Differences in respiratory consultations in primary care between underweight, normal-weight, and overweight children

Janneke Van Leeuwen,Marienke Van Middelkoop,Winifred D Paulis,Bart W Koes,Patrick J E Bindels,Zoubeir El Jaouhari

doi:10.1038/s41533-019-0131-0

Janneke Van Leeuwen, Marienke Van Middelkoop + Show 4 more

Open Access

https://doi.org/10.1038/s41533-019-0131-0

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Abstract

This prospective cohort study investigates whether the suggested association between weight status and respiratory complaints in open populations is also reflected in the frequency of consultations for respiratory complaints at the general practice. Children aged 2–18 years presenting at one of the participating general practices in the Netherlands could be included. Electronic medical files were used to extract data on consultations. Logistic regression analyses and negative binomial regression analyses were used to assess the associations between weight status and the presence, and frequency of respiratory consultations, respectively, during 2-year follow-up. Subgroup analyses were performed in children aged 2–6, 6–12, and 12–18 years old. Of the 617 children, 115 (18.6%) were underweight, 391 (63.4%) were normal-weight, and 111 (18%) were overweight. Respiratory consultations were not more prevalent in underweight children compared to normal-weight children (odds ratio (OR) 0.87, 95% confidence inteval (CI) 0.64–1.10), and in overweight children compared to normal-weight children (OR 1.33, 95% CI 0.99–1.77). Overweight children aged 12–18 years had more respiratory consultations (OR 2.14, 95% CI 1.14–4.01), more asthma-like consultations (OR 3.94, 95%CI 1.20–12.88), and more respiratory allergy-related consultations (OR 3.14, 95% CI 1.25–7.86) than normal-weight children. General practitioners should pay attention to weight loss as part of the treatment of respiratory complaints in overweight and obese children.

Highlights

Pediatric underweight, overweight, and obesity are, among other diseases, associated with respiratory diseases and symptoms, such as asthma and allergic rhinitis.[1,2,3,4,5] Previous studies have shown a ushaped association between weight status and prevalence of asthma.[3,5] Several underlying mechanisms have been suggested for the higher prevalence of asthma in obese children.[6,7] One of these include that high body weight may exacerbate airway inflammation, which may contribute to the development of asthma.[8]
This study investigated the association between weight status and the number of respiratory consultations in general, and specific respiratory consultations at the general practitioner (GP), which include asthmalike consultations, respiratory inflammatory consultations, and respiratory allergy-related consultations
No significant differences were found in the number of children visiting the GP with at least one respiratory complaint between underweight and normal-weight children, and overweight and normal-weight children during 2 years of follow-up

Summary

Introduction

Overweight, and obesity are, among other diseases, associated with respiratory diseases and symptoms, such as asthma and allergic rhinitis.[1,2,3,4,5] Previous studies have shown a ushaped association between weight status and prevalence of asthma.[3,5] Several underlying mechanisms have been suggested for the higher prevalence of asthma in obese children.[6,7] One of these include that high body weight may exacerbate airway inflammation, which may contribute to the development of asthma.[8] Symptoms of asthma in overweight and obese children are partly due to the excess weight itself, and its accompanying fat deposition in the upper body, abdomen, and upper airways.[9] Besides asthma, obesity is linked to atopy, like allergic rhinitis; the evidence for this association is contradicting.[8,10,11]

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