Division of Allergy/Immunology and Pulmonary Medicine, Duke University School of Medicine, Duke Children's Hospital and Health Center, Durham, North Carolina.
Department of Biomedical Research, Nemours/Alfred I. DuPont Hospital for Children, Wilmington, Delaware.
Pediatr Pulmonol. 2019 Nov;54(11):1684-1693. doi: 10.1002/ppul.24470. Epub 2019 Aug 30.
Obesity in children increases the risk for new asthma. How age, sex, race/ethnicity, and allergy status affect the relationship between obesity and asthma is unclear. This study describes the relationship between high body mass index (BMI) and incident asthma.
We conducted a retrospective cohort study to compare asthma incidence among normal weight, overweight, and obese 2 to 6, 7 to 11, and 12 to 17 year olds to define the effects of sex, race/ethnicity, and allergy status. Weight status was determined at baseline and asthma incidence was defined as ≥2 asthma encounters and ≥1 asthma prescriptions. We used multivariable Poisson regression to estimate adjusted incident asthma rates and risk ratios.
Data from 192 843 2 to 6 year olds, 157 284 7 to 11 year olds, and 157 369 12 to 17 year olds were included. The relative risks (95% confidence interval [CI]) of new asthma among obese children in 2 to 6 year olds, 7 to 11 year olds, and 12 to 17 year olds were 1.25 (1.15, 1.37), 1.49 (1.32, 1.69) and 1.40 (1.21, 1.63), respectively. Among children with underlying allergic rhinitis, obesity did not increase the risk of new asthma. In children without allergic rhinitis, the risk for obesity-related asthma was highest in 7 to 11 year olds (risk ratio = 1.50 95% CI, 1.33, 1.60). Before age 12, females had a higher risk for obesity-related asthma; but after age 12, obese males had a higher asthma risk (interaction P-value < .05).
Obesity is a major preventable risk factor for pediatric asthma that appears to vary along the pediatric age continuum and depends on sex, race/ethnicity and atopy status.
儿童肥胖会增加新发生哮喘的风险。年龄、性别、种族/民族和过敏状态如何影响肥胖与哮喘之间的关系尚不清楚。本研究描述了高体重指数（BMI）与新发生哮喘之间的关系。
我们进行了一项回顾性队列研究，比较了正常体重、超重和肥胖的 2 至 6 岁、7 至 11 岁和 12 至 17 岁儿童的哮喘发病率，以确定性别、种族/民族和过敏状态的影响。体重状况在基线时确定，哮喘发病率定义为≥2 次哮喘发作和≥1 次哮喘处方。我们使用多变量泊松回归估计调整后的哮喘发病率和风险比。
纳入了 192843 名 2 至 6 岁儿童、157284 名 7 至 11 岁儿童和 157369 名 12 至 17 岁儿童的数据。肥胖儿童在 2 至 6 岁、7 至 11 岁和 12 至 17 岁儿童中发生新哮喘的相对风险（95%置信区间[CI]）分别为 1.25（1.15，1.37）、1.49（1.32，1.69）和 1.40（1.21，1.63）。在患有潜在过敏性鼻炎的儿童中，肥胖并未增加新哮喘的风险。在没有过敏性鼻炎的儿童中，肥胖相关哮喘的风险在 7 至 11 岁儿童中最高（风险比=1.50，95%CI，1.33，1.60）。在 12 岁之前，女性肥胖相关哮喘的风险较高；但 12 岁以后，肥胖男性哮喘风险较高（交互 P 值<0.05）。
肥胖是儿科哮喘的一个主要可预防风险因素，它似乎沿着儿科年龄连续体而变化，并且取决于性别、种族/民族和过敏状态。
