will be invited to enroll in the study and participate in a six-lesson series using the HomeStyles-2 program or an attention control program. The primary outcome measures related to parent weight-related behaviors will be assessed on the individual level. Linear mixed models with a hierarchical design will be used to assess outcomes of interest. DISCUSSION This study has the potential to demonstrate the effectiveness of a new curriculum implemented in a federal nutrition education program. Because of the COVID-19 pandemic, adjustments were made to the intervention design to allow for virtual delivery of the intervention through SNAP-Ed. This unanticipated change will offer much-needed research on the effectiveness of virtual nutrition education, which may help to expand SNAP-Ed's reach across the country. TRIAL REGISTRATION NCT05019339.
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Affiliation(s)
- Kaley Carman
- Department of Family, Youth and Community Sciences, University of Florida, 3028 McCarty Hall D, Gainesville, FL 32611, United States of America
| | - LaToya J O'Neal
- Department of Family, Youth and Community Sciences, University of Florida, 3028 McCarty Hall D, Gainesville, FL 32611, United States of America
| | - Carol Byrd-Bredbenner
- Department of Nutritional Sciences, Rutgers University, 211 Davison Hall, New Brunswick, NJ 08901, United States of America
| | - Melissa D Olfert
- Department of Human Nutrition and Foods, West Virginia University, 1194 Evansdale Drive G28, Morgantown, WV 26506, United States of America
| | - Karla P Shelnutt
- Department of Family, Youth and Community Sciences, University of Florida, 3028 McCarty Hall D, Gainesville, FL 32611, United States of America.
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22
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McLoughlin RF, McDonald VM. The Management of Extrapulmonary Comorbidities and Treatable Traits; Obesity, Physical Inactivity, Anxiety, and Depression, in Adults With Asthma. FRONTIERS IN ALLERGY 2022; 2:735030. [PMID: 35387051 PMCID: PMC8974714 DOI: 10.3389/falgy.2021.735030] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 08/19/2021] [Indexed: 12/31/2022] Open
Abstract
Asthma is a complex and heterogenous disease characterized by variability in disease expression and severity. Multiple extrapulmonary comorbidities and treatable traits are common in people with asthma, and there is an increasing appreciation of how these may complicate asthma management. This review will discuss the prevalence and impact of extrapulmonary comorbidities/risk factors or "traits," which have been found to co-exist in asthma (obesity, symptoms of depression and/or anxiety and physical inactivity), the impact these traits have on future outcomes (including exacerbation risk and quality of life) and asthma management, and how we should target treatment in asthma when these extrapulmonary traits are present.
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Affiliation(s)
- Rebecca F McLoughlin
- National Health and Medical Research Council, Centre of Excellence in Treatable Traits, New Lambton Heights, NSW, Australia.,School of Nursing and Midwifery, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia.,School of Nursing and Midwifery, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia
| | - Vanessa M McDonald
- National Health and Medical Research Council, Centre of Excellence in Treatable Traits, New Lambton Heights, NSW, Australia.,School of Nursing and Midwifery, Hunter Medical Research Institute, New Lambton Heights, NSW, Australia.,School of Nursing and Midwifery, College of Health, Medicine and Wellbeing, University of Newcastle, Callaghan, NSW, Australia.,Department of Respiratory and Sleep Medicine, John Hunter Hospital, New Lambton Heights, NSW, Australia
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Examining adolescents' obesogenic behaviors on structured days: a systematic review and meta-analysis. Int J Obes (Lond) 2022; 46:466-475. [PMID: 34987203 DOI: 10.1038/s41366-021-01040-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 11/17/2021] [Accepted: 11/24/2021] [Indexed: 11/08/2022]
Abstract
BACKGROUND The structured days hypothesis posits that 'structured days' (i.e., days with pre-planned, segmented, and adult-supervised environments) reduce youth obesogenic behaviors. Structured days may be especially important for adolescents', as adolescence (12-19 years) is a period of developmental milestones and increased autonomy. Therefore, the objective of this systematic review and meta-analysis is to evaluate the relationship between structured days and adolescents' obesogenic behaviors (i.e., physical activity, diet, screen time, and/or sleep). METHODS From February to April of 2020, four databases (i.e., Embase, PubMed, Web of Science, and PsychINfo) were searched for cross-sectional, longitudinal, and intervention (i.e., baseline data only) studies reporting obesogenic behaviors on more structured versus less structured days (i.e., weekday versus weekend or school year versus summer/holiday). RESULTS A total of 42,878 unique titles and abstracts were screened with 2767 full-text articles retrieved. After review of full-text articles, 296 studies were identified (sleep k = 147, physical activity k = 88, screen time k = 81, diet k = 8). Most studies were conducted in North America, Europe & Central Asia, or East Asia & the Pacific used self-report measures and compared school days to weekend days. Meta-analyses indicated that adolescents' physical activity (standardized mean difference [SMD] = -0.25 [95%CI - 0.48, -0.03]) and screen time (SMD = -0.48 [95%CI - 0.66, -0.29]) were less healthy on less structured days. Differences did not reach statistical significance for sleep (SMD = -0.23 [95%CI - 0.48, 0.02]) and diet (SMD = -0.13 [95%CI - 0.77, 0.51]), however, sleep timing (SMD = -1.05 [95%CI - 1.31, -0.79]) and diet quantity (SMD = -0.29 [95%CI - 0.35, -0.23]) were less healthy on less structured days. The review identified studies with large heterogeneity. CONCLUSIONS Findings indicate that adolescents' physical activity, screen time, sleep timing, and diet quantity are less healthy on less structured days. Interventions for adolescents to prevent and treat obesity may be more successful if they are designed to target times that are less structured.
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Harrison MR, Palma G, Buendia T, Bueno-Tarodo M, Quell D, Hachem F. A Scoping Review of Indicators for Sustainable Healthy Diets. FRONTIERS IN SUSTAINABLE FOOD SYSTEMS 2022. [DOI: 10.3389/fsufs.2021.822263] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
Introduction: Diets are currently unsustainable in many countries as evidenced by the growing burden of malnutrition, degradation of natural resources, contributions to climate change, and unaffordability of healthy diets. Agreement on what constitutes a healthy and sustainable diet has been debated. In 2019, FAO and WHO published the Sustainable Healthy Diets Guiding Principles, defining what qualifies as a sustainable healthy diet. While valuable, these principles require measurable indicators to support their operationalization. Our scoping review aims to describe how sustainable healthy diets have been assessed in the literature since 2010.Methods: A search for English-language articles published in peer-reviewed journals was conducted from January 2010 through February 2020 across three databases. Out of the 504 articles initially identified, 103 articles were included. Metadata were extracted from each article on: publication year, country of study, study aims, methods, main data sources, indicators used to assess sustainable healthy diets, reported indicator strengths or limitations, and main study findings. A qualitative content analysis identified major conceptual themes across indicators and their frequency of use.Findings: From the 103 empirical articles included in our review, 57.3% were published after 2017. Most studies were carried out in high-income countries (74%). Approximately 42% of the articles assessed the sustainability of diets using solely health and environmental indicators; <25% assessed the sustainability of diets across health, environmental, and sociocultural aspects of sustainability. We found a substantial number of unique indicators used for assessing health (n = 82), environmental (n = 117), and sociocultural (n = 43) aspects of diets. These indicators covered concepts related to health outcomes, aspects of diet quality, natural resources, climate change, cultural acceptability, and cost of diets. The preponderance of indicators currently used in research likely poses challenges for stakeholders to identify the most appropriate measures.Conclusion: Robust indicators for sustainable healthy diets are critical for understanding trends, setting targets, and monitoring progress across national and sub-national levels. Our review highlights the geographical imbalance, the narrow focus on health and environmental aspects, and the lack of common measures used in research. Measures registries could provide the decision-support needed by stakeholders to aid in the indicator selection process.
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Fainardi V, Passadore L, Labate M, Pisi G, Esposito S. An Overview of the Obese-Asthma Phenotype in Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19020636. [PMID: 35055456 PMCID: PMC8775557 DOI: 10.3390/ijerph19020636] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 12/21/2021] [Accepted: 12/30/2021] [Indexed: 12/14/2022]
Abstract
Asthma is the most common chronic disease in childhood. Overweight and obesity are included among the comorbidities considered in patients with difficult-to-treat asthma, suggesting a specific phenotype of the disease. Therefore, the constant increase in obesity prevalence in children and adolescents raises concerns about the parallel increase of obesity-associated asthma. The possible correlation between obesity and asthma has been investigated over the last decade by different authors, who suggest a complex multifactorial relationship. Although the particular non-eosinophilic endotype of obesity-related asthma supports the concept that high body weight precedes asthma development, there is ongoing debate about the direct causality of these two entities. A number of mechanisms may be involved in asthma in combination with obesity disease in children, including reduced physical activity, abnormal ventilation, chronic systemic inflammation, hormonal influences, genetics and additional comorbidities, such as gastroesophageal reflux and dysfunctional breathing. The identification of the obesity-related asthma phenotype is crucial to initiate specific therapeutic management. Besides the cornerstones of asthma treatment, lifestyle should be optimized, with interventions aiming to promote physical exercise, healthy diet, and comorbidities. Future studies should clarify the exact association between asthma and obesity and the mechanisms underlying the pathogenesis of these two related conditions with the aim to define personalized therapeutic strategies for asthma management in this population.
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26
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Uong A, Hametz P, Zhu D, Kopp A, Warman K. Acute asthma management with IV magnesium in obese, overweight and non-overweight inner-city children. J Asthma 2021; 59:2181-2188. [PMID: 34793278 DOI: 10.1080/02770903.2021.2008425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE IV Magnesium (IV Mg) is increasingly used as adjunctive therapy for asthma exacerbations. In obese patients, delays in recognition of asthma severity may lead to delays in IV Mg administration. Our objective was to examine whether timing of IV Mg administration varied by Body Mass Index (BMI) category and whether this relates to hospitalization course. METHODS This is a retrospective chart review of IV Mg use for asthma in children 2-17 years of age hospitalized in an urban children's hospital. Weight status was categorized by BMI percentile for age. The primary outcome was time to IV Mg administration. Secondary outcomes included admission to the intensive care unit, time to discharge readiness and Length of Stay (LOS). Continuous variables were analyzed using Student's t-test or Mann-Whitney test, categorical variables with Chi-Square test or Fisher's exact test, as appropriate. A linear regression model examined factors related to time to IV Mg administration. RESULTS In 2017, 361/698 (52%) of patients admitted with acute asthma received IV Mg. Of these, 210 patients met study criteria. Except for age, baseline characteristics did not vary by BMI category. No differences were found in Time to IV Mg, rates of admission to the intensive care unit, time to discharge readiness, or LOS comparing non-overweight to overweight or obese patients. CONCLUSIONS In this sample of inner-city children who received IV Mg there were no differences in timing of IV Mg based on BMI category. Further work is needed to examine whether standardizing timing of IV Mg improves care.
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Affiliation(s)
- Audrey Uong
- Department of Pediatrics, Children's Hospital at Montefiore, Bronx, NY, USA
| | - Patricia Hametz
- Department of Pediatrics, Children's Hospital at Montefiore, Bronx, NY, USA
| | - Denzel Zhu
- Department of Pediatrics, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Adam Kopp
- Department of Medicine, Columbia University Irving Medical Center, New York, NY, USA
| | - Karen Warman
- Department of Pediatrics, Children's Hospital at Montefiore, Bronx, NY, USA
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Wende ME, Stowe EW, Eberth JM, McLain AC, Liese AD, Breneman CB, Josey MJ, Hughey SM, Kaczynski AT. Spatial clustering patterns and regional variations for food and physical activity environments across the United States. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2021; 31:976-990. [PMID: 31964175 DOI: 10.1080/09603123.2020.1713304] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Accepted: 01/06/2020] [Indexed: 06/10/2023]
Abstract
This study examined spatial patterns of obesogenic environments for US counties. We mapped the geographic dispersion of food and physical activity (PA) environments, assessed spatial clustering, and identified food and PA environment differences across U.S. regions and rurality categories. Substantial low food score clusters were located in the South and high score clusters in the Midwest and West. Low PA score clusters were located in the South and high score clusters in the Northeast and Midwest (p < .0001). For region, the South had significantly lower food and PA environment scores. For rurality, rural counties had significantly higher food environment scores and metropolitan counties had significantly higher PA environment scores (p < .0001). This study highlights geographic clustering and disparities in food and PA access nationwide. State and region-wide environmental inequalities may be targeted using structural interventions and policy initiatives to improve food and PA access.
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Affiliation(s)
- Marilyn E Wende
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, USA
| | - Ellen W Stowe
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, USA
| | - Jan M Eberth
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, USA
- Rural and Minority Health Research Center, Arnold School of Public Health, University of South Carolina, Columbia, USA
| | - Alexander C McLain
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, USA
| | - Angela D Liese
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, USA
| | - Charity B Breneman
- Rural and Minority Health Research Center, Arnold School of Public Health, University of South Carolina, Columbia, USA
| | - Michele J Josey
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, USA
- Rural and Minority Health Research Center, Arnold School of Public Health, University of South Carolina, Columbia, USA
| | - S Morgan Hughey
- Department of Health and Human Performance, College of Charleston, Charleston, USA
| | - Andrew T Kaczynski
- Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, USA
- Prevention Research Center, Arnold School of Public Health, University of South Carolina, Columbia, USA
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Tripicchio GL, Kay M, Herring S, Cos T, Bresnahan C, Gartner D, Sosinsky LS, Bass SB. Development and Preliminary Feasibility of iByte4Health: A Mobile Health (mHealth) Pediatric Obesity Prevention Intervention to Engage Parents with Low-Income of Children 2-9 Years. Nutrients 2021; 13:nu13124240. [PMID: 34959792 PMCID: PMC8708273 DOI: 10.3390/nu13124240] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 11/23/2021] [Accepted: 11/24/2021] [Indexed: 01/22/2023] Open
Abstract
This research describes the development and preliminary feasibility of iByte4Health, a mobile health (mHealth) obesity prevention intervention designed for parents with a low-income of children 2–9 years of age. Study 1 (n = 36) presents findings from formative work used to develop the program. Study 2 (n = 23) presents a 2-week proof-of-concept feasibility testing of iByte4Health, including participant acceptability, utilization, and engagement. Based on Study 1, iByte4Health was designed as a text-messaging program, targeting barriers and challenges identified by parents of young children for six key obesity prevention behaviors: (1) snacking; (2) physical activity; (3) sleep; (4) sugary drinks; (5) fruit and vegetable intake; and (6) healthy cooking at home. In Study 2, participants demonstrated high program retention (95.7% at follow-up) and acceptability (90.9% reported liking or loving the program). Users were engaged with the program; 87.0% responded to at least one self-monitoring text message; 90.9% found the videos and linked content to be helpful or extremely helpful; 86.4% found text messages helpful or extremely helpful. iByte4Health is a community-informed, evidenced-based program that holds promise for obesity prevention efforts, especially for those families at the increased risk of obesity and related disparities. Future work is warranted to test the efficacy of the program.
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Affiliation(s)
- Gina L. Tripicchio
- Center for Obesity Research and Education, Temple University, Philadelphia, 19140 PA, USA;
- Department of Social and Behavioral Sciences, Temple University, Philadelphia, 19122 PA, USA;
- Correspondence: ; Tel.: +1-215-707-8642
| | - Melissa Kay
- Department of Psychology & Neuroscience, Duke University, Durham, 27708 NC, USA;
| | - Sharon Herring
- Center for Obesity Research and Education, Temple University, Philadelphia, 19140 PA, USA;
| | - Travis Cos
- Department of Health and Rehabilitation Sciences, Temple University, Philadelphia, 19122 PA, USA;
| | - Carolyn Bresnahan
- Department of Health Policy and Management, Johns Hopkins University, Baltimore, 21205 MD, USA;
| | - Danielle Gartner
- Health Science Center at Houston, University of Texas, Houston, 77030 TX, USA;
| | - Laura Stout Sosinsky
- Research and Evaluation Group, Public Health Management Corporation, Philadelphia, 19102 PA, USA;
| | - Sarah B. Bass
- Department of Social and Behavioral Sciences, Temple University, Philadelphia, 19122 PA, USA;
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Pediatric Obesity-Related Asthma: The Role of Nutrition and Nutrients in Prevention and Treatment. Nutrients 2021; 13:nu13113708. [PMID: 34835964 PMCID: PMC8620690 DOI: 10.3390/nu13113708] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 09/30/2021] [Accepted: 10/20/2021] [Indexed: 12/31/2022] Open
Abstract
Childhood obesity rates have dramatically risen in numerous countries worldwide. Obesity is likely a factor in increased asthma risk, which is already one of the most widespread chronic respiratory pathologies. The pathogenic mechanism of asthma risk has still not yet been fully elucidated. Moreover, the role of obesity-related inflammation and pulmonary overreaction to environmental triggers, which ultimately result in asthma-like symptoms, and the importance of dietary characteristics is well recognized. Diet is an important adjustable element in the asthma development. Food-specific composition of the diet, in particular fat, sugar, and low-quality nutrients, is likely to promote the chronic inflammatory state seen in asthmatic patients with obesity. An unbalanced diet or supplementation as a way to control asthma more efficiently has been described. A personalized dietary intervention may improve respiratory symptoms and signs and therapeutic response. In this narrative review, we presented and discussed more recent literature on asthma associated with obesity among children, focusing on the risk of asthma among children with obesity, asthma as a result of obesity focusing on the role of adipose tissue as a mediator of systemic and local airway inflammation implicated in asthma regulation, and the impact of nutrition and nutrients in the development and treatment of asthma. Appropriate early nutritional intervention could possibly be critical in preventing and managing asthma associated with obesity among children.
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Calco GN, Proskocil BJ, Jacoby DB, Fryer AD, Nie Z. Metformin prevents airway hyperreactivity in rats with dietary obesity. Am J Physiol Lung Cell Mol Physiol 2021; 321:L1105-L1118. [PMID: 34668415 DOI: 10.1152/ajplung.00202.2021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Increased insulin is associated with obesity-related airway hyperreactivity and asthma. We tested whether the use of metformin, an anti-diabetic drug used to reduce insulin resistance, can reduce circulating insulin, thereby preventing airway hyperreactivity in rats with dietary obesity. Male and female rats were fed a high- or low-fat diet for 5 weeks. Some male rats were simultaneously treated with metformin (100 mg/kg, p.o.). In separate experiments, after 5 weeks of a high-fat diet, some rats were switched to a low-fat diet, while others continued a high-fat diet for an additional 5 weeks. Bronchoconstriction and bradycardia in response to bilateral electrical vagus nerve stimulation or to inhaled methacholine were measured in anesthetized and vagotomized rats. Body weight, body fat, caloric intake, fasting glucose and insulin were measured. Vagally-induced bronchoconstriction was potentiated only in male rats on a high-fat diet. Males gained more body weight, body fat, and had increased levels of fasting insulin, compared to females. Metformin prevented development of vagally-induced airway hyperreactivity in male rats on high-fat diet, in addition to inhibiting weight gain, fat gain and increased insulin. In contrast, switching rats to a low-fat diet for 5 weeks reduced body weight and body fat, it did not reverse fasting glucose, fasting insulin or potentiation of vagally-induced airway hyperreactivity. These data suggest that medications that target insulin may be effective treatment for obesity-related asthma.
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Affiliation(s)
- Gina N Calco
- Division of Pulmonary and Critical Care Medicine, Oregon Health and Science University, Portland, Oregon, United States
| | - Becky J Proskocil
- Division of Pulmonary and Critical Care Medicine, Oregon Health and Science University, Portland, Oregon, United States
| | - David B Jacoby
- Division of Pulmonary and Critical Care Medicine, Oregon Health and Science University, Portland, Oregon, United States
| | - Allison D Fryer
- Division of Pulmonary and Critical Care Medicine, Oregon Health and Science University, Portland, Oregon, United States
| | - Zhenying Nie
- Division of Pulmonary and Critical Care Medicine, Oregon Health and Science University, Portland, Oregon, United States
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Weaver RG, Hunt E, Armstrong B, Beets MW, Brazendale K, Turner-McGrievy G, Pate RR, Maydeu-Olivares A, Saelens B, Youngstedt SD, Dugger R, Parker H, von Klinggraeff L, Jones A, Burkhart S, Ressor-Oyer L. Impact of a year-round school calendar on children's BMI and fitness: Final outcomes from a natural experiment. Pediatr Obes 2021; 16:e12789. [PMID: 33763967 PMCID: PMC8440426 DOI: 10.1111/ijpo.12789] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 02/17/2021] [Accepted: 02/23/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND Structure may mitigate children's accelerated summer BMI gain and cardiorespiratory-fitness (CRF) loss. OBJECTIVES Examine BMI and CRF change during school and summer for year-round and traditional calendar school children. METHODS Three schools (N = 2279, 1 year-round) participated in this natural experiment. Children's BMI z-score (zBMI) and CRF (PACER laps) were measured from 2017 to 2019 each May/August. Mixed effects regression estimated monthly zBMI and CRF change during school/summer. Secondary analyses examined differences by weight status and race. Spline regression models estimated zBMI and CRF growth from kindergarten-sixth grade. RESULTS Compared to traditional school, children attending a year-round school gained more zBMI (difference = 0.015; 95CI = 0.002, 0.028) during school, and less zBMI (difference = -0.029; 95CI = -0.041, -0.018), and more CRF (difference = 0.834; 95CI = 0.575, 1.093) monthly during summer. Differences by weight status and race were observed during summer and school. Growth models demonstrated that the magnitude of overall zBMI and CRF change from kindergarten-sixth grade was similar for year-round or traditional school children. CONCLUSIONS Contrary to traditional school children zBMI increased during the traditional 9-month school calendar and zBMI decreased during the traditional summer vacation for year-round school children. Structured summer programming may mitigate accelerated summer BMI gain and CRF loss especially for overweight or obese, and/or Black children.
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Affiliation(s)
- Robert Glenn Weaver
- Department of Exercise Science, University of South Carolina, Columbia, South Carolina
| | - Ethan Hunt
- Department of Exercise Science, University of South Carolina, Columbia, South Carolina
| | - Bridget Armstrong
- Department of Exercise Science, University of South Carolina, Columbia, South Carolina
| | - Michael W. Beets
- Department of Exercise Science, University of South Carolina, Columbia, South Carolina
| | - Keith Brazendale
- Department of Health Sciences, University of Central Florida, Orlando, Florida
| | - Gabrielle Turner-McGrievy
- Department of Health Promotion, Education, and Behavior, University of South Carolina, Columbia, South Carolina
| | - Russell R. Pate
- Department of Exercise Science, University of South Carolina, Columbia, South Carolina
| | | | - Brian Saelens
- Center for Child Health Behavior and Development, Seattle Children’s Hospital, Seattle, Washington
| | - Shawn D. Youngstedt
- Department of Nursing and Health Innovation, Arizona State University, Phoenix, Arizona
| | - Roddrick Dugger
- Department of Exercise Science, University of South Carolina, Columbia, South Carolina
| | - Hannah Parker
- Department of Exercise Science, University of South Carolina, Columbia, South Carolina
| | | | - Alexis Jones
- Department of Exercise Science, University of South Carolina, Columbia, South Carolina
| | - Sarah Burkhart
- Department of Exercise Science, University of South Carolina, Columbia, South Carolina
| | - Layton Ressor-Oyer
- Department of Exercise Science, University of South Carolina, Columbia, South Carolina
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Lourenço LO, Ribeiro AM, Lopes FDTQDS, Tibério IDFLC, Tavares-de-Lima W, Prado CM. Different Phenotypes in Asthma: Clinical Findings and Experimental Animal Models. Clin Rev Allergy Immunol 2021; 62:240-263. [PMID: 34542807 DOI: 10.1007/s12016-021-08894-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/24/2021] [Indexed: 10/20/2022]
Abstract
Asthma is a respiratory allergic disease presenting a high prevalence worldwide, and it is responsible for several complications throughout life, including death. Fortunately, asthma is no longer recognized as a unique manifestation but as a very heterogenic manifestation. Its phenotypes and endotypes are known, respectively, as pathologic and molecular features that might not be directly associated with each other. The increasing number of studies covering this issue has brought significant insights and knowledge that are constantly expanding. In this review, we intended to summarize this new information obtained from clinical studies, which not only allowed for the creation of patient clusters by means of personalized medicine and a deeper molecular evaluation, but also created a connection with data obtained from experimental models, especially murine models. We gathered information regarding sensitization and trigger and emphasizing the most relevant phenotypes and endotypes, such as Th2-high asthma and Th2-low asthma, which included smoking and obesity-related asthma and mixed and paucigranulocytic asthma, not only in physiopathology and the clinic but also in how these phenotypes can be determined with relative similarity using murine models. We also further investigated how clinical studies have been treating patients using newly developed drugs focusing on specific biomarkers that are more relevant according to the patient's clinical manifestation of the disease.
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Affiliation(s)
- Luiz Otávio Lourenço
- Department of Biosciences, Federal University of São Paulo, Campus Baixada Santista, Santos, SP, Brazil
| | - Alessandra Mussi Ribeiro
- Department of Biosciences, Federal University of São Paulo, Campus Baixada Santista, Santos, SP, Brazil
| | | | | | - Wothan Tavares-de-Lima
- Department of Pharmacology, Institute of Biomedical Sciences, University of Sao Paulo, Sao Paulo, SP, Brazil
| | - Carla Máximo Prado
- Department of Biosciences, Federal University of São Paulo, Campus Baixada Santista, Santos, SP, Brazil. .,Department of Medicine, School of Medicine, University of São Paulo, São Paulo, SP, Brazil.
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The Cotton Dust-Related Allergic Asthma: Prevalence and Associated Factors among Textile Workers in Nam Dinh Province, Vietnam. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18189813. [PMID: 34574732 PMCID: PMC8467793 DOI: 10.3390/ijerph18189813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Revised: 09/09/2021] [Accepted: 09/12/2021] [Indexed: 11/16/2022]
Abstract
Objective: To determine the prevalence of cotton dust-related allergic asthma and associated factors among textile workers in Nam Dinh province, Vietnam. Methods: A cross-sectional study was performed with 1082 workers in two textile garment companies using the asthma diagnostic criteria of the GINA (Global Initiative for Asthma) 2016 guidelines. Results: Among study participants, 11.9% had suspected asthma symptoms, 7.4% were diagnosed with asthma, and 4.3% (3.6% in men and 4.5% in women) were diagnosed with cotton dust-related allergic asthma. Overweight, seniority more than 10 years, history of asthma, allergic rhinitis, family history of allergy, and exposure to cotton dust from more than one hour per day in the working environment were found to be important predictors of cotton dust-related allergic asthma among textile workers. Conclusions: Textile workers in two companies in Nam Dinh, Vietnam had a high prevalence of dust-related allergic asthma compared to estimates from the general population. There is a need to design appropriate measures of prevention, screening, and care for dust-related asthma in the textile industry. Further evaluation with better exposure assessment is necessary.
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Banić I, Lovrić M, Cuder G, Kern R, Rijavec M, Korošec P, Turkalj M. Treatment outcome clustering patterns correspond to discrete asthma phenotypes in children. Asthma Res Pract 2021; 7:11. [PMID: 34344475 PMCID: PMC8330019 DOI: 10.1186/s40733-021-00077-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 07/18/2021] [Indexed: 11/10/2022] Open
Abstract
Despite widely and regularly used therapy asthma in children is not fully controlled. Recognizing the complexity of asthma phenotypes and endotypes imposed the concept of precision medicine in asthma treatment. By applying machine learning algorithms assessed with respect to their accuracy in predicting treatment outcome, we have successfully identified 4 distinct clusters in a pediatric asthma cohort with specific treatment outcome patterns according to changes in lung function (FEV1 and MEF50), airway inflammation (FENO) and disease control likely affected by discrete phenotypes at initial disease presentation, differing in the type and level of inflammation, age of onset, comorbidities, certain genetic and other physiologic traits. The smallest and the largest of the 4 clusters- 1 (N = 58) and 3 (N = 138) had better treatment outcomes compared to clusters 2 and 4 and were characterized by more prominent atopic markers and a predominant allelic (A allele) effect for rs37973 in the GLCCI1 gene previously associated with positive treatment outcomes in asthmatics. These patients also had a relatively later onset of disease (6 + yrs). Clusters 2 (N = 87) and 4 (N = 64) had poorer treatment success, but varied in the type of inflammation (predominantly neutrophilic for cluster 4 and likely mixed-type for cluster 2), comorbidities (obesity for cluster 2), level of systemic inflammation (highest hsCRP for cluster 2) and platelet count (lowest for cluster 4). The results of this study emphasize the issues in asthma management due to the overgeneralized approach to the disease, not taking into account specific disease phenotypes.
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Affiliation(s)
- Ivana Banić
- Srebrnjak Children's Hospital, Srebrnjak 100, 10000, Zagreb, Croatia
| | - Mario Lovrić
- Know-Center, Infeldgasse 13, Graz, AT-8010, Austria. .,Institute of Interactive Systems and Data Science, Graz University of Technology, Inffeldgasse 16C, AT-8010, Graz, Austria.
| | - Gerald Cuder
- Institute of Interactive Systems and Data Science, Graz University of Technology, Inffeldgasse 16C, AT-8010, Graz, Austria
| | - Roman Kern
- Know-Center, Infeldgasse 13, Graz, AT-8010, Austria.,Institute of Interactive Systems and Data Science, Graz University of Technology, Inffeldgasse 16C, AT-8010, Graz, Austria
| | - Matija Rijavec
- University Clinic of Respiratory and Allergic Diseases Golnik, Golnik 36, 4204, Golnik, Slovenia
| | - Peter Korošec
- University Clinic of Respiratory and Allergic Diseases Golnik, Golnik 36, 4204, Golnik, Slovenia
| | - Mirjana Turkalj
- Srebrnjak Children's Hospital, Srebrnjak 100, 10000, Zagreb, Croatia.,Faculty of Medicine, J.J, Strossmayer University of Osijek, Josipa Huttlera 4, 31000, Osijek, Croatia.,Catholic University of Croatia, Ilica 242, 10000, Zagreb, Croatia
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35
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Landré B, Nadif R, Goldberg M, Gourmelen J, Zins M, Ankri J, Herr M. Asthma is associated with frailty among community-dwelling adults: the GAZEL cohort. BMJ Open Respir Res 2021; 7:7/1/e000526. [PMID: 32066563 PMCID: PMC7047496 DOI: 10.1136/bmjresp-2019-000526] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 01/14/2020] [Accepted: 01/17/2020] [Indexed: 12/15/2022] Open
Abstract
Introduction Early management of chronic respiratory diseases (CRDs) and frailty have been identified as key targets towards healthy ageing, but the association between CRDs and frailty has been poorly investigated. We studied the association between asthma and frailty in adults of the GAZEL cohort using different definitions of asthma over the 26 years of follow-up. Methods Current asthma definitions are based on yearly self-reports of symptoms or medication (in 2015, constant reports or at least one report between 1990 and 2015), or on a detailed respiratory symptoms questionnaire in 2002. Frailty definition is based on weakness, fatigue, unintentional weight loss, low physical activity and mobility in 2015. Frail participants had three criteria or more, pre-frail 1 or 2, and robust 0. Multinomial regression models adjusted for age, sex, body mass index, smoking, education, marital status and comorbidities were performed. Results In 2015, 12 345 adults (73% men, 61 to 77 years old) were included: 3% of them reported current asthma, 1.6% had constant reports during the follow-up and 9% reported current asthma at least once. In 2015, 6% were frail, 34% pre-frail and 13% of current asthmatics and 6% of non-asthmatics were frail (adjusted OR (aOR) 2.19 (1.44 to 3.34)). Significant associations were also found with the 2002 definition (aOR 2.24 (1.73 to 2.90)), constant reports (aOR 3.67 (1.70 to 7.93)) or at least once (aOR 1.50 (1.15 to 1.98)). Current asthma was also associated with pre-frailty with the 2002 definition (aOR 1.46 (1.26 to 1.68)). Discussion Participants with asthma had increased risk of frailty. A better understanding of their relationship could help to define and evaluate strategies for a better ageing of asthmatics.
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Affiliation(s)
- Benjamin Landré
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, Echappement aux anti-infectieux et pharmaco-épidémiologie, CESP, 94807, Villejuif, France
| | - Rachel Nadif
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, Équipe d'Épidémiologie Respiratoire Intégrative, CESP, 94807, Villejuif, France
| | - Marcel Goldberg
- UMS 011: Population-based Epidemiological Cohorts, INSERM, Paris, France.,Faculty of Medicine, Université Paris Descartes, Paris, France
| | - Julie Gourmelen
- UMS 011: Population-based Epidemiological Cohorts, INSERM, Paris, France
| | - Marie Zins
- UMS 011: Population-based Epidemiological Cohorts, INSERM, Paris, France.,Faculty of Medicine, Université Paris Descartes, Paris, France
| | - Joël Ankri
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, Echappement aux anti-infectieux et pharmaco-épidémiologie, CESP, 94807, Villejuif, France.,Département Hospitalier d'Epidémiologie et de Santé Publique, Groupe Hospitalier AP-HP, Université Paris Saclay, Assistance Publique Hopitaux de Paris, Paris, France
| | - Marie Herr
- Université Paris-Saclay, UVSQ, Univ. Paris-Sud, Inserm, Echappement aux anti-infectieux et pharmaco-épidémiologie, CESP, 94807, Villejuif, France.,Département Hospitalier d'Epidémiologie et de Santé Publique, Groupe Hospitalier AP-HP, Université Paris Saclay, Assistance Publique Hopitaux de Paris, Paris, France
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36
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Ather JL, Van Der Vliet KE, Mank MM, Reed LF, Dixon AE, Poynter ME. Obese adipose tissue modulates proinflammatory responses of mouse airway epithelial cells. Am J Physiol Regul Integr Comp Physiol 2021; 321:R79-R90. [PMID: 34105399 DOI: 10.1152/ajpregu.00316.2020] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Although recognized as an important endocrine organ, little is known about the mechanisms through which adipose tissue can regulate inflammatory responses in distant tissues, such as lung that are affected by obesity. To explore potential mechanisms, male C57BL/6J mice were provided either high-fat diet, low-fat diet, or were provided a high-fat diet then switched to the low-fat diet to promote weight loss. Visceral adipocytes were then cultured in vitro to generate conditioned media (CM) that was used to treat both primary (mouse tracheal epithelial cells; MTECs) and immortalized (mouse-transformed club cells; MTCCs) airway epithelial cells. Adiponectin levels were greatly depressed in the CM from both obese and diet-switched adipocytes relative to mice continually fed the low-fat diet. MTECs from mice with obesity secreted higher baseline levels of inflammatory cytokines than MTECs from lean or diet-switched mice. MTECs treated with obese adipocyte CM increased their secretion of these cytokines compared with MTECs treated with lean CM. Diet-switched CM modestly decreased the production of cytokines compared with obese CM, and these effects were recapitulated when the CM was used to treat MTCCs. Adipose stromal vascular cells from mice with obesity expressed genes consistent with an M1 macrophage phenotype and decreased eosinophil abundance compared with lean stromal vascular fraction, a profile that persisted in the lean diet-switched mice despite substantial weight loss. Soluble factors secreted from obese adipocytes exert a proinflammatory effect on airway epithelial cells, and these alterations are attenuated by diet-induced weight loss, which could have implications for the airway dysfunction related to obese asthma and its mitigation by weight loss.
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Affiliation(s)
- Jennifer L Ather
- Division of Pulmonary Disease and Critical Care, Vermont Lung Center, Department of Medicine, The University of Vermont, Burlington, Vermont
| | - Katherine E Van Der Vliet
- Division of Pulmonary Disease and Critical Care, Vermont Lung Center, Department of Medicine, The University of Vermont, Burlington, Vermont
| | - Madeleine M Mank
- Division of Pulmonary Disease and Critical Care, Vermont Lung Center, Department of Medicine, The University of Vermont, Burlington, Vermont
| | - Leah F Reed
- Division of Pulmonary Disease and Critical Care, Vermont Lung Center, Department of Medicine, The University of Vermont, Burlington, Vermont
| | - Anne E Dixon
- Division of Pulmonary Disease and Critical Care, Vermont Lung Center, Department of Medicine, The University of Vermont, Burlington, Vermont
| | - Matthew E Poynter
- Division of Pulmonary Disease and Critical Care, Vermont Lung Center, Department of Medicine, The University of Vermont, Burlington, Vermont
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37
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White A, Liburd LC, Coronado F. Addressing Racial and Ethnic Disparities in COVID-19 Among School-Aged Children: Are We Doing Enough? Prev Chronic Dis 2021; 18:E55. [PMID: 34081577 PMCID: PMC8220967 DOI: 10.5888/pcd18.210084] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
The disproportionate impact of COVID-19 and associated disparities among Hispanic, non-Hispanic Black, and non-Hispanic American Indian/Alaska Native children and teenagers has been documented. Reducing these disparities along with overcoming unintended negative consequences of the pandemic, such as the disruption of in-person schooling, calls for broad community-based collaborations and nuanced approaches. Based on national survey data, children from some racial and ethnic minority groups have a higher prevalence of obesity, asthma, type 2 diabetes, and hypertension; were diagnosed more frequently with COVID-19; and had more severe outcomes compared with their non-Hispanic White (NHW) counterparts. Furthermore, a higher proportion of children from some racial and ethnic minority groups lived in families with incomes less than 200% of the federal poverty level or in households lacking secure employment compared with NHW children. Children from some racial and ethnic minority groups were also more likely to attend school via online learning compared with NHW counterparts. Because the root causes of these disparities are complex and multifactorial, an organized community-based approach is needed to achieve greater proactive and sustained collaborations between local health departments, local school systems, and other public and private organizations to pursue health equity. This article provides a summary of potential community-based health promotion strategies to address racial and ethnic disparities in COVID-19 outcomes and educational inequities among children and teens, specifically in the implementation of strategic partnerships, including initial collective work, outcomes-based activities, and communication. These collaborations can facilitate policy, systems, and environmental changes in school systems that support emergency preparedness, recovery, and resilience when faced with public health crises.
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Affiliation(s)
- Arica White
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia.,Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, 4770 Buford Highway, MS S107-4, Atlanta GA, 30341.
| | - Leandris C Liburd
- COVID-19 Response, Chief Health Equity Officer, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Fátima Coronado
- Division for Heart Disease and Stroke Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
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Lietzén R, Suominen S, Sillanmäki L, Virtanen P, Virtanen M, Vahtera J. Multiple adverse childhood experiences and asthma onset in adulthood: Role of adulthood risk factors as mediators. J Psychosom Res 2021; 143:110388. [PMID: 33639528 DOI: 10.1016/j.jpsychores.2021.110388] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 01/21/2021] [Accepted: 02/01/2021] [Indexed: 02/08/2023]
Abstract
OBJECTIVE This population-based study of 21,902 Finnish adults examined whether adulthood risk factors for asthma mediate the association between the exposure to multiple adverse childhood experiences (ACEs) assessed retrospectively and the risk of new-onset asthma in adulthood. METHODS Baseline characteristics, occurrence of ACEs, and risk factors of asthma in adulthood were collected with a postal survey at baseline in 1998. The participants were linked to records on incident asthma from national health registers from 1999 to 2012. Counterfactual mediation analysis was used to examine the effects of multiple ACEs (≥2) on asthma through adulthood risk factors of asthma (mediators). RESULTS Of the 21,902 participants without asthma at baseline, 7552 (34%) were exposed to multiple ACEs during childhood. During the follow-up period, 2046 participants were diagnosed with incident asthma. Exposure to multiple ACEs increased the risk of asthma onset by 31% compared with ≤1 ACE. The association between ACEs and asthma onset was partly mediated by the following adulthood risk factors: severe life events (29%), smoking (15%), allergic rhinitis (8%), low education level (6%), and obesity (3%). Specific stressful life events mediating the ACE-asthma association were 'severe financial difficulties' (24%), 'emotional, physical or sexual violence' (15%), 'major increase in marital problems' (8%), 'severe conflicts with supervisor' (7%), and 'divorce or separation' (5%). CONCLUSIONS Exposure to multiple ACEs increased the risk of asthma in adulthood. Adulthood risk factors of asthma mediated a significant proportion of the effect of ACEs on the risk of asthma onset.
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Affiliation(s)
- Raija Lietzén
- Department of Public Health, University of Turku and Turku University Hospital, Turku, Finland.
| | - Sakari Suominen
- Department of Public Health, University of Turku and Turku University Hospital, Turku, Finland; University of Skövde, School of Health Sciences, Department of Public Health, Sweden.
| | - Lauri Sillanmäki
- Department of Public Health, University of Turku and Turku University Hospital, Turku, Finland; Department of Public Health, University of Helsinki, Finland.
| | - Pekka Virtanen
- Faculty of Social Sciences, Tampere University, Tampere, Finland.
| | - Marianna Virtanen
- School of Educational Sciences and Psychology, University of Eastern Finland, Joensuu, Finland.
| | - Jussi Vahtera
- Department of Public Health, University of Turku and Turku University Hospital, Turku, Finland; Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland.
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McLoughlin RF, Berthon BS, Wood LG. Weight loss in obese children with asthma - is it important? Paediatr Respir Rev 2021; 37:10-14. [PMID: 32303450 DOI: 10.1016/j.prrv.2020.02.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 02/28/2020] [Indexed: 12/12/2022]
Abstract
Obesity is a significant public health problem worldwide, and it has been identified as an independent risk factor for asthma in both adults and children. Not only does obesity increase asthma risk, but it is also associated with decreased asthma-related quality of life, worsened symptoms and asthma control, increased frequency and severity of asthma exacerbations and reduced response to asthma medications. In this review we examine the epidemiology and implications of obesity in both children and adults with asthma, and how the obesogenic "western" diet contributes to asthma prevalence and progression. Finally, we summarise the current evidence on the impact of weight loss on asthma outcomes in both adults and children, highlighting the need for further research to be conducted in the paediatric population.
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Affiliation(s)
- Rebecca F McLoughlin
- Priority Research Centre for Healthy Lungs, Hunter Medical Research Institute, University of Newcastle, NSW, Australia.
| | - Bronwyn S Berthon
- Priority Research Centre for Healthy Lungs, Hunter Medical Research Institute, University of Newcastle, NSW, Australia.
| | - Lisa G Wood
- Priority Research Centre for Healthy Lungs, Hunter Medical Research Institute, University of Newcastle, NSW, Australia.
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40
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Cartanyà-Hueso À, González-Marrón A, Lidón-Moyano C, Garcia-Palomo E, Martín-Sánchez JC, Martínez-Sánchez JM. Association between Leisure Screen Time and Junk Food Intake in a Nationwide Representative Sample of Spanish Children (1-14 Years): A Cross-Sectional Study. Healthcare (Basel) 2021; 9:healthcare9020228. [PMID: 33670729 PMCID: PMC7922666 DOI: 10.3390/healthcare9020228] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 02/03/2021] [Accepted: 02/11/2021] [Indexed: 11/17/2022] Open
Abstract
Evidence on the association between new patterns of leisure screen time and junk food consumption in Spanish children at the national level is scarce. The aim of this study is to assess the relation between daily leisure screen time and the frequency of sweet, soft drink, fast food, and snack intake in a representative sample of Spanish children and adolescents aged from 1 to 14 years. We conducted a cross-sectional study using a representative sample of the Spanish population under 15 years recruited for the 2017 Spanish National Health Survey (n = 5480). We dichotomized sweet, soft drink, fast food, and snack intake (high/low) and categorized daily leisure screen time (0–59, 60–119, 120–179, and ≥180 min). We calculated crude prevalence ratios and adjusted prevalence ratios, and their 95% confidence intervals (95% CI), of high frequency of sweet, soft drink, fast food, and snack intake. Children spending at least one hour of daily leisure screen time had higher prevalence of high frequency of sweet and snack intake than children being exposed less than one hour. For soft drinks and fast food, prevalence of high frequency intake was significantly higher from two and three hours of exposure, respectively. Longer periods of screen exposure in Spanish children during their leisure time may be associated with poorer dietary behaviors. The negative effects of excessive screen time in pediatrics population should be further studied.
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Mei K, Huang H, Xia F, Hong A, Chen X, Zhang C, Qiu G, Chen G, Wang Z, Wang C, Yang B, Xiao Q, Jia P. State-of-the-art of measures of the obesogenic environment for children. Obes Rev 2021; 22 Suppl 1:e13093. [PMID: 32725754 PMCID: PMC7988549 DOI: 10.1111/obr.13093] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 06/17/2020] [Indexed: 11/27/2022]
Abstract
Various measures of the obesogenic environment have been proposed and used in childhood obesity research. The variety of measures poses methodological challenges to designing new research because methodological characteristics integral to developing the measures vary across studies. A systematic review has been conducted to examine the associations between different levels of obesogenic environmental measures (objective or perceived) and childhood obesity. The review includes all articles published in the Cochrane Library, PubMed, Web of Science and Scopus by 31 December 2018. A total of 339 associations in 101 studies have been identified from 18 countries, of which 78 are cross-sectional. Overall, null associations are predominant. Among studies with non-null associations, negative relationships between healthy food outlets in residential neighbourhoods and childhood obesity is found in seven studies; positive associations between unhealthy food outlets and childhood obesity are found in eight studies, whereas negative associations are found in three studies. Measures of recreational or physical activity facilities around the participants' home are also negatively correlated to childhood obesity in nine out of 15 studies. Results differ by the types of measurement, environmental indicators and geographic units used to characterize obesogenic environments in residential and school neighbourhoods. To improve the study quality and compare reported findings, a reporting standard for spatial epidemiological research should be adopted.
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Affiliation(s)
- Kun Mei
- Health Assessment Center, Wenzhou Medical University, Wenzhou, China.,Zhejiang Provincial Key Laboratory of Watershed Science and Health, School of Public Health and Management, Wenzhou Medical University, Wenzhou, China
| | - Hong Huang
- Health Assessment Center, Wenzhou Medical University, Wenzhou, China.,Zhejiang Provincial Key Laboratory of Watershed Science and Health, School of Public Health and Management, Wenzhou Medical University, Wenzhou, China
| | - Fang Xia
- School of Life Science, Shaoxing University, Shaoxing, China
| | - Andy Hong
- The George Institute for Global Health, University of Oxford, Oxford, UK.,International Institute of Spatial Lifecourse Epidemiology (ISLE), Hong Kong, China
| | - Xiang Chen
- Department of Geography, University of Connecticut, Storrs, Connecticut, USA
| | - Chi Zhang
- Zhejiang Provincial Key Laboratory of Watershed Science and Health, School of Public Health and Management, Wenzhou Medical University, Wenzhou, China
| | - Ge Qiu
- International Institute of Spatial Lifecourse Epidemiology (ISLE), Hong Kong, China
| | - Gang Chen
- Zhejiang Provincial Key Laboratory of Watershed Science and Health, School of Public Health and Management, Wenzhou Medical University, Wenzhou, China
| | - Zhenfeng Wang
- Health Assessment Center, Wenzhou Medical University, Wenzhou, China.,Zhejiang Provincial Key Laboratory of Watershed Science and Health, School of Public Health and Management, Wenzhou Medical University, Wenzhou, China
| | - Chongjian Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Bo Yang
- Institute of Lipids Medicine, Wenzhou Medical University, Wenzhou, China.,School of Public Health, Wenzhou Medical University, Wenzhou, China
| | - Qian Xiao
- International Institute of Spatial Lifecourse Epidemiology (ISLE), Hong Kong, China.,Department of Epidemiology, Human Genetics, and Environmental Sciences, The University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Peng Jia
- Health Assessment Center, Wenzhou Medical University, Wenzhou, China.,International Institute of Spatial Lifecourse Epidemiology (ISLE), Hong Kong, China.,Department of Land Surveying and Geo-Informatics, The Hong Kong Polytechnic University, Hong Kong, China.,Faculty of Geo-information Science and Earth Observation, University of Twente, Enschede, The Netherlands
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Kelley GA, Kelley KS, Pate RR. Inter-individual differences in body mass index were not observed as a result of aerobic exercise in children and adolescents with overweight and obesity. Pediatr Obes 2021; 16:e12692. [PMID: 32657544 DOI: 10.1111/ijpo.12692] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 04/09/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND Exercise has been recommended as an important intervention for reducing adiposity in children and adolescents with overweight and obesity. OBJECTIVE Determine whether inter-individual differences exist in relation to exercise-induced changes in adiposity among children and adolescents with overweight and obesity. METHODS Meta-analysis of randomized controlled aerobic exercise trials and body mass index (BMI) in kg · m-2 . Change outcome standard deviations were pooled using the inverse-variance heterogeneity model. RESULTS Twenty-eight studies (1185 participants) were included. Inter-individual differences in BMI were -0.1 (95% compatibility interval, -0.7 to 0.7). The 95% prediction interval for inter-individual responses in a future study was -2.9 to 2.9. The probability of a clinically meaningful difference in variability was 29% (possibly clinically important) in favour of controls vs exercisers. CONCLUSIONS Inter-individual differences for BMI in kg · m-2 were not observed as a result of aerobic exercise in children and adolescents with overweight and obesity.
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Affiliation(s)
- George A Kelley
- School of Public Health, Department of Biostatistics, Robert C. Byrd Health Sciences Center, West Virginia University, Morgantown, West Virginia, USA
| | - Kristi S Kelley
- School of Public Health, Department of Biostatistics, Robert C. Byrd Health Sciences Center, West Virginia University, Morgantown, West Virginia, USA
| | - Russell R Pate
- Children's Physical Activity Research Group, Department of Exercise Science, University of South Carolina, Columbia, South Carolina, USA
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Serhal S, Saini B, Bosnic-Anticevich S, Krass I, Wilson F, Armour C. Medication Adherence in a Community Population with Uncontrolled Asthma. PHARMACY 2020; 8:pharmacy8040183. [PMID: 33036454 PMCID: PMC7711630 DOI: 10.3390/pharmacy8040183] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 09/29/2020] [Accepted: 10/03/2020] [Indexed: 12/12/2022] Open
Abstract
It is well documented that the use of medications in asthma and allergic rhinitis is often suboptimal, and consequently, patients remain symptomatic. This study aimed to determine the extent and type of medication-related issues contributing to poor asthma control by profiling medication management in those most at risk—a population with clinically uncontrolled asthma. Participants (n = 363) were recruited from Australian community pharmacies, and a dispensed medication history report for the previous 12 months was collected to examine medication adherence and factors affecting adherence. Information was also collected regarding participant asthma control and asthma/allergic rhinitis (if applicable) management. The participants’ mean asthma control score was 2.49 (± 0.89 SD, IQR = 1.20) (score ≥ 1.5 indicative of poorly controlled asthma), and 72% were either non-adherent or yet to initiate preventer therapy. Almost half had been prescribed high doses of inhaled corticosteroid and 24% reported use of oral corticosteroids. Only 22% of participants with concomitant allergic rhinitis were using first line treatment. A logistic regression model highlighted that participant health care concession status and hospital admissions were associated with better adherence. Suboptimal medication management is evident in this at-risk population.
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Affiliation(s)
- Sarah Serhal
- Woolcock Institute of Medical Research, 431 Glebe Point Road, Glebe, NSW 2031, Australia; (B.S.); (S.B.-A.); (F.W.); (C.A.)
- Correspondence: ; Tel.: +61-4-1495-9883
| | - Bandana Saini
- Woolcock Institute of Medical Research, 431 Glebe Point Road, Glebe, NSW 2031, Australia; (B.S.); (S.B.-A.); (F.W.); (C.A.)
- School of Pharmacy, The University of Sydney, A15, Science Rd, Camperdown, NSW 2006, Australia;
| | - Sinthia Bosnic-Anticevich
- Woolcock Institute of Medical Research, 431 Glebe Point Road, Glebe, NSW 2031, Australia; (B.S.); (S.B.-A.); (F.W.); (C.A.)
- School of Medical Sciences, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW 2006, Australia
| | - Ines Krass
- School of Pharmacy, The University of Sydney, A15, Science Rd, Camperdown, NSW 2006, Australia;
| | - Frances Wilson
- Woolcock Institute of Medical Research, 431 Glebe Point Road, Glebe, NSW 2031, Australia; (B.S.); (S.B.-A.); (F.W.); (C.A.)
| | - Carol Armour
- Woolcock Institute of Medical Research, 431 Glebe Point Road, Glebe, NSW 2031, Australia; (B.S.); (S.B.-A.); (F.W.); (C.A.)
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Al Heialy S, Gaudet M, Ramakrishnan RK, Mogas A, Salameh L, Mahboub B, Hamid Q. Contribution of IL-17 in Steroid Hyporesponsiveness in Obese Asthmatics Through Dysregulation of Glucocorticoid Receptors α and β. Front Immunol 2020; 11:1724. [PMID: 32849611 PMCID: PMC7417474 DOI: 10.3389/fimmu.2020.01724] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 06/29/2020] [Indexed: 12/18/2022] Open
Abstract
Obesity is on the rise worldwide and is one of the most common comorbidities of asthma. The chronic inflammation seen in obesity is believed to contribute to this process. Asthma and obesity are associated with a poorer prognosis, more frequent exacerbations, and poor asthma control to standard controller medication. Difficult-to-treat asthma is associated with increased levels of Th17 cytokines which have been shown to play a central role in the upregulation of glucocorticoid receptor-beta (GR-β), a dominant-negative inhibitor of the classical GR-α. In this study, we studied the role of IL-17 cytokines in steroid hyporesponsiveness in obese asthmatics. We stimulated lean and obese adipocytes with IL-17A and IL-17F. Adipocytes obtained from obese patients cultured in vitro in the presence of IL-17A for 48 h showed a decrease in GRα/GRβ ratio as compared to adipocytes from lean subjects where GR-α/GR-β ratio was increased following IL-17A and IL-17F stimulation. At protein level, GR-β was increased in obese adipocytes with IL-17A and IL-17F stimulation. IL-8 and IL-6 expression was increased in IL-17-stimulated obese adipocytes. Pre-incubation with Dexamethasone (Dexa) led to a decrease in GR-α/GR-β ratio in obese adipocytes which was further affected by IL-17A whereas Dexa led to an increase in GR-α/GR-β ratio in lean adipocytes which was decreased in response to IL-17A. TGF-β mRNA expression was decreased in obese adipocytes in response to Th17 cytokines. We next sought to validate these findings in obese asthmatic patients. Serum obtained from obese asthmatic subjects showed a decrease in GRα/GRβ protein expression with an increase in IL-17F and IL-13 as compared to serum obtained from non-obese asthmatics. In conclusion, steroid hyporesponsiveness in obese asthmatic patients can be attributed to Th17 cytokines which are responsible for the dysregulation of the GRα/GRβ ratio and the inflammatory response.
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Affiliation(s)
- Saba Al Heialy
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates.,Meakins-Christie Laboratories, Research Institute of the McGill University Healthy Center, Montreal, QC, Canada
| | - Mellissa Gaudet
- Meakins-Christie Laboratories, Research Institute of the McGill University Healthy Center, Montreal, QC, Canada
| | - Rakhee K Ramakrishnan
- Sharjah Institute for Medical Research, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Andrea Mogas
- Meakins-Christie Laboratories, Research Institute of the McGill University Healthy Center, Montreal, QC, Canada
| | - Laila Salameh
- Sharjah Institute for Medical Research, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates.,Pulmonary Medicine Department, Rashid Hospital, Dubai, United Arab Emirates
| | - Bassam Mahboub
- Sharjah Institute for Medical Research, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates.,Pulmonary Medicine Department, Rashid Hospital, Dubai, United Arab Emirates
| | - Qutayba Hamid
- Meakins-Christie Laboratories, Research Institute of the McGill University Healthy Center, Montreal, QC, Canada.,Sharjah Institute for Medical Research, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
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45
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Quirós-Alcalá L, Hansel NN, McCormack M, Calafat AM, Ye X, Peng RD, Matsui EC. Exposure to bisphenols and asthma morbidity among low-income urban children with asthma. J Allergy Clin Immunol 2020; 147:577-586.e7. [PMID: 32736870 DOI: 10.1016/j.jaci.2020.05.031] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 03/24/2020] [Accepted: 05/06/2020] [Indexed: 12/25/2022]
Abstract
BACKGROUND Bisphenol A (BPA) has been linked with pediatric asthma development and allergic airway inflammation in animal models. Whether exposure to BPA or its structural analogs bisphenol S (BPS) and bisphenol F (BPF) is associated with asthma morbidity remains unknown. OBJECTIVE We examined associations between bisphenols and morbidity due to pediatric asthma. METHODS We quantified concentrations of BPA, BPS, and BPF in 660 urine samples from 148 predominantly low-income, African American children (aged 5-17 years) with established asthma. We used biobanked biospecimens and data on symptoms, health care utilization, and pulmonary function and inflammation that were collected every 3 months over the course of a year. We used generalized estimating equations to examine associations between concentrations or detection of urinary bisphenols and morbidity outcomes and assessed heterogeneity of associations by sex. RESULTS We observed consistent positive associations between BPA exposure and measures of asthma morbidity. For example, we observed increased odds of general symptom days (adjusted odds ratio [aOR] = 1.40 [95% C = 1.02-1.92]), maximal symptom days (aOR = 1.36 [95% CI = 1.00-1.83]), and emergency department visits (aOR = 2.12 [95% CI =1.28-3.51]) per 10-fold increase in BPA concentration. We also observed evidence of sexually dimorphic effects; BPA concentrations were associated with increased odds of symptom days and health care utilization only among boys. Findings regarding BPS and BPF did not consistently point to associations with asthma symptoms or health care utilization. CONCLUSION We found evidence to suggest that BPA exposure in a predominantly low-income, minority pediatric cohort is associated with asthma morbidity and that associations may differ by sex. Our findings support additional studies, given the high pediatric asthma burden and widespread exposure to BPA in the United States.
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Affiliation(s)
- Lesliam Quirós-Alcalá
- Department of Environmental Health and Engineering, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Md; Maryland Institute of Applied Environmental Health, School of Public Health, University of Maryland, College Park, Md.
| | - Nadia N Hansel
- School of Medicine, Johns Hopkins University, Baltimore, Md
| | | | - Antonia M Calafat
- National Center for Environmental Health, US Centers for Disease Control and Prevention, Atlanta, Ga
| | - Xiaoyun Ye
- National Center for Environmental Health, US Centers for Disease Control and Prevention, Atlanta, Ga
| | - Roger D Peng
- Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Md
| | - Elizabeth C Matsui
- School of Medicine, Johns Hopkins University, Baltimore, Md; Dell Medical School, University of Texas, Austin, Tex
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Tavalire HF, Budd EL, Natsuaki MN, Neiderhiser JM, Reiss D, Shaw DS, Ganiban JM, Leve LD. Using a sibling-adoption design to parse genetic and environmental influences on children's body mass index (BMI). PLoS One 2020; 15:e0236261. [PMID: 32687510 PMCID: PMC7371159 DOI: 10.1371/journal.pone.0236261] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Accepted: 07/01/2020] [Indexed: 12/13/2022] Open
Abstract
Dietary and physical activity behaviors formed early in life can increase risk for childhood obesity and have continued negative consequences for lifelong health. Previous research has highlighted the importance of both genetic and environmental (e.g., cultural environment or parental lifestyle) contributions to obesity risk, although these studies typically involve genetically-related individuals residing in the same household, where genetic similarity and rearing environment are inextricably linked. Here we utilize a sibling-adoption design to independently estimate genetic and environmental contributions to obesity risk in childhood and describe how these influences might vary as children age. As part of a prospective adoption study, the current investigation used data from biological siblings reared either apart or together, and nonbiological siblings reared together to estimate the contributions of genetics and environment to body mass indices (BMI) in a large cohort of children (N = 711). We used a variance partitioning model to allocate variation in BMI to that which is due to shared genetics, common environment, or unique environment in this cohort during middle childhood and adolescence. We found 63% of the total variance in BMI could be attributed to heritable factors in middle childhood sibling pairs (age 5-11.99; 95% CI [0.41,0.85]). Additionally, we observed that common environment explained 31% of variation in BMI in this group (95% CI [0.11,0.5]), with unique environment and error explaining the remaining variance. We failed to detect an influence of genetics or common environment in older sibling pairs (12-18) or pairs spanning childhood and adolescence (large sibling age difference), but home type (adoptive versus birth) was an important predictor of BMI in adolescence. The presence of strong common environment effects during childhood suggests that early interventions at the family level in middle childhood could be effective in mitigating obesity risk in later childhood and adolescence.
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Affiliation(s)
- Hannah F. Tavalire
- Prevention Science Institute, University of Oregon, Eugene, Oregon, United States of America
- Instutite of Ecology and Evolution, University of Oregon, Eugene, Oregon, United States of America
| | - Elizabeth L. Budd
- Prevention Science Institute, University of Oregon, Eugene, Oregon, United States of America
- Counseling Psychology and Human Services Department, College of Education, University of Oregon, Eugene, Oregon, United States of America
| | - Misaki N. Natsuaki
- Department of Psychology, University of California, Riverside, California, United States of America
| | - Jenae M. Neiderhiser
- Department of Psychology, The Pennsylvania State University, University Park, Pennsylvania, United States of America
| | - David Reiss
- Child Study Center, Yale University, New Haven, Connecticut, United States of America
| | - Daniel S. Shaw
- Department of Psychology, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Jody M. Ganiban
- Department of Psychology, George Washington University, Washington, DC, United States of America
| | - Leslie D. Leve
- Prevention Science Institute, University of Oregon, Eugene, Oregon, United States of America
- Counseling Psychology and Human Services Department, College of Education, University of Oregon, Eugene, Oregon, United States of America
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47
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Kaczynski AT, Eberth JM, Stowe EW, Wende ME, Liese AD, McLain AC, Breneman CB, Josey MJ. Development of a national childhood obesogenic environment index in the United States: differences by region and rurality. Int J Behav Nutr Phys Act 2020; 17:83. [PMID: 32615998 PMCID: PMC7330993 DOI: 10.1186/s12966-020-00984-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Accepted: 06/10/2020] [Indexed: 11/24/2022] Open
Abstract
Background Diverse environmental factors are associated with physical activity (PA) and healthy eating (HE) among youth. However, no study has created a comprehensive obesogenic environment index for children that can be applied at a large geographic scale. The purpose of this study was to describe the development of a childhood obesogenic environment index (COEI) at the county level across the United States. Methods A comprehensive search of review articles (n = 20) and input from experts (n = 12) were used to identify community-level variables associated with youth PA, HE, or overweight/obesity for potential inclusion in the index. Based on strength of associations in the literature, expert ratings, expertise of team members, and data source availability, 10 key variables were identified – six related to HE (# per 1000 residents for grocery/superstores, farmers markets, fast food restaurants, full-service restaurants, and convenience stores; as well as percentage of births at baby (breastfeeding)-friendly facilities) and four related to PA (percentage of population living close to exercise opportunities, percentage of population < 1 mile from a school, a composite walkability index, and number of violent crimes per 1000 residents). Data for each variable for all counties in the U.S. (n = 3142) were collected from publicly available sources. For each variable, all counties were ranked and assigned percentiles ranging from 0 to 100. Positive environmental variables (e.g., grocery stores, exercise opportunities) were reverse scored such that higher values for all variables indicated a more obesogenic environment. Finally, for each county, a total obesogenic environment index score was generated by calculating the average percentile for all 10 variables. Results The average COEI percentile ranged from 24.5–81.0 (M = 50.02,s.d. = 9.01) across US counties and was depicted spatially on a choropleth map. Obesogenic counties were more prevalent (F = 130.43,p < .0001) in the South region of the U.S. (M = 53.0,s.d. = 8.3) compared to the Northeast (M = 43.2,s.d. = 6.9), Midwest (M = 48.1,s.d. = 8.5), and West (M = 48.4,s.d. = 9.8). When examined by rurality, there were also significant differences (F = 175.86,p < .0001) between metropolitan (M = 46.5,s.d. = 8.4), micropolitan (M = 50.3,s.d. = 8.1), and rural counties (M = 52.9,s.d. = 8.8) across the U.S. Conclusion The COEI can be applied to benchmark obesogenic environments and identify geographic disparities and intervention targets. Future research can examine associations with obesity and other health outcomes.
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Affiliation(s)
- Andrew T Kaczynski
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA. .,Prevention Research Center, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA.
| | - Jan M Eberth
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA.,Rural and Minority Health Research Center, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA
| | - Ellen W Stowe
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA
| | - Marilyn E Wende
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA
| | - Angela D Liese
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA
| | - Alexander C McLain
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA
| | - Charity B Breneman
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA
| | - Michele J Josey
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA.,Rural and Minority Health Research Center, Arnold School of Public Health, University of South Carolina, Columbia, SC, 29208, USA
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48
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LeRouge CM, Hah H, Deckard GJ, Jiang H. Designing for the Co-Use of Consumer Health Technology in Self-Management of Adolescent Overweight and Obesity: Mixed Methods Qualitative Study. JMIR Mhealth Uhealth 2020; 8:e18391. [PMID: 32597788 PMCID: PMC7367539 DOI: 10.2196/18391] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 04/05/2020] [Accepted: 05/14/2020] [Indexed: 01/28/2023] Open
Abstract
BACKGROUND Overweight and obesity in adolescents has reached epidemic proportions in the United States. Consumer health technology (CHT) can serve as a behavioral and social support tool for the management of overweight in adolescence. Recognizing CHT as a social support tool during design enables input from multiple stakeholders who engage in shared co-use to reinforce and empower adolescents in their self-management efforts. OBJECTIVE This study aimed to explore design requirements and enabling factors for the use of CHT as a social support tool for patients (as primary users) and parents and health care providers (as co-users). Our model incorporates key components of the unified theory of acceptance and use of technology (UTAUT) within the framework of the obesity care model (OCM) by recognizing patient self-management as the central process with the influence of their care support network on CHT use and outcomes. METHODS This study was part of a larger two-staged usability study combining focus group, semistructured interviews, and usability walkthroughs of CHT mockups from adolescents (BMI in the 85th-99th percentile range), parents, and physicians. In phase 1, 48 adolescents between the ages of 12 and 17 years, 10 of their parents, and 6 health care providers participated in identifying design requirements and enabling factors for the use of a potential CHT. In phase 2, 70 adolescents and 10 health care providers evaluated the CHT mockups and indicated enabling factors and willingness to use the proposed CHT. RESULTS Our qualitative analysis identified adolescents' intention for the use of CHT in alignment with UTAUT elements of performance expectancy, effort expectancy, and facilitating conditions. Our reconceptualization of social influence identified the expectations and envisioned roles of parents and health care providers as co-users and influencing factors on the co-use of CHT in managing overweight in adolescence. Parents were expected to monitor, to provide guidance and motivation, and to suggest modifications in daily habits, for example, recipes and meals, whereas health care providers were expected to encourage and monitor progress in a clinical setting. These expected roles and co-use patterns were congruent among all 3 stakeholders; the co-use of CHT was desired to be minimally invasive for parents and health care providers and controlled by the adolescents. CONCLUSIONS Our study integrates and extends the perspectives of 2 seminal models to explore design features and social influence roles for the successful user-centered design of CHT for weight self-management in adolescents. Although the co-users (ie, adolescents, parents, health care providers) suggested differing features consistent with their roles, role definitions were congruent. All users recognized the adolescent as the primary user with differential, supportive use from parents and health care providers. This multistakeholder approach can guide successful CHT design that reinforces the collective perspective of self-management.
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Affiliation(s)
- Cynthia M LeRouge
- Department of Information Systems and Business Analytics, Florida International University, Miami, FL, United States
| | - Hyeyoung Hah
- Department of Information Systems and Business Analytics, Florida International University, Miami, FL, United States
| | - Gloria J Deckard
- Department of Information Systems and Business Analytics, Florida International University, Miami, FL, United States
| | - Haoqiang Jiang
- College of Informatics, Northern Kentucky University, Highland Heights, KY, United States
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49
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Mhamed SC, Saad AB, Migaou A, Fahem N, Rouatbi N, Joobeur S. [Asthma and obesity: relationship and therapeutic implications in patients with asthma at the Department of Pneumology in Monastir, Tunisia]. Pan Afr Med J 2020; 36:49. [PMID: 32774625 PMCID: PMC7388602 DOI: 10.11604/pamj.2020.36.49.21098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 03/15/2020] [Indexed: 11/11/2022] Open
Abstract
Introduction L’obésité et l’asthme sont deux maladies chroniques touchant des millions d’individus à travers le monde. La présence d’un lien de causalité est suggérée. L'objectif de notre travail est d'étudier le profil de l’asthmatique obèse et de déterminer la relation entre les différents paramètres de sévérité de l’asthme avec les grades de l’obésité. Méthodes Il s'agit d'une étude rétrospective, monocentrique, analytique menée au Service de Pneumologie et d’Allergologie au CHU Fattouma Bourguiba de Monastir portant sur 450 asthmatiques, ayant un indice de masse corporelle (IMC) ≥ 30 kg/m2 avec un recul d’au moins 6 mois. Résultats L’âge moyen au moment du diagnostic était de 45±12.8 ans. L’IMC moyen était de 34,8±4,2 kg/m2. L’asthme était bien contrôlé chez 55,3% des patients. Des critères de sévérité étaient notés dans 37.4% des cas. Selon GINA 2016, 24,2% sont traités par le palier 4. Deux phénotypes de l’asthme associé à l’obésité étaient notés. Le premier phénotype (52,4%) était caractérisé par un asthme à début précoce, associé à une fréquence plus élevée d’allergie, et des manifestations d'atopie. Le deuxième (47,6 %) était caractérisé par un asthme à début tardif, fréquemment associé au sexe féminin et un taux plus élevé de comorbidités et d’hospitalisations. Les obèses de grade II et III avaient un déficit ventilatoire important (CVF: p = 0,002 et VEMS: p = 0,007). Conclusion L’obésité est l’un des facteurs clefs impliqués dans le mauvais contrôle de l’asthme. Sa prise en charge, qui n'est pas encore codifiée, doit être multidisciplinaire.
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Affiliation(s)
- Saousen Cheikh Mhamed
- Service de Pneumologie et d'Allergologie, Hôpital Universitaire Fattouma Bourguiba, Rue 1 juin, 5000 Monastir, Tunisie
| | - Ahmed Ben Saad
- Service de Pneumologie et d'Allergologie, Hôpital Universitaire Fattouma Bourguiba, Rue 1 juin, 5000 Monastir, Tunisie
| | - Asma Migaou
- Service de Pneumologie et d'Allergologie, Hôpital Universitaire Fattouma Bourguiba, Rue 1 juin, 5000 Monastir, Tunisie
| | - Nesrine Fahem
- Service de Pneumologie et d'Allergologie, Hôpital Universitaire Fattouma Bourguiba, Rue 1 juin, 5000 Monastir, Tunisie
| | - Naceur Rouatbi
- Service de Pneumologie et d'Allergologie, Hôpital Universitaire Fattouma Bourguiba, Rue 1 juin, 5000 Monastir, Tunisie
| | - Samah Joobeur
- Service de Pneumologie et d'Allergologie, Hôpital Universitaire Fattouma Bourguiba, Rue 1 juin, 5000 Monastir, Tunisie
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50
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Zhang Y, Chen Z, Berhane K, Urman R, Chatzi VL, Breton C, Gilliland FD. The Dynamic Relationship Between Asthma and Obesity in Schoolchildren. Am J Epidemiol 2020; 189:583-591. [PMID: 31712801 PMCID: PMC7443205 DOI: 10.1093/aje/kwz257] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Revised: 10/28/2019] [Accepted: 10/29/2019] [Indexed: 12/24/2022] Open
Abstract
Asthma and obesity are among the most prevalent chronic health conditions in children. Although there has been compelling evidence of co-occurrence of asthma and obesity, it is uncertain whether asthma contributes to the development of obesity or obesity contributes to the onset of asthma or both. In this study, we used a joint transition modeling approach with cross-lagged structure to understand how asthma and obesity influence each other dynamically over time. Subjects for this study included 5,193 kindergarten and first-grade students enrolled from 13 communities in 2002-2003 in the Southern California Children's Health Study, with up to 10 years of follow-up. We found that nonobese children with diagnosed asthma at a study visit were at 37% higher odds of becoming obese by the next annual visit compared with children without asthma (odds ratio = 1.38; 95% credible interval: 1.12, 1.71). However, the presence of obesity at the current visit was not statistically significantly associated with asthma onset in the next visit (odds ratio = 1.25; 95% credible interval: 0.94, 1.62). In conclusion, childhood asthma appears to drive an increase in the onset of obesity among schoolchildren, while the onset of obesity does not necessarily imply the future onset of asthma, at least in the short term.
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Affiliation(s)
- Yue Zhang
- Department of Internal Medicine, Division of Epidemiology, School of Medicine, University of Utah, Salt Lake City, Utah
- Department of Family and Preventive Medicine, School of Medicine, University of Utah, Salt Lake City, Utah
- Veteran Affairs Salt Lake City Health Care System, Salt Lake City, Utah
| | - Zhanghua Chen
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Kiros Berhane
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Robert Urman
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Vaia Lida Chatzi
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Carrie Breton
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Frank D Gilliland
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California
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