Allergy Department, 2nd Pediatric Clinic, National & Kapodistrian University of Athens, University of Athens, Athens, Greece.
Allergy. 2013 Oct;68(10):1298-305. doi: 10.1111/all.12245. Epub 2013 Sep 21.
To date, an obesity/asthma link is well defined in adults; however, the nature of such a link is obscure in children, partly due to Body Mass Index (BMI) limitations as a surrogate fat mass marker in childhood. We thus opted to investigate the association of adiposity with asthma in children of different ages, using several indices to assess fat mass.
Wheeze ever/in the last 12 months (current) and physician-diagnosed asthma were retrospectively reported via questionnaire by the parents of 3641 children, participating in two cross-sectional studies: 1626 children aged 2-5 (the Genesis Study) and 2015 children aged 9-13 (the Healthy Growth Study). Perinatal data were recorded from the children's medical records or reported by parents. Anthropometric measurements (i.e., BMI, waist/hip circumference, biceps/triceps/subscapular/suprailiac skinfold thickness) were conducted in both cohorts; bioelectric impedance analysis (BIA) was conducted only in preadolescent children.
In children aged 2-5, asthma was positively correlated with conicity index, waist/hip circumference, waist-to-height ratio, skinfold thickness, and skinfold-derived percentage fat mass (P < 0.05) but not BMI or BMI-defined overweight/obesity, after adjusting for several confounders. In children aged 9-13, asthma was positively associated with conicity index, waist circumference, waist-to-height ratio, skinfold thickness, skinfold-derived percentage fat mass, BIA-derived percentage fat mass, BMI, and BMI-defined overweight/obesity, following adjustment (P < 0.05). Current/ever wheeze was not consistently associated with fat mass in either population.
Fat mass is positively linked to asthma in both 2-5 and 9-13 age spans. However, the failure of BMI to correlate with preschool asthma suggests its potential inefficiency in asthma studies at this age range.
迄今为止，肥胖与哮喘之间的关联在成年人中已得到明确界定；然而，在儿童中，这种关联的性质尚不清楚，部分原因是身体质量指数（BMI）作为儿童时期脂肪量替代标志物的局限性。因此，我们选择使用几种评估脂肪量的指标来研究不同年龄段儿童肥胖与哮喘之间的关联。
通过问卷，由参加两项横断面研究的 3641 名儿童的家长回顾性报告过去 12 个月内（当前）和过去 12 个月内（当前）喘息发作或喘息发作（既往）以及医生诊断的哮喘。两项研究分别纳入了 1626 名 2-5 岁（Genesis 研究）和 2015 名 9-13 岁（健康成长研究）的儿童。围产期数据来自儿童病历或家长报告。对两个队列的儿童进行了人体测量学测量（即 BMI、腰围/臀围、肱二头肌/肱三头肌/肩胛下/髂嵴皮褶厚度）；仅对青春期前儿童进行生物电阻抗分析（BIA）。
在 2-5 岁儿童中，哮喘与锥形指数、腰围/臀围、腰围身高比、皮褶厚度和皮褶厚度衍生的体脂百分比（P<0.05）呈正相关，但与 BMI 或 BMI 定义的超重/肥胖无关，调整了几个混杂因素后。在 9-13 岁儿童中，哮喘与锥形指数、腰围、腰围身高比、皮褶厚度、皮褶厚度衍生的体脂百分比、BIA 衍生的体脂百分比、BMI 和 BMI 定义的超重/肥胖呈正相关，调整后（P<0.05）。当前/既往喘息与两个人群的脂肪量均无一致相关性。
在 2-5 岁和 9-13 岁两个年龄段，脂肪量与哮喘呈正相关。然而，BMI 与学龄前哮喘不相关表明其在该年龄段哮喘研究中的潜在效率低下。
