ASTHMA UPDATE

Weight responsible for asthma in one-quarter of patients with obesity

Obesity causes asthma in up to 27% of children who are obese, according to research published in Pediatrics.

"Asthma is the No. 1 chronic disease in children, and some of the causes such as genetics and viral infections during childhood are things we cannot prevent," Jason E. Lang, MD, associate professor of pediatrics at Duke University, said in a press release. "Obesity may be the only risk factor for childhood asthma that could be preventable. This is another piece of evidence that keeping kids active and at a healthy weight is important."

Lang and colleagues conducted a retrospective cohort study of more than 500,000 patients aged 2 to 17 years with healthy weight, overweight or obesity between January 2009 and December 2015.

They found that children who had overweight were at heightened risk for asthma (RR = 1.17; 95% CI, 1.1-1.25), as were children who had obesity (RR= 1.26; 95% CI, 1.18-1.34). When spirometry was used to confirm an asthma diagnosis, the risk for asthma in children with obesity increased slightly (RR = 1.29; 95% CI, 1.16-1.42).

The researchers adjusted their analysis for factors such as sex, age, socioeconomic status and allergies, and said they found similar results.

Lang and colleagues wrote that based on these findings, obesity is the cause of an estimated 23% to 27% of all asthma cases in children with obesity. By reaching and maintaining a healthy weight, the researchers suggested that 10% of all asthma cases could be avoided - or a total of almost 1 million cases.

"I think it is reasonable to be concerned that it is a causal relationship," Lang said. "It appears becoming overweight or obese as a child significantly increases your risk of developing asthma, directing attention again to the importance of preventing obesity at an early age." – by Katherine Bortz

(Reference: Lang JE, et al. Pediatrics. 2018;doi:10.1542/peds.2018-2119.)