Division of Epidemiology & Biostatistics, School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
BMC Public Health. 2011 Jun 14;11:469. doi: 10.1186/1471-2458-11-469.
Factors which determine the development of atopy and the observed rural-urban gradient in its prevalence are not fully understood. High body mass index (BMI) has been associated with asthma and potentially atopy in industrialized countries. In developing countries, the transition from rural to urban areas has been associated with lifestyle changes and an increased prevalence of high BMI; however, the effect of high BMI on atopy remains unknown in this population. We therefore investigated the association between high BMI and atopy among schoolchildren living in rural and urban areas of Ghana.
Data on skin prick testing, anthropometric, parasitological, demographic and lifestyle information for 1,482 schoolchildren aged 6-15 years was collected. Atopy was defined as sensitization to at least one tested allergen whilst the Centres for Disease Control and Prevention (CDC, Atlanta) growth reference charts were used in defining high BMI as BMI ≥ the 85th percentile. Logistic regression was performed to investigate the association between high BMI and atopy whilst adjusting for potential confounding factors.
The following prevalences were observed for high BMI [Rural: 16%, Urban: 10.8%, p < 0.001] and atopy [Rural: 25.1%, Urban: 17.8%, p < 0.001]. High BMI was not associated with atopy; but an inverse association was observed between underweight and atopy [OR: 0.57, 95% CI: 0.33-0.99]. Significant associations were also observed with male sex [Rural: OR: 1.49, 95% CI: 1.06-2.08; Urban: OR: 1.90, 95% CI: 1.30-2.79], and in the urban site with older age [OR: 1.76, 95% CI: 1.00-3.07], family history of asthma [OR: 1.58, 95% CI: 1.01-2.47] and occupational status of parent [OR: 0.33, 95% CI: 0.12-0.93]; whilst co-infection with intestinal parasites [OR: 2.47, 95% CI: 1.01-6.04] was associated with atopy in the rural site. After multivariate adjustment, male sex, older age and family history of asthma remained significant.
In Ghanaian schoolchildren, high BMI was not associated with atopy. Further studies are warranted to clarify the relationship between body weight and atopy in children subjected to rapid life-style changes associated with urbanization of their environments.
导致特应性发展和其流行的城乡梯度的因素尚未完全理解。高身体质量指数（BMI）与工业化国家的哮喘和潜在特应性有关。在发展中国家，从农村到城市地区的过渡与生活方式的改变和高 BMI 的流行有关；然而，高 BMI 对特应性的影响在该人群中尚不清楚。因此，我们研究了加纳农村和城市地区的学龄儿童中高 BMI 与特应性之间的关联。
对 1482 名 6-15 岁学龄儿童的皮肤点刺试验、人体测量学、寄生虫学、人口统计学和生活方式信息进行了数据分析。特应性定义为对至少一种测试过敏原的致敏，而疾病控制和预防中心（亚特兰大）生长参考图表则用于定义高 BMI 为 BMI≥第 85 百分位数。使用逻辑回归来研究高 BMI 与特应性之间的关联，同时调整潜在的混杂因素。
观察到高 BMI 的以下患病率[农村：16%，城市：10.8%，p<0.001]和特应性[农村：25.1%，城市：17.8%，p<0.001]。高 BMI 与特应性无关；但与消瘦之间存在反比关系[OR：0.57，95%CI：0.33-0.99]。男性[农村：OR：1.49，95%CI：1.06-2.08；城市：OR：1.90，95%CI：1.30-2.79]和城市地区年龄较大[OR：1.76，95%CI：1.00-3.07]也存在显著相关性，父母的职业状况[OR：0.33，95%CI：0.12-0.93]和家庭哮喘病史[OR：1.58，95%CI：1.01-2.47]；而农村地区肠道寄生虫的合并感染[OR：2.47，95%CI：1.01-6.04]与特应性有关。在多变量调整后，男性、年龄较大和家庭哮喘病史仍然显著。
在加纳学龄儿童中，高 BMI 与特应性无关。需要进一步研究以阐明与城市化相关的生活方式快速变化对儿童体重和特应性之间的关系。
