Chen Zhanghua, Salam Muhammad T, Alderete Tanya L, Habre Rima, Bastain Theresa M, Berhane Kiros, Gilliland Frank D
1 Department of Preventive Medicine, Division of Environmental Health and.
2 Department of Psychiatry, Kern Medical Center, Bakersfield, California.
Am J Respir Crit Care Med. 2017 May 1;195(9):1181-1188. doi: 10.1164/rccm.201608-1691OC.
Asthma and obesity often occur together in children. It is unknown whether asthma contributes to the childhood obesity epidemic.
We aimed to investigate the effects of asthma and asthma medication use on the development of childhood obesity.
The primary analysis was conducted among 2,171 nonobese children who were 5-8 years of age at study enrollment in the Southern California Children's Health Study (CHS) and were followed for up to 10 years. A replication analysis was performed in an independent sample of 2,684 CHS children followed from a mean age of 9.7 to 17.8 years.
Height and weight were measured annually to classify children into normal, overweight, and obese categories. Asthma status was ascertained by parent- or self-reported physician-diagnosed asthma. Cox proportional hazards models were fitted to assess associations of asthma history with obesity incidence during follow-up. We found that children with a diagnosis of asthma at cohort entry were at 51% increased risk of developing obesity during childhood and adolescence compared with children without asthma at baseline (hazard ratio, 1.51; 95% confidence interval, 1.08-2.10) after adjusting for confounders. Use of asthma rescue medications at cohort entry reduced the risk of developing obesity (hazard ratio, 0.57; 95% confidence interval, 0.33-0.96). In addition, the significant association between a history of asthma and an increased risk of developing obesity was replicated in an independent CHS sample.
Children with asthma may be at higher risk of obesity. Asthma rescue medication use appeared to reduce obesity risk independent of physical activity.
哮喘和肥胖在儿童中常常同时出现。尚不清楚哮喘是否导致了儿童肥胖的流行。
我们旨在研究哮喘及哮喘药物使用对儿童肥胖发展的影响。
对南加州儿童健康研究（CHS）中2171名在研究入组时年龄为5至8岁的非肥胖儿童进行了初步分析，并对其进行了长达10年的随访。在一个独立样本中对2684名CHS儿童进行了重复分析，这些儿童的随访年龄范围为9.7岁至17.8岁。
每年测量身高和体重，将儿童分为正常、超重和肥胖类别。哮喘状态通过家长或自我报告的医生诊断哮喘来确定。采用Cox比例风险模型来评估哮喘病史与随访期间肥胖发生率之间的关联。我们发现，在调整混杂因素后，与基线时无哮喘的儿童相比，队列入组时被诊断为哮喘的儿童在儿童期和青春期发生肥胖的风险增加了51%（风险比，1.51；95%置信区间，1.08 - 2.10）。队列入组时使用哮喘急救药物降低了发生肥胖的风险（风险比，0.57；95%置信区间，0.33 - 0.96）。此外，在一个独立的CHS样本中重复了哮喘病史与肥胖发生风险增加之间的显著关联。
哮喘儿童可能有更高的肥胖风险。使用哮喘急救药物似乎能独立于身体活动降低肥胖风险。
