Clinical and Experimental Sciences Academic Unit, University of Southampton Faculty of Medicine, Southampton, UK.
Thorax. 2013 Apr;68(4):372-9. doi: 10.1136/thoraxjnl-2012-202556. Epub 2013 Jan 3.
Obesity and asthma have increased in westernised countries. Maternal obesity may increase childhood asthma risk. If this relation is causal, it may be mediated through factors associated with maternal adiposity, such as fetal development, pregnancy complications or infant adiposity. We investigated the relationships of maternal body mass index (BMI) and fat mass with childhood wheeze, and examined the influences of infant weight gain and childhood obesity.
Maternal prepregnancy BMI and estimated fat mass (from skinfold thicknesses) were related to asthma, wheeze and atopy in 940 children. Transient or persistent/late wheeze was classified using questionnaire data collected at ages 6, 12, 24 and 36 months and 6 years. At 6 years, skin-prick testing was conducted and exhaled nitric oxide and spirometry measured. Infant adiposity gain was calculated from skinfold thickness at birth and 6 months.
Greater maternal BMI and fat mass were associated with increased childhood wheeze (relative risk (RR) 1.08 per 5 kg/m(2), p=0.006; RR 1.09 per 10 kg, p=0.003); these reflected associations with transient wheeze (RR 1.11, p=0.003; RR 1.13, p=0.002, respectively), but not with persistent wheeze or asthma. Infant adiposity gain was associated with persistent wheeze, but not significantly. Adjusting for infant adiposity gain or BMI at 3 or 6 years did not reduce the association between maternal adiposity and transient wheeze. Maternal adiposity was not associated with offspring atopy, exhaled nitric oxide, or spirometry.
Greater maternal adiposity is associated with transient wheeze but not asthma or atopy, suggesting effects upon airway structure/function but not allergic predisposition.
在西方国家，肥胖和哮喘的发病率都有所上升。母亲肥胖可能会增加儿童哮喘的风险。如果这种关系是因果关系，那么它可能是通过与母亲肥胖相关的因素来介导的，例如胎儿发育、妊娠并发症或婴儿肥胖。我们研究了母亲的体重指数（BMI）和体脂与儿童喘息的关系，并研究了婴儿体重增加和儿童肥胖的影响。
在 940 名儿童中，母亲孕前 BMI 和估计体脂（来自皮褶厚度）与哮喘、喘息和特应性有关。使用在 6、12、24 和 36 个月和 6 岁时收集的问卷调查数据对喘息进行分类。在 6 岁时进行皮肤点刺试验，并测量呼气一氧化氮和肺活量。从出生和 6 个月时的皮褶厚度计算婴儿脂肪量的增加。
母亲 BMI 和体脂较高与儿童喘息增加相关（相对风险（RR）每 5 kg/m(2)增加 1.08，p=0.006；每增加 10 kg 增加 1.09，p=0.003）；这反映了与短暂性喘息（RR 1.11，p=0.003；RR 1.13，p=0.002）相关，但与持续性喘息或哮喘无关。婴儿脂肪量的增加与持续性喘息有关，但不显著。调整婴儿脂肪量的增加或 3 或 6 岁时的 BMI 并不能降低母亲肥胖与短暂性喘息之间的关联。母亲肥胖与后代特应性、呼气一氧化氮或肺活量无关。
母亲肥胖与短暂性喘息有关，但与哮喘或特应性无关，提示其对气道结构/功能有影响，但对过敏易感性没有影响。
