Atopy, but not obesity is associated with asthma severity among children with persistent asthma

Abstract

Background and Objective Obesity is associated with an increased risk of asthma in children. Atopic sensitization is a major risk factor for asthma including severe asthma in children. It is unclear if obesity is associated with worse asthma control or severity in children and how its effects compare to atopy. We sought to examine relationships of weight status and atopy to asthma control and severity among a population of predominantly low income, minority children and adolescents with persistent asthma. Methods A cross-sectional analysis of 832 children and adolescents, age range 5–17 years, with persistent asthma was performed. Clinical assessments included asthma questionnaires of symptoms, asthma severity score, health care utilization and medication treatment step, lung function testing, and skin prick testing as well as measures of adiposity. Data were collected between December 2010 and August 2014 from Johns Hopkins Hospital in Baltimore, MD and Children’s Hospital of Boston, MA. Results Obesity was not associated with worse asthma control or severity in this group of predominantly low income, minority children and adolescents with persistent asthma. However, a greater degree of atopy was associated with lower lung function, higher asthma severity score, and higher medication treatment step. Conclusion Atopy may be a more important risk factor for asthma severity than obesity among low-income minority children and adolescents with persistent asthma living in Northeastern cities in the United States.

Asthma and Obesity during Childhood: A Review of More than an Occasional Association

“…Lu et al report that there was no relation between obesity and worse asthma control or severity in low-income, minority (non-Caucasian) children and adolescents with persistent asthma [40]. Yaşar et al state that no relationship between BMI and asthma control levels could be found [41].…”

Correlations of severity of asthma in children with body mass index, adiponectin and leptin

“…Once asthma occurs, it will bring much inconvenience to the patients’ life and work. Moreover, obesity has not only a greater impact on adults, but also a close correlation with asthma in children . Clinical studies have showed that asthma in children is related to the environment and climate changes, indicating a close correlation with the body system.…”

Special Considerations in Preschool Age

“…Persistent childhood wheezing is associated with atopy, and in turn, atopy is one of the strongest risk factors for later asthma and is related to an increased severity of asthma [32]. Atopic children, especially those with multiple sensitization, with asthma tend to be at higher treatment steps and have decreased lung function and more severe asthma in general [33]. In infants, sensitization to egg and milk typically occurs first, later to be followed by sensitization to other foods and airborne allergens.…”