Jay Melanie, Wijetunga N Ari, Stepney Cesalie, Dorsey Karen, Chua Danica Marie, Bruzzese Jean-Marie
Pediatr Allergy Immunol Pulmonol. 2012 Sep;25(3):159-167. doi: 10.1089/ped.2012.0145.
Asthma and obesity, which have reached epidemic proportions, impact urban youth to a great extent. Findings are inconsistent regarding their relationship; no studies have considered asthma management. We explored the association of obesity and asthma-related morbidity, asthma-related health care utilization, and asthma management in urban adolescents with uncontrolled asthma. We classified 373 early adolescents (mean age=12.8 years; 82% Hispanic or Black) from New York City public middle schools into 4 weight categories: normal (body mass index [BMI]<85th percentile); overweight (85th percentile≤BMI<95th percentile); obese (95th percentile≤BMI<97th percentile); and very obese (BMI≥97th percentile). We compared sample obesity prevalence to national estimates, and tested whether weight categories predicted caregiver reported asthma outcomes, adjusting for age and race/ethnicity. Obesity prevalence was 37%, with 28% of the sample being very obese; both rates were significantly higher than national estimates. We found no significant differences in asthma-related health care utilization or asthma management between weight categories, and a few differences in asthma-related morbidity. Relative to normal weight and obese youth, overweight youth had higher odds of never having any days with asthma-related activity limitations. They also had higher odds of never having asthma-related school absences compared with obese youth. Overweight youth with asthma-related activity limitations had more days with limitations compared with normal weight youth. Overweight, but not obese youth, missed more school due to asthma than normal weight youth. Overweight and obesity prevalence was very high in urban, Hispanic, and Black adolescents with uncontrolled asthma, but not strongly associated with asthma-related morbidity, asthma-related health care utilization, or asthma management practices.
哮喘和肥胖已呈流行态势,在很大程度上影响着城市青少年。关于它们之间的关系,研究结果并不一致;尚无研究考虑哮喘管理情况。我们探讨了肥胖与城市中未得到控制的哮喘青少年的哮喘相关发病率、哮喘相关医疗保健利用情况以及哮喘管理之间的关联。我们将来自纽约市公立中学的373名青少年(平均年龄 = 12.8岁;82%为西班牙裔或黑人)分为4个体重类别:正常(体重指数[BMI]<第85百分位数);超重(第85百分位数≤BMI<第95百分位数);肥胖(第95百分位数≤BMI<第97百分位数);以及极肥胖(BMI≥第97百分位数)。我们将样本肥胖患病率与全国估计值进行比较,并检验体重类别是否能预测照料者报告的哮喘结果,同时对年龄和种族/族裔进行了调整。肥胖患病率为37%,样本中有28%为极肥胖;这两个比率均显著高于全国估计值。我们发现体重类别之间在哮喘相关医疗保健利用或哮喘管理方面没有显著差异,而在哮喘相关发病率方面有一些差异。与正常体重和肥胖青少年相比,超重青少年从未有过任何哮喘相关活动受限天数的几率更高。与肥胖青少年相比,他们从未因哮喘缺课的几率也更高。有哮喘相关活动受限的超重青少年与正常体重青少年相比,受限天数更多。超重但非肥胖的青少年因哮喘缺课比正常体重青少年更多。在患有未得到控制的哮喘的城市西班牙裔和黑人青少年中,超重和肥胖患病率非常高,但与哮喘相关发病率、哮喘相关医疗保健利用或哮喘管理实践没有密切关联。