Abstract
PurposeAsthma is a highly prevalent noncommunicable lung disease. The aim of this study was to evaluate the longitudinal association of obesity/adiposity with wheezing and atopy.MethodsThe population of the study was composed of participants from the 1993 Pelotas (Brazil) Birth Cohort. The following outcome variables were measured at 22 years: wheezing in the last 12 months, wheezing with atopy, wheezing without atopy, only atopy, and persistent wheezing at 18 and 22 years. Exposure variables were obesity body mass index, percent fat mass (FM), and fat mass index, which were obtained by precise methods (BOD POD and dual-energy X-ray absorptiometry [DXA]). Crude and adjusted logistic and multinomial logistic regressions were used in the analyses.ResultsThe prevalence of wheezing (with and without atopy), wheezing without atopy, only atopy, and persistent wheezing were 10.6%, 3.9%, 30.9%, and 4.0%, respectively. To be obese or to belong to the highest tertile of obesity/adiposity at two follow-ups showed a cumulative and positive association with wheezing in the adjusted analysis; for atopy there was no significant association. The odds ratio (OR) for wheezing according to the percentage of total FM measured by DXA in the highest tertile at both follow-ups was 1.58 (95% CI: 1.14–2.20) against an OR of 1.16 (95% CI: 0.92–1.47) for atopy. Persistent wheezing was also associated with adiposity, but without statistical significance.ConclusionsWe found a positive longitudinal association between several measures of adiposity and wheezing at 22 years old. The effect was higher for cumulative adiposity; the results for atopy were not consistent.
Highlights
Most of the literature shows a direct association between asthma or wheezing and obesity.[1,2,3,4] Two systematic reviews among children[5,6] showed that overweight and obesity are associated with an increased risk of childhood asthma
The outcomes were defined according to the questionnaire of the “International Study of Asthma and Allergies in Childhood Steering Committee”, which has already been validated in Brazil[14,15]: a) presence of wheezing in the last year collected at 22 years, b) wheezing without atopy at 22 years, c) wheezing with atopy, and d) only atopy symptoms
Atopy symptoms were assessed based on binary questions about rhinitis and eczema: 1) “In the last 12 months, have you had any problems with sneezing, runny nose, or stuffy nose without having a flu or a cold?”; 2) “Have you ever had itchy rash, which have appeared and disappeared for at least 6 months? 3) In the last 12 months, have you had these itchy rashes on your skin?”; If the participant answered yes for any of the three questions, we considered that he had atopy symptoms in the last year
Summary
Most of the literature shows a direct association between asthma or wheezing and obesity.[1,2,3,4] Two systematic reviews among children[5,6] showed that overweight and obesity are associated with an increased risk of childhood asthma. Besides the systematic reviews among children, a systematic analysis among adults showed that asthma incidence increases by 50% in overweight/obese subjects with a dose–response relationship without effect of gender.[7].
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