Scholtens Salome, Wijga Alet H, Seidell Jacob C, Brunekreef Bert, de Jongste Johan C, Gehring Ulrike, Postma Dirkje S, Kerkhof Marjan, Smit Henriette A
Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands.
J Allergy Clin Immunol. 2009 Jun;123(6):1312-8.e2. doi: 10.1016/j.jaci.2009.02.029. Epub 2009 May 5.
Asthma may be more prevalent in overweight children. However, how early overweight and changes in weight status during childhood affect the asthma risk is unclear.
To investigate overweight and changes in overweight status in children age 1 to 8 years in relation to asthma symptoms in childhood.
We studied 3756 children who participated in a large birth cohort study. The parents reported their children's weight and height, and wheeze, dyspnea, and prescription of inhaled corticosteroids in yearly questionnaires. Sensitization to inhalant allergens and bronchial hyperresponsiveness (BHR) were determined at 8 years.
At 8 years, 275 children (7.3%) wheezed, 361 (9.6%) had dyspnea, and 268 (7.1%) had a prescription of inhaled corticosteroids in the preceding year. Children who had a persistent high body mass index (BMI, weight/height2) during childhood or a high BMI at 6 to 7 years had a significantly increased risk of dyspnea (adjusted odds ratio, 1.68; 95% CI, 1.18-2.39, for a high BMI at 6-7 years) and measured BHR (adjusted odds ratio, 1.66; 95% CI, 1.10-2.52) at 8 years. Children with a high BMI at a young age, but who developed a normal BMI at 6 to 7 years, did not have an increased risk of dyspnea or BHR at 8 years. BMI was not associated with sensitization.
Children with a current high BMI are at increased risk to have dyspnea and BHR at 8 years. A high BMI at an earlier age is not related to an increased risk if the child has become normal weight at 6 to 7 years.
哮喘在超重儿童中可能更为普遍。然而，儿童期超重出现的时间以及体重状况的变化如何影响哮喘风险尚不清楚。
调查1至8岁儿童的超重情况及其超重状况的变化与儿童期哮喘症状的关系。
我们研究了3756名参与大型出生队列研究的儿童。家长们通过年度问卷报告孩子的体重和身高，以及喘息、呼吸困难和吸入性糖皮质激素的处方情况。在8岁时测定对吸入性过敏原的致敏情况和支气管高反应性（BHR）。
8岁时，275名儿童（7.3%）有喘息症状，361名（9.6%）有呼吸困难，268名（7.1%）在前一年有吸入性糖皮质激素处方。儿童期持续高体重指数（BMI，体重/身高²）或6至7岁时BMI较高的儿童，8岁时出现呼吸困难（校正比值比，1.68；95%可信区间，1.18 - 2.39，6 - 7岁时BMI较高）和测定的BHR（校正比值比，1.66；95%可信区间，1.10 - 2.52）的风险显著增加。年幼时BMI较高但6至7岁时BMI恢复正常的儿童，8岁时出现呼吸困难或BHR的风险并未增加。BMI与致敏无关。
当前BMI较高的儿童在8岁时出现呼吸困难和BHR的风险增加。如果儿童在6至7岁时体重恢复正常，较早年龄时的高BMI与风险增加无关。
