School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, China.
Intensive Care Unit, Qingdao Municipal Hospital, Qingdao, China.
Pediatr Pulmonol. 2021 Dec;56(12):3720-3727. doi: 10.1002/ppul.25662. Epub 2021 Sep 13.
Physical activity (PA) may be associated with asthma management. Whether PA is associated with childhood asthma control is not well studied, and the role of body mass index (BMI) in this association remains unclarified. This study aimed to evaluate the association between PA and childhood asthma control and investigate the potential mediating and modifying role of BMI in the association.
This cross-sectional study involved 303 asthmatic children aged 5-14 years. Information on PA was collected from children. Asthma control was assessed using a valid questionnaire by children and their parents. Height and weight were objectively measured and BMI was calculated and classified. Multiple linear regression, mediation, and moderation analyses were performed.
There was a positive association between PA and childhood asthma control with adjustment for variates (B = 0.144, p = .012). Mediation analysis indicated that BMI status negatively mediated the association (estimate = -0.656, 95% credit interval: -1.645, -0.006), and such indirect effect is lower than the direct effect (indirect effect/direct effect = 58.3%). No evidence of effect modification by BMI was observed (P = 0.516). Stratified analyses showed that the significant association was only observed in children with overweight/obesity (normal weight: B = 0.863, p = .189; overweight/obese: B = 1.494, p = .044).
Increased PA is associated with improved childhood asthma control, especially for children with higher BMI. BMI exhibited a negative effect but not effect modification in this association. PA should be encouraged to improve asthma control for asthmatic children. Besides, mechanisms other than weight loss may explain the association.
身体活动（PA）可能与哮喘管理有关。PA 是否与儿童哮喘控制有关尚未得到充分研究，而 BMI 在这种关联中的作用仍不清楚。本研究旨在评估 PA 与儿童哮喘控制之间的关联，并探讨 BMI 在该关联中的潜在中介和调节作用。
本横断面研究纳入了 303 名 5-14 岁的哮喘儿童。通过儿童收集 PA 信息。通过儿童及其父母使用有效的问卷评估哮喘控制情况。客观测量身高和体重，并计算和分类 BMI。进行了多元线性回归、中介和调节分析。
在调整了变量后，PA 与儿童哮喘控制之间存在正相关（B=0.144，p=0.012）。中介分析表明，BMI 状态负向介导了这种关联（估计值=-0.656，95%置信区间：-1.645，-0.006），并且这种间接效应低于直接效应（间接效应/直接效应=58.3%）。没有证据表明 BMI 存在调节作用（P=0.516）。分层分析表明，这种显著关联仅在超重/肥胖儿童中观察到（正常体重：B=0.863，p=0.189；超重/肥胖：B=1.494，p=0.044）。
增加 PA 与改善儿童哮喘控制有关，特别是对于 BMI 较高的儿童。BMI 在这种关联中表现出负向作用，但没有调节作用。应鼓励 PA 以改善哮喘儿童的哮喘控制。此外，体重减轻以外的机制可能解释这种关联。
