Division of Allergy and Immunology, SUNY Downstate Medical Center, New York, New York.
Division of Allergy and Immunology, Jacobi Medical Center, Bronx, New York.
Pediatr Pulmonol. 2021 Jan;56(1):34-41. doi: 10.1002/ppul.25005. Epub 2020 Oct 27.
Epidemiologic studies have found low/absence of atopy in obese asthmatic children, but the association or lack thereof of atopy with disease morbidity, including pulmonary function, in obese asthma is not well understood. We sought to define the association of atopy with pulmonary function in overweight/obese minority children with asthma.
In a retrospective chart review of 200 predominantly minority children evaluated at an academic Pediatric Asthma Center over 5 years, we compared the prevalence of atopy, defined as 1 positive skin prick test or serum-specific immunoglobulin E quantification to environmental allergens, and its association with pulmonary function in overweight/obese (body mass index [BMI] > 85th percentile) (n = 99) to healthy-weight children (BMI, 5th-85th percentile for age) (n = 101).
In a cohort comprised of 47.5% Hispanics and 39.5% African Americans, 81% of overweight/obese and 74% of healthy-weight children were atopic. While atopic healthy-weight children had lower percent-predicted forced expiratory volume in the first second (FEV ) (93 ± 13.6 vs 107% ± 33.2%, P = .03) and lower percent-predicted forced vital capacity (FVC) (93% ± 12.2% vs 104% ± 16.1%, P = .01) as compared to nonatopic children, atopy was not associated with FEV (P = .7) or FVC (P = .17) in overweight/obese children. Adjusting for demographic and clinical variables, atopy was found to be an independent predictor of FEV and FVC in healthy-weight (β = -2.4, P = .07 and β = -1.7, P = .04, respectively) but not in overweight/obese children (β = .6, P = .5 and β = .8, P = .3).
Atopy is associated with lower lung function in healthy-weight asthmatics but not in overweight/obese asthmatics, supporting the role of nonallergic mechanisms in disease burden in pediatric obesity-related asthma.
流行病学研究发现，肥胖哮喘儿童的过敏发生率较低/不存在，但过敏与肥胖哮喘的疾病发病率（包括肺功能）之间的关联尚不清楚。我们旨在确定超重/肥胖的少数族裔哮喘儿童中过敏与肺功能的关系。
在对一个学术儿科哮喘中心的 200 名主要为少数族裔的儿童进行的回顾性图表审查中，我们比较了过敏的患病率，过敏定义为 1 种阳性皮肤点刺试验或血清特异性免疫球蛋白 E 定量对环境过敏原，以及其与超重/肥胖（体重指数[BMI]>第 85 个百分位）（n=99）与健康体重儿童（BMI，年龄的第 5-85 个百分位）（n=101）的肺功能之间的关系。
在由 47.5%的西班牙裔和 39.5%的非裔美国人组成的队列中，81%的超重/肥胖儿童和 74%的健康体重儿童是过敏的。虽然过敏的健康体重儿童的第一秒用力呼气量（FEV）的预计百分比较低（93±13.6%比 107%±33.2%，P=.03）和用力肺活量（FVC）的预计百分比较低（93%±12.2%比 104%±16.1%，P=.01）与非过敏儿童相比，过敏与超重/肥胖儿童的 FEV（P=.7）或 FVC（P=.17）无关。在调整人口统计学和临床变量后，发现过敏是健康体重儿童的 FEV 和 FVC 的独立预测因子（β=-2.4，P=.07 和 β=-1.7，P=.04，分别），但不是超重/肥胖儿童的 FEV 和 FVC 的独立预测因子（β=6，P=.5 和 β=8，P=.3）。
过敏与健康体重哮喘儿童的肺功能降低有关，但与超重/肥胖哮喘儿童无关，这支持了非过敏性机制在儿科肥胖相关哮喘疾病负担中的作用。
