Overweight, Obesity Linked to Asthma Development in Children and Adolescents

This article is part of Pulmonology Advisor‘s coverage of the American Thoracic Society’s International Conference, taking place in San Diego, California. Our staff will report on medical research related to asthma and other respiratory conditions, conducted by experts in the field. Check back regularly for more news from ATS 2018.

SAN DIEGO — Overweight or obese children are more likely to develop new onset asthma compared with normal weight controls, according to research presented at the American Thoracic Society 2018 International Conference held May 18-23 in San Diego, California.

Researchers used data from the PEDSnet clinical research network, consisting of 6 pediatric academic medical centers in the United States. Data were collected from 2009 to 2015 and were analyzed using a retrospective cohort design.

In total, 507,496 children age 2 to 17 without asthma at baseline, including 19.58 million outpatient, inpatient, and emergency department encounters were included in the study.

Each patient with overweight or obesity was randomly matched 1:1 to a normal weight patient based on age at initial visit, sex, race, ethnicity, and insurance status. Researchers compared incident asthma rates in patients with obesity or who were overweight with the matched normal weight controls; asthma during the observation period was defined as 2 or more encounters with a diagnosis of asthma, and 1 or more encounters with an anti-asthma controller prescription. 
 

Over mean observation periods of 4, 4, and 3.9 years in  overweight, obese, and normal weight controls, respectively, researchers identified a prevalence of new asthma diagnosis of 8.5%, 9.7%, and 7.4%, respectively, in each group (P <.001 for all).

Crude rate ratios (RR) for any asthma diagnosis in overweight or obese patients were 1.13 (95% CI, 1.10-1.16) and 1.33 (95% CI, 1.30-1.36; P <.0001 for both), respectively. Asthma incidence was then adjusted for observation period duration and risk ratios were calculated. The authors pointed out that the adjusted risk for new asthma was significantly higher in overweight (RR 1.17, 95% CI, 1.10-1.25) and overweight (RR 1.26, 95% CI, 1.18-1.34) children. However, the adjusted risk for spirometry-confirmed asthma was only significantly increased in obese (RR 1.29) but not overweight (RR 1.9) children. 

“Children with obesity experience a 35% increased risk of new asthma diagnosis,” the researchers concluded. “Future PEDSnet analysis involving pairing of spirometry, comorbidity, and medication data will provide new epidemiologic insights into the relationship between obesity and asthma in children.” The authors emphasized reducing childhood obesity as a “targeted strategy to reduce the epidemic of childhood asthma.”

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Reference

Lang J, Hossain M, Wysocki T, Bunnell T. Effect of obesity on incident childhood asthma: results from the national PEDSnet clinical data research network. Presented at: American Thoracic Society 2018 International Conference; May 18-23, 2018; San Diego, CA. Abstract 4599.