Lucas Jennifer A, Moonie Sheniz, Olsen-Wilson Kimberly, Hogan Mary Beth
a School of Community Health Sciences, University of Nevada , Las Vegas, Las Vegas , Nevada , USA.
b University of Nevada School of Medicine , Department of Pediatrics , Las Vegas , Nevada , USA.
J Asthma. 2017 Aug;54(6):594-599. doi: 10.1080/02770903.2016.1244829. Epub 2016 Oct 14.
The majority of pediatric asthma is atopic, but whether pediatric obese asthma is atopic is indeterminate in the literature. In Nevada, children become sensitized to aeroallergens, a risk factor for asthma, at young ages. Additionally, Nevada children have high rates of obesity. Our objective is to determine whether elevated body mass index (BMI) is associated with asthma severity, allergen sensitization, and polysensitization.
Medical records from a pediatric allergy clinic provided BMI percentile, physician-diagnosed asthma severity, skin prick test data, and sociodemographics such as age, race, sex, and insurance status from asthmatic patients. Descriptive statistics and binary and multinomial logistic regression were conducted.
In this population (N = 125) aged 1-16, 61% were male, 65% were white, and 74% had private health insurance. Sixty-five percent of children were under/healthy weight and 29% were overweight/obese. Asthma symptoms were moderate in 66% of the population, and severe in 18%. Nearly 85% of this population was atopic, and 82% were polysensitized. Sensitization and polysensitization occurred in all weight categories. Asthma severity and elevated BMI were not associated significantly. Overweight/obese children (≥85 percentile) had lower odds of allergen sensitization (adjusted odds ratio 0.26, 95% CI = 0.85-0.78, p = 0.016) and polysensitization (adjusted odds ratio 0.30, 95% CI = 0.11-0.85, p = 0.023) than healthy weight children (<85 percentile).
Although overweight children did show allergen sensitization, those who were overweight had lower odds of allergen sensitization and lower odds of polysensitization, as compared to normal weight asthmatic children. Elevated BMI was not a significant predictor of asthma severity.
大多数小儿哮喘是特应性的,但小儿肥胖性哮喘是否为特应性在文献中尚无定论。在内华达州,儿童在幼年时就会对气传变应原致敏,而气传变应原是哮喘的一个危险因素。此外,内华达州儿童的肥胖率很高。我们的目的是确定体重指数(BMI)升高是否与哮喘严重程度、变应原致敏及多重致敏相关。
从一家儿科过敏诊所的病历中获取哮喘患者的BMI百分位数、医生诊断的哮喘严重程度、皮肤点刺试验数据以及年龄、种族、性别和保险状况等社会人口统计学信息。进行描述性统计以及二元和多项逻辑回归分析。
在这个1至16岁的人群(N = 125)中,61%为男性,65%为白人,74%拥有私人医疗保险。65%的儿童体重正常/健康,29%超重/肥胖。66%的人群哮喘症状为中度,18%为重度。近85%的人群为特应性,82%为多重致敏。所有体重类别中均出现致敏和多重致敏情况。哮喘严重程度与BMI升高无显著关联。超重/肥胖儿童(≥第85百分位数)变应原致敏(调整优势比0.26,95%置信区间 = 0.85 - 0.78,p = 0.016)和多重致敏(调整优势比0.30,95%置信区间 = 0.11 - 0.85,p = 0.023)的几率低于体重正常的儿童(<第85百分位数)。
尽管超重儿童确实表现出变应原致敏,但与体重正常的哮喘儿童相比,超重儿童变应原致敏和多重致敏的几率较低。BMI升高并非哮喘严重程度的显著预测指标。