Abstract
BackgroundChildhood asthma and obesity prevalence have increased in recent years suggesting a potential association. However, the direction of any association is poorly understood and the potential causal-relationship is unknown.MethodsWe examined the association between overweight/obesity, defined by body mass index (BMI) <18 years of age, and subsequent physician-diagnosed incident asthma at least one year after BMI assessment. We sought to explore potential effect modification by sex. PubMed and Embase were searched using keywords and restricted to subjects aged 0–18 years. There were no date or language restrictions. From each study we extracted: authors, publication date, location, overweight/obesity definitions, asthma definitions, number of participants, recruitment duration, description of cohort, follow-up time, adjusted effect estimates (with 95% CI) and estimates of subgroup analysis.ResultsSix prospective cohort studies which focused on children <18 years of age met criteria for inclusion. The combined risk ratio (RR) of overweight was associated with asthma (RR = 1.35; 95% CI = 1.15, 1.58). In boys, the combined RR of overweight on asthma was significant (RR = 1.41; 95% CI = 1.05, 1.88). For girls, when BMI was defined by Z-score, the combined RR of overweight on asthma was also significant (RR = 1.19; 95% CI = 1.06, 1.34). The combined risk ratio (RR) of obesity was associated with asthma in both boys and girls (RR = 1.50; 95% CI = 1.22, 1.83), in boys only (RR = 1.40; 95% CI = 1.01, 1.93) and in girls only (RR = 1.53; 95% CI = 1.09, 2.14).ConclusionsOverweight and, especially, obese children are at increased risk of subsequent physician diagnosed asthma in comparison to normal weight children. Except for sex, no studies reported any other potential effect modifiers. The observed sex effects were inconsistent.
Highlights
Childhood asthma and obesity prevalence have increased in recent years suggesting a potential association
The results suggest that the risk of adult incident-asthma increases with increasing body mass index (BMI) among both men and women it is unclear how each study included in the meta-analysis defined incident asthma
Categorical overweight/ obese variables based on age- and sex-specific percentiles on the CDC or International Obesity Task Force BMI growth charts can be used [5,25]
Summary
Childhood asthma and obesity prevalence have increased in recent years suggesting a potential association. The direction of any association is poorly understood and the potential causal-relationship is unknown Both asthma and obesity have increased in prevalence in recent years which suggests a possible association between the two conditions [1]. Childhood asthma/wheeze and obesity, measured by body mass index (BMI), have been linked in cross-sectional, case–control, and prospective epidemiologic studies. It is unknown whether the obesity and childhood physician-diagnosed. Energy intake and energy expenditure, including appetite and metabolism are regulated by pro-inflammatory mediators that are derived from adipose tissue. Leptin has a pro-inflammatory effect as it is responds to adipose-derived inflammatory cytokines These cytokines include resistin which affects insulin resistance, inflammation and energy homeostasis [16]. Some researchers hypothesize that asthma and obesity may have additive synergistic proinflammatory effects [18]
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