HEALTH-RELATED QUALITY OF LIFE, LUNG FUNCTION AND ASTHMA CONTROL IN OBESE ASTHMATIC INDIAN CHILDREN

Abstract

Objective: Obesity is a major risk factor for asthma in children. Obese children have an increased risk of asthma; have more frequent and severe exacerbations, decreased lung function, and poor quality of life. However, the relationship between obesity, lung function, and asthma control remains unclear in obese asthmatic Indian children. Therefore, we examined the relationship of body mass index (BMI) with lung function, asthma control, and quality of life in obese asthmatic children. Design and method: Forty-seven children (8–15 years) with asthma according to Global Initiative for Asthma (GINA) guidelines were enrolled in the study from the Pediatric Chest Clinic of All India Institute of Medical Sciences, New Delhi, India. Weight was recorded to the nearest 0.1 kg and height was measured using a stadiometer nearest to 0.1 cm. The measurements of height and weight were used to calculate BMI. BMI derived was categorized by using Z score tables of WHO-BMI for age standards for boys and girls between 5 and 19 years. Lung function was assessed using spirometry parameters (Super spiro MK2 Micro Medical Ltd, UK), HRQoL was assessed using Juniper’s Pediatric Asthma Quality of Life Questionnaire (PAQLQ), and level of asthma control was assessed by Juniper’s Asthma control questionnaire (ACQ). ACQ score ranges from 0 (well controlled) to 6 (extremely poorly controlled). Spearman’s rank correlation analysis was performed to study the relationship between BMI, lung function parameters, PAQLQ score, and asthma control score Results: Obese children had mean (SD) age of 10.7 (2.5) years, BMI = 25.9 ± 7.5 kg/m2, forced expiratory volume-1 second (FEV1)/ forced vital capacity (FVC) was 82.8 ± 10.7%, ACQ score of 1.5 (0.8), and PAQLQ score of 5.5 (1.1).BMI was significantly directly correlated with ACQ score (r = 0.610, p < 0.001), and inversely correlated with predicted FEV1/FVC (r = -0.537, p = 0.002) and PAQLQ score (r = -0.625, p < 0.002). Conclusions: In obese asthmatic children, obesity is associated with a reduction in lung function and poor asthma control, and quality of life. Early weight-loss interventions could play role in preventing obesity and related pulmonary function impairment in asthmatic children.