Figueroa-Muñoz J I, Chinn S, Rona R J
Department of Public Health Sciences, King's College, 5th Floor, Capital House, 42 Weston Street, London SE1 3QD, UK.
Thorax. 2001 Feb;56(2):133-7. doi: 10.1136/thorax.56.2.133.
There is evidence of a positive association between asthma and obesity in adults and in children. We investigated, in a large sample of English and Scottish primary school children, whether there is a consistent association between fatness and asthma symptoms in Britain.
A cross sectional analysis was made of 18 218 children aged 4-11 years who participated in the 1993 or 1994 surveys of the National Study of Health and Growth (NSHG). Children belonged either to English or Scottish representative samples, or an English inner city sample. Asthma attacks in the previous year, occasional wheeze, or persistent wheeze were the symptoms used in the analysis. Body mass index (BMI) and the sum of triceps and subscapular skinfolds converted to standard deviation scores (SDS) were used to assess levels of fatness.
A total of 14 908 children (81.8%) were included in the analysis. In the multiple logistic analysis BMI and asthma (asthma attacks or wheeze) were associated in the representative sample (OR for the comparison of the 10th and 90th centiles of BMI 1.28, 95% CI 1.11 to 1.48), but sum of skinfolds was unrelated to asthma symptoms in most analyses. The association between asthma and BMI was stronger in girls than in boys in the inner city sample, but less convincingly in the representative sample.
Levels of obesity are associated with asthma symptoms regardless of ethnicity. The association is more consistent for BMI than for sum of skinfolds, partly because obese children are more advanced in their maturation than other children. There is some evidence that, as in adults, the association is stronger in girls than in boys, but only in the multiethnic inner city sample.
有证据表明，成人和儿童的哮喘与肥胖之间存在正相关。我们在大量英格兰和苏格兰小学生样本中，调查了在英国肥胖与哮喘症状之间是否存在一致的关联。
对18218名4至11岁儿童进行了横断面分析，这些儿童参加了1993年或1994年的全国健康与成长研究（NSHG）调查。儿童属于英格兰或苏格兰代表性样本，或一个英格兰内城区样本。分析中使用的症状为前一年的哮喘发作、偶尔喘息或持续喘息。体重指数（BMI）以及肱三头肌和肩胛下皮褶厚度之和转换为标准差分数（SDS），用于评估肥胖程度。
共有14908名儿童（81.8%）纳入分析。在多因素逻辑分析中，代表性样本中BMI与哮喘（哮喘发作或喘息）相关（BMI第10百分位数与第90百分位数比较的OR为1.28，95%CI为1.11至1.48），但在大多数分析中皮褶厚度之和与哮喘症状无关。在内城区样本中，哮喘与BMI之间的关联在女孩中比男孩更强，但在代表性样本中不太明显。
无论种族如何，肥胖水平都与哮喘症状相关。BMI的关联比皮褶厚度之和更一致，部分原因是肥胖儿童比其他儿童成熟度更高。有一些证据表明，与成人一样，这种关联在女孩中比男孩更强，但仅在多民族内城区样本中如此。
