Effects of age, sex, race/ethnicity, and allergy status in obesity‐related pediatric asthma

Lang, Jason E.; Bunnell, H. Timothy; Lima, John J.; Hossain, Jobayer; Wysocki, Tim; Bacharier, Leonard B.; Ulrich, Lisa; Test, M.; Forrest, Christopher B.

doi:10.1002/ppul.24470

Cited by 21 publications

(19 citation statements)

References 25 publications

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“…Although childhood obesity is indeed considered a global epidemic, few studies have assessed adiposity measures thoroughly, showing inconsistent results. Furthermore, epidemiological studies in children demonstrated that the risk of newly diagnosed asthma is not constant across the pediatric populations [ 19 ]. Several common disease-modifying factors including age, sex, ethnicity, the development of atopic conditions, and metabolic alterations significantly affect the onset and phenotypic characteristics of asthma [ 20 , 21 ].…”

Section: Resultsmentioning

confidence: 99%

Asthma and Obesity in Children

et al. 2020

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Asthma and obesity are two major chronic diseases in children and adolescents. Recent scientific evidence points out a causative role of obesity in asthma predisposition. However, studies assessing the real impact of excessive weight gain on lung function in children have shown heterogeneous results. In this review, the pathological mechanisms linking obesity and development of asthma in children are summarized and factors influencing this relationship are evaluated. Common disease modifying factors including age, sex, ethnicity, development of atopic conditions, and metabolic alterations significantly affect the onset and phenotypic characteristics of asthma. Given this, the impact of these several factors on the obesity–asthma link were considered, and from revision of the literature we suggest the possibility to define three main clinical subtypes on the basis of epidemiological data and physiological–molecular pathways: obese-asthmatic and atopy, obese-asthmatic and insulin-resistance, and obese-asthmatic and dyslipidemia. The hypothesis of the different clinical subtypes characterizing a unique phenotype might have an important impact for both future clinical management and research priorities. This might imply the necessity to study the obese asthmatic child with a “multidisciplinary approach”, evaluating the endocrinological and pneumological aspects simultaneously. This different approach might also make it possible to intervene earlier in a specific manner, possibly with a personalized and tailored treatment. Surely this hypothesis needs longitudinal and well-conducted future studies to be validated.

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Section: Resultsmentioning

confidence: 99%

Asthma and Obesity in Children

et al. 2020

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“…Sex and age are important confounders both in FA 14,21 and asthma. 22,23 Nevertheless, to verify this possibility in our database several linear models were designed to examine the effect of our predictors on the dependent variables. Comparing the effect of all the predictors on the other predictors' linear regression coefficients confirmed that age and sex were the two confounding variables present in our database.…”

Section: Discussionmentioning

confidence: 99%

“…For this matter, we ensured that all residual distributions were normal and checked variance equality with the Levene test. The literature suggests that both FA 21 and asthma 22,23 have different traits in boys and girls when studied separately. Consequently, normalization for sex was obtained through stratification into boys and girls.…”

Section: Discussionmentioning

confidence: 99%

“…We would also like to highlight that pre-and post-normalization data has been presented and analyzed to emphasize the need for this statistical tool. Moreover, a sex-specific approach is recommended in the literature for FA and asthma in children and adolescents, 14,[21][22][23] but it is usually mentioned as a sub-analysis, not included in the primary study design. We can observe in this study how statistically significant differences appear after age and sex normalization that were not present before applying these corrections.…”

Section: Discussionmentioning

confidence: 99%

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Food allergy as an asthma comorbidity in children and adolescents: a practical approach through a real-world study

Esteban-Gorgojo¹,

Gorgojo²,

Sastre

et al. 2021

aei

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Introduction: Several studies have shown interactions between food allergy (FA) and asthma, but the influence of FA in asthma traits has been scarcely studied. Methods: A real-world retrospective observational study was conducted among patients between 3 and 18 years old referred to our Asthma Clinic from November 2014 to November 2017. Data were obtained from daily clinical practice. Only patients properly diagnosed with asthma and FA were included. Results: 815 patients were included: 483 asthmatics and 332 non-asthmatics and 180 FA and 635 no FA. Food allergy was statistically more prevalent among asthma patients (p = 0.014). In a high pollen exposure area, Madrid, among subjects with asthma (121 FA, 362 no-FA), sensitization to lipid transfer protein (LTP) (p = 0.016, OR: 3.064, RR: 2.512) and pollen (p = 0.016, OR: 3.064, RR: 2.512) are risk factors to have a concomitant FA diagnosis, whereas sensitization to profilin is not. Peripheral blood eosinophils were higher in subjects with asthma and FA (≥450 eos/µL) than in asthmatics without FA (≤300 eos/µL) (p = 0.031). Blood eosinophilia, using a cut-off >300 eos/µL, was only present in the FA group. Therefore, this trait should be considered when phenotyping a patient as eosinophilic asthma. Sex had an impact on several variables: height, weight, BMI, blood eosinophils count, sensitization profile, and early-onset asthma. Conclusions: Asthma and FA are closely related and the presence of FA should be investigated in every asthma patient. This study shows an association between asthma with concomitant FA and sensitization to pollen and LTP, blood eosinophilia, and growth alterations. Differences between boys and girls were also described, so a sex-specific approach is recommended.

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“…Obesity is an independent risk factor for asthma 2,3 . Obese children with asthma have a substantial clinical and economic healthcare burden.…”

Section: Introductionmentioning

confidence: 99%

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

Farhat

Vos

et al. 2020

Pediatric Pulmonology

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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.

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Effects of age, sex, race/ethnicity, and allergy status in obesity‐related pediatric asthma

Cited by 21 publications

References 25 publications

Asthma and Obesity in Children

Asthma and Obesity in Children

Food allergy as an asthma comorbidity in children and adolescents: a practical approach through a real-world study

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

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