Atopy and pulmonary function among healthy‐weight and overweight/obese children with asthma

Abstract

Introduction Epidemiologic studies have found low/absence of atopy in obese asthmatic children, but the association or lack thereof of atopy with disease morbidity, including pulmonary function, in obese asthma is not well understood. We sought to define the association of atopy with pulmonary function in overweight/obese minority children with asthma. Methods In a retrospective chart review of 200 predominantly minority children evaluated at an academic Pediatric Asthma Center over 5 years, we compared the prevalence of atopy, defined as ≥1 positive skin prick test or serum‐specific immunoglobulin E quantification to environmental allergens, and its association with pulmonary function in overweight/obese (body mass index [BMI] > 85th percentile) (n = 99) to healthy‐weight children (BMI, 5th‐85th percentile for age) (n = 101). Results In a cohort comprised of 47.5% Hispanics and 39.5% African Americans, 81% of overweight/obese and 74% of healthy‐weight children were atopic. While atopic healthy‐weight children had lower percent‐predicted forced expiratory volume in the first second (FEV1) (93 ± 13.6 vs 107% ± 33.2%, P = .03) and lower percent‐predicted forced vital capacity (FVC) (93% ± 12.2% vs 104% ± 16.1%, P = .01) as compared to nonatopic children, atopy was not associated with FEV1 (P = .7) or FVC (P = .17) in overweight/obese children. Adjusting for demographic and clinical variables, atopy was found to be an independent predictor of FEV1 and FVC in healthy‐weight (β = −2.4, P = .07 and β = −1.7, P = .04, respectively) but not in overweight/obese children (β = .6, P = .5 and β = .8, P = .3). Conclusions Atopy is associated with lower lung function in healthy‐weight asthmatics but not in overweight/obese asthmatics, supporting the role of nonallergic mechanisms in disease burden in pediatric obesity‐related asthma.

Comparison of Pulmonary Function and Inflammation in Children/Adolescents with New-Onset Asthma with Different Adiposity Statuses

“…The divergence may be due to the relatively small sample size. These results were in accordance with those of other studies [ 34 , 36 ]. The similar atopic inflammatory profile might further suggest that the standard treatment with inhaled corticosteroids could be effective in obese asthmatic patients.…”

“…The baseline FEF25–75% was significantly reduced in obese patients showing a lower peripheral airflow compared to that in those with normal weight or overweight. Similarly, previous studies also showed a lower FEF25–75% in overweight or obese asthmatic children than in normal-weight children [ 31 , 34 ].…”

Paediatric asthma and non‐allergic comorbidities: A review of current risk and proposed mechanisms

“…These results are further supported by a recent meta‐analysis which found the pooled RR to be 1.47 (95% CI, 1.25, 1.72) 24 . Furthermore, comorbidity was higher in boys, 20,21 black children 25 and physically inactive individuals (Figure 2). 22,26 …”

“…[21][22][23] These results are further supported by a recent meta-analysis which found the pooled RR to be 1.47 (95% CI, 1.25, 1.72). 24 Furthermore, comorbidity was higher in boys, 20,21 black children 25 and physically inactive individuals (Figure 2). 22,26 The mechanisms linking asthma with obesity are unclear, but it is hypothesized that the two conditions may share common etiological pathways.…”

Intermittent Fasting Modulates Immune Response by Generating Tregs via TGF-β Dependent Mechanisms in Obese Mice with Allergic Contact Dermatitis

“…Obesity refers to a state in which excess energy is stored as fat because energy intake is higher than energy consumption. Obesity can cause diseases such as asthma, cardiovascular disease, and diabetes ( Goran et al ., 2003 ; Farhat et al ., 2021 ). Adipose tissues (ATs) contain various immune cells, including T cells generated from the spleen or lymph node (LN), which modulate the immune response and, in turn, influence the metabolism in ATs ( Kohlgruber et al ., 2016 ).…”