Childhood obesity in relation to poor asthma control and exacerbations

Abstract

Rational: The relationship between obesity and asthma severity in children is inconsistent across studies. Objectives: To estimate the association between obesity and poor asthma control/ risk of exacerbations in asthmatic children, and to assess whether these associations are different by gender. Methods: A meta-analysis was performed on unpublished data from three North-European pediatric asthma cohorts (BREATHE, PACMAN and PAGES) and 11 previously published studies. Body mass index (BMI) was classified as obesity (BMI≥95th percentile) and non-obesity ( Measurement and main results: In 52,140 asthmatic children and adolescents, there was no statistically significant association between obesity and poor asthma control (OR: 1.17, 95% confidence interval (CI): 0.95-1.45, p-value, 0.15). However obese children compared with non-obese peers had a small but significant increased risk of asthma exacerbations (OR: 1.13, 95% CI: 1.00-1.28; p-value, 0.04). After stratification for gender, the differences in ORs for girls and boys were similar, yet no longer statistically significant. Conclusions: In asthmatic children, obesity is associated with a minor increased risk of asthma exacerbations but not with poor asthma control. Gender does not appear to modify this risk.