Being overweight increases susceptibility to indoor pollutants among urban children with asthma

Abstract

Background Both being overweight and exposure to indoor pollutants, which have been associated with worse health of asthmatic patients, are common in urban minority populations. Whether being overweight is a risk factor for the effects of indoor pollutant exposure on asthma health is unknown. Objectives We sought to examine the effect of weight on the relationship between indoor pollutant exposure and asthma health in urban minority children. Methods One hundred forty-eight children (age, 5–17 years) with persistent asthma were followed for 1 year. Asthma symptoms, health care use, lung function, pulmonary inflammation, and indoor pollutants were assessed every 3 months. Weight category was based on body mass index percentile. Results Participants were predominantly African American (91%) and had public health insurance (85%). Four percent were underweight, 52% were normal weight, 16% were overweight, and 28% were obese. Overweight or obese participants had more symptoms associated with exposure to fine particulate matter measuring less than 2.5 μm in diameter (PM2.5) than normal-weight participants across a range of asthma symptoms. Overweight or obese participants also had more asthma symptoms associated with nitrogen dioxide (NO2) exposure than normal-weight participants, although this was not observed across all types of asthma symptoms. Weight did not affect the relationship between exposure to coarse particulate matter measuring between 2.5 and 10 μm in diameter and asthma symptoms. Relationships between indoor pollutant exposure and health care use, lung function, or pulmonary inflammation did not differ by weight. Conclusion Being overweight or obese can increase susceptibility to indoor PM2.5 and NO2 in urban children with asthma. Interventions aimed at weight loss might reduce asthma symptom responses to PM2.5 and NO2, and interventions aimed at reducing indoor pollutant levels might be particularly beneficial in overweight children.

Mechanisms of Asthma in Obesity. Pleiotropic Aspects of Obesity Produce Distinct Asthma Phenotypes

“…Overweight and obese children are more susceptible to indoor air pollutants, especially particulate matter and nitrogen dioxide, than are lean children (63). We have reported that in nonobese mouse models, nitrogen dioxide inhalation causes allergic asthma-like disease through NLRP3 and IL-1 signaling (64) and inherent asthma-like disease through activation of the transcription factor nuclear factor-kB (NF-kB) in the airway epithelium (65).…”

Obesity and Asthma

“…In another prospective cohort study, 148 children aged 5 to 17 years with persistent asthma were followed for 1 year during which associations between indoor PM 2.5 and nitrogen dioxide (NO 2 ) levels and respiratory symptoms were examined every 3 months. 73 Overweight children were more susceptible to the pulmonary effects of indoor PM 2.5 and NO 2 , and it was suggested that the combination of a high prevalence of overweight status and high indoor pollutant exposure in urban children with asthma could explain some of the disproportionate asthma morbidity seen in this population.…”

Adipose tissue content and distribution in children and adolescents with bronchial asthma

“…In overweight asthma sufferers who lose weight, the course of the disease improves, and so do respiratory parameters [10]. Excess body weight increases susceptibility to indoor pollutants among children with asthma, which further aggravates the symptoms and complicates treatment [11].…”