Abstract
BackgroundThe prevalence of asthma and obesity have increased over the last decades. A possible association between these two chronic illnesses has been suggested, since the prevalence of asthmatic symptoms rises with increasing Body Mass Index (BMI). However, asthma is only one of several possible causes of shortness of breath in obese children. The aim of this study is to evaluate the prevalence of overtreatment with asthma medication in a cohort overweight/obese children with respiratory symptoms visiting a pediatric outpatient clinic.MethodsChildren referred to a pediatric outpatient clinic aged ≥4- ≤ 18 years with overweight/obesity (defined as BMI-sds > 1.1) and asthmatic symptoms were included. The diagnosis asthma was evaluated and classified in no, unlikely, probable and confirmed asthma, based on clinical parameters and/or spirometry results. Overtreatment was defined as asthma medication prescribed in participants classified as no or unlikely asthma. And undertreatment as probable or confirmed asthma without asthma medication prescribed .ResultsThree hundred thirty-eight participants were included, of which 92.6% (313/338) had a prescription for asthma medication. Overtreatment was observed in 27.2% (92/338) participants. Nine participants were undertreated.ConclusionMore than 25% overtreatment with asthma medication was observed in a cohort overweight/obese children with asthmatic symptoms. This finding emphasizes that the diagnosis of asthma must be confirmed before commencement of medication. The diagnosis of asthma should be based on standard questionnaires evaluating asthmatic symptoms, lung functions test and regular reassessments. Further studies concerning overtreatment with asthma medication in normal weight pediatric populations are warranted, to evaluate whether overtreatment is specific for overweight/obese children.
Highlights
The prevalence of asthma and obesity have increased over the last decades
On account of an excess of adipose tissue, obesity is characterized by a chronic low-grade systemic inflammation, which can result in asthmatic symptoms [1, 12]
Asthma medication was prescribed in 92.6% (313/ 338) of the participants, and spirometry was performed in 74.3% (251/338)
Summary
A possible association between these two chronic illnesses has been suggested, since the prevalence of asthmatic symptoms rises with increasing Body Mass Index (BMI). The aim of this study is to evaluate the prevalence of overtreatment with asthma medication in a cohort overweight/obese children with respiratory symptoms visiting a pediatric outpatient clinic. Since the prevalence of asthma and obesity have increased over the last decades, a possible association. Due to fat excess in the thoracic compartment there is an increased pulmonary blood volume, leading to impairment of the pulmonary function [1]. Overdiagnosis of asthma is increasingly suggested as cause for the higher prevalence and differences in asthma medication response, due to an enhanced perception of nonspecific symptoms such as dyspnea [5, 11, 13,14,15,16,17,18]
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