Association between obesity and asthma among teenagers

Effect of childhood BMI on asthma: a systematic review and meta-analysis of case-control studies

Background

Asthma is a multifactorial syndrome that threatens the health of children. Body mass index (BMI) might be one of the potential factors but the evidence is controversial. The aim of this study is to perform a comprehensive meta-analysis to investigate the association between asthma and BMI.

Methods

Electronic databases including, Web of Science, Pubmed, Scopus, Science Direct, ProQuest, up to April 2017, were searched by two researchers independently. The keywords “asthma, body mass index, obesity, overweight, childhood and adolescence” were used. Random and fixed effects models were applied to obtain the overall odds ratios (ORs) and standardized mean difference (SMD). Heterogeneity between the studies was examined using I² and Cochrane Q statistics.

Results

After reviewing 2511 articles, 16 studies were eligible for meta-analysis according to inclusion/exclusion criteria. A meta-analysis from 11 case-control studies revealed OR of asthma and overweight as OR = 1.64; (95% Confidence Interval (CI): 1.13–2.38) and from 14 case-control studies, OR for asthma and obesity was OR = 1.92 (95% CI: 1.39–2.65), which indicated that risk of asthma in overweight and obese children and adolescence was significantly higher (1.64 and 1.92 times) than that of individuals with (p-value < 0.01 for underweight/normal weight in both cases). Furthermore, there was a significant relationship between asthma and BMI > 85 percentile according to SMD SMD = 0.21; (95%CI: 0.03–0.38; p-value = 0.021).

Conclusions

The results showed a significant relationship between BMI (obesity/overweight) and asthma among children and adolescents. It is important to study the confounding factors that affect the relationship between asthma and BMI in future epidemiological researches.

Electronic supplementary material

The online version of this article (10.1186/s12887-018-1093-z) contains supplementary material, which is available to authorized users.

Association of obesity with chronic disease and musculoskeletal factors

SummaryIntroduction:overweight and obesity in adolescents are major public health problems with particular interest, because of their potential association with risk factors for development of diseases. The study aimed to determine the prevalence of overweight and obesity in adolescents in southern Portugal and investigate the association with risk factors for development of cardiovascular, respiratory and musculoskeletal diseases.Methods:the sample consisted of 966 adolescents aged 10 to 16 years. The calculation of body mass index (BMI), evaluation of blood glucose, total cholesterol and triglycerides, blood pressure, spirometry and application of low back pain (LBP) questionnaire were performed.Results:178 (18.4%) adolescents were overweight and 52 (5.4%) obese. None of the variables revealed a statistically significant association with overweight and obesity. The presence of high blood pressure was observed in 200 (20.7%) individuals and hypertension in 158 (16.4%) adolescents. Overweight and obese adolescents are 2.3 times more likely to develop signs of pre-hypertension and hypertension. 559 (57.9%) students had restrictive respiratory disorders and 23 (2.4%) had obstructive disorders. Those who were overweight and obese had 0.64 probability of having restrictive respiratory disorders.Conclusion:there was a high prevalence of overweight and obesity in Portuguese adolescents and these showed a statistically significant relationship with the development of pre-hypertension and hypertension, and restrictive respiratory disorders.

Obesity and asthma: association or epiphenomenon?

OBJECTIVE

To relate obesity and asthma by comparing gender, age, initial classification of asthma, clinical control, basal forced expiratory volume in one second (FEV1) and forced expiratory flow between 25 and 75% (FEF25-75%) with rates of body mass index (BMI) in asthmatic adolescents.

METHODS

Cross-sectional study involving 120 asthmatics patients (1.9 male: 1 female) with a mean age of 14.1 years (9 to 20.1 years of age), classified according to asthma severity and control, and evaluated by spirometry using their basal FEV1 and FEF25-75%. The data were described by frequency, mean and standard deviation or median and range and analyzed by ANOVA, unpaired t test, Fischer's exact test, Kruskal-Wallis and Pearson's correlation, considering significant p<0.05.

RESULTS

There was no difference between gender in relation to the initial classification and the level of asthma control; 91.7% (100 cases) received initial classification as persistent and 106 cases (88.3%) were partially or totally controlled. There was no statistical difference between controlled patients and the others in relation to BMI. No significant correlations were found between zBMI and FEV1 and between zBMI and FEF25-75%, analyzing all patients and only patients with overweight or obese.

CONCLUSIONS

In this study, no significant correlation was found between overweight/obesity and asthma using clinical, anthropometric and spirometric parameters.

A systematic review of the association between obesity and asthma in children

AIM

To provide a comprehensive integration of contemporary studies focusing on the relationship between obesity and asthma in paediatric populations.

BACKGROUND

The simultaneous increase in asthma and obesity prevalence has been widely discussed over the past 20 years. Although studies have discovered a positive correlation between the two, evidence-based findings are needed to develop nursing interventions.

DESIGN

A quantitative systematic review on the literature was conducted from June-December 2011.

DATA SOURCES

An electronic database search was conducted for studies published between January 1966-May 2011. Additional articles were identified through the reference lists of reviewed papers.

REVIEW METHODS

Inclusion/exclusion criteria and quality appraisal were applied to ensure research primarily designed to study the relationship between obesity and asthma in children was included.

RESULTS

The majority of studies support a positive association between obesity and asthma in children. Among correlates recognized as important effect modifiers, gender was the most prominent, with obese girls more likely to have asthma diagnoses than obese boys. Scrutinization of covariates in selected studies revealed that most related to children's demographic characteristics and were inconsistent across the studies.

CONCLUSIONS

This review was designed to integrate contemporary scientific findings on the association between obesity and asthma by including a large number of studies with variant research designs. To identify high-risk groups and develop nursing interventions to help children affected by both epidemics, more interdisciplinary and well-designed investigations focusing on an expanded spectrum of correlates including demographic and behavioural factors are warranted.

Asthma in Mexican school-age children is not associated with passive smoking or obesity

Background

Asthma has increased in various regions of the world. The factors associated with the growth in prevalence are still to be determined.

Objective

To evaluate the degree of association of the prevalence of asthma with passive smoking and obesity in school-children in western Mexico.

Methods

A population-based cross-section analytic study. A stratified random sample of 740 primary school pupils of between 6 and 12 years of age was chosen. Asthma, passive smoking and a background of allergic diseases were identified by means of a standardized questionnaire filled out by the parents of the participants. Obesity was identified by means of the body mass index. Proportional sections of population were estimated and the degree of association between asthma (dependent variable) and the independent variables was evaluated by means of multivariate logistic regression.

Results

The following factors of prevalence were found: asthma 8.1%; obesity 19.9%; background of smoking in the father 6.7% and in the mother 13.3%. There was no significant association to be found with asthma in either passive smoking where one of the parents smoked (p = 0.39) or in obesity (p = 0.09). On the other hand, the background of allergic diseases in the mother showed statistically significant association with asthma in the boys (odds ratio = 3.5, 95% confidence interval 1.4 to 8.59), but not in the girls.

Conclusion

With the exception of the maternal background of allergy, neither obesity nor passive smoking are factors associated with asthma in Mexican children.

Asthma in late adolescents of Western Mexico: prevalence and associated factors

INTRODUCTION

Given the number of changes that occur during late adolescence, it is possible that the behavior of asthma may also be different. The aim of our paper is to determine the prevalence of asthma in a population of late adolescents and its possible association with obesity, tobacco smoke exposure and family history of allergic disease.

METHODS AND SUBJECTS

In a cross-sectional, population-based analytical study design, we selected a stratified random sample of subjects aged 15 to 18. By modeling risk through logistic regression, we assessed the relationship between asthma and the following covariables: gender, obesity, excess weight, family history of allergic disease and tobacco smoke exposure.

RESULTS

1,600 subjects were included, and the following prevalences were identified: asthma 7.8%, obesity 9.6%, active smoking in the father 2 9.8%, active smoking in the mother 18.6% and active smoking habit in the study subjects 15.1%. In the final model, a significant association was found between asthma and the following variables: 1) asthma in the mother (adjusted OR [aOR]=2.95, 95% CI, 1.55 to 5.6); 2) history of allergic rhinitis (aOR=4.66, 95% CI, 2.63 to 8.25); and 3) male sex (aOR=1.48, 95% CI, 1.02 to 2.15). No association was seen with obesity or tobacco smoking of the parents.

CONCLUSION

Our results suggest that maternal history of asthma, personal history of allergic rhinitis and male sex are related with asthma late adolescence, while smoking and being overweight are not.

A review of cardiopulmonary research in Brazilian medical journals: clinical, surgical and epidemiological data

Research in the field of cardiopulmonary disease in Brazil has been very active in recent decades. The combination of PUBMED, SCieLO, open access and online searching has provided a significant increase in the visibility of Brazilian journals. This newly acquired international visibility has in turn resulted in the appearance of more original research reports in the Brazilian scientific press. This review is intended to highlight part of this work for the benefit of the readers of "Clinics." We searched through PUBMED for noteworthy articles published in Brazilian medical journals included in the Journal of Citation Reports of the Institute of Scientific Information to better expose them to our readership. The following journals were examined: "Arquivos Brasileiros de Cardiologia," "Arquivos Brasileiros de Endocrinologia e Metabologia," "Brazilian Journal of Medical and Biological Reviews," "Jornal Brasileiro de Pneumologia," "Jornal de Pediatria," "Revista Brasileira de Cirurgia Cardiovascular," "Revista da Associação Médica Brasileira," Revista da Escola de Enfermagem U.S.P." and "São Paulo Medical Journal." These journals publish original investigations in the field of cardiopulmonary disease. The search produced 71 references, which are briefly examined.

Broncoespasmo induzido pelo exercício em adolescentes asmáticos obesos e não-obesos

OBJETIVO: Avaliar e comparar a frequência e intensidade do broncoespasmo induzido pelo exercício (BIE) em adolescentes asmáticos obesos e não-obesos. MÉTODOS: Estudo transversal e descritivo realizado com 39 adolescentes de ambos os sexos, com idade entre dez e 16 anos, divididos em dois grupos conforme o histórico clínico de asma e/ou rinite alérgica e o índice de massa corporal: asmáticos obesos (n=18); asmáticos não-obesos (n=21). Utilizou-se o teste de broncoprovocação com exercício para a avaliação do BIE, considerando-se positiva uma diminuição do volume expiratório forçado no primeiro segundo (VEF1) >15% do valor pré-exercício. Para avaliar a intensidade e a recuperação do BIE, foram calculadas a queda percentual máxima do VEF1 (QM%VEF1) e a área acima da curva (AAC0-30). A análise estatística utilizou o teste exato de Fischer para comparar a frequência de BIE e o teste de Mann-Whitney para a intensidade e recuperação. Rejeitou-se a hipótese de nulidade se p<0,05. RESULTADOS: Não houve diferença significativa na frequência de BIE entre os grupos de asmáticos obesos (50%) e não-obesos (38%). Entretanto, a queda máxima do VEF1 e a AAC0-30 foram maiores nos asmáticos obesos em comparação aos não-obesos (respectivamente 37,7% e 455 versus 24,5% e 214, p<0,03). CONCLUSÕES: A obesidade não contribuiu para o aumento da frequência do BIE em asmáticos e não-asmáticos, entretanto, a obesidade contribuiu para o aumento da intensidade e do tempo de recuperação da crise de BIE em asmáticos