Severe airway hyperresponsiveness in school-aged boys with a high body mass index

An-Soo Jang, June Huk Lee, Sung Woo Park, Mee Yong Shin, Do Jin Kim, Choon-Sik Park, An-Soo Jang, June Huk Lee, Sung Woo Park, Mee Yong Shin, Do Jin Kim, Choon-Sik Park

Abstract

Background: An association between obesity and asthma has been reported. The prevalence of airway hyperresponsiveness (AHR), results of skin prick tests, body mass index (BMI), and asthma symptoms were examined in schoolchildren.

Methods: The results of BMI (kg/m2) determination, skin prick testing, spirometry, asthma questionnaires, and methacholine challenge tests were obtained in a cross-sectional survey of 667 schoolchildren. The methacholine concentration causing a 20% fall in FEV1 (PC20) was used as the threshold of AHR. If the PC20 was less than 16 mg/mL, the subject was considered to have methachloine mediated AHR.

Results: The mean BMI was 17.1 +/- 0.09 kg/m2. The prevalence of AHR was 42.70%. The sensitization rate to common inhalant allergens was 30.3%. PC20 in children with BMIs > or = 17.1 kg/m2 was significantly lower than that in children with BMIs 17.1 kg/m2. The mean BMIs of boys and girls were not significantly different. The levels of PC20 by sex were not different. The children were grouped by sex into percentile of BMI. PC20 in boys was lower in the obese group than in the non-weight and overweight groups (p<0.05). PC20 in boys and girls with atopy was significantly lower than in those without atopy. In a multiple logistic regression model that included all of the children and adjusted for confounding variables, independent associations with AHR were seen with BMI, asthma symptoms, and atopy.

Conclusions: BMI had an association with AHR in school-age boys.

References

    1. Black PN, Sharpe S. Dietary fat and asthma: is there connection? Eur Respir J. 1997;10:6–12.
    1. Shin TS, Lee KJ, Yun HS. A survey of the distribution of allergic disease in primary school children. Allergy. 1990;10:201–212.
    1. Fluge O, Omenaas E, Eide GE, Gulsvik A. Fish consumption and respiratory symptoms among young adults in a Norwegian community. Eur Respir J. 1998;12:336–340.
    1. Shaheen SO, Sterne JA, Montgomery SM, Azima H. Birth weight, body mass index in young adults. Thorax. 1999;54:396–402.
    1. Ahn HC, Hwang KY, Nam HS, Park JS, Lee JH, Park SW, Kim DJ, Park CS. Association between asthma and anthropometric indices in Korean adults. J Asthma Allergy Clin Immunol. 2003;23:358–365.
    1. Jang AS, Son MH, Choi IS, Koh YI. High body mass index is associated with wheezing among older adults living in high-altitude area in Korea. J Korean Med Sci. 2002;17:479–482.
    1. Camargo CA, Weiss ST, Zhang S, Willett WC, Speizer FE. Prospective study of body mass index and risk of adult-onset asthma. Am J Respir Crit Care Med. 1998;157(Suppl):A47.
    1. Huang SL, Shiao GM, Chou P. Association between body mass index and allergy in teenage girls in Taiwan. Clin Exp Allergy. 1999;29:323–329.
    1. Castro-Rodriguez JA, Holberg CJ, Morgan WJ, Wright AL, Martinez FD. Increased incidence of asthmalike symptoms in girls who become overweight or obese during the school years. Am J Respir Crit Care Med. 2001;163:1344–1349.
    1. Gennuso J, Epstein LH, Paluch RA, Cerny F. The relationship between asthma and obesity in urban minority children and adolescents. Arch Pediatr Adolesc Med. 1998;152:1197–1200.
    1. Chen Y, Dales R, Krewski D, Breithaupt K. Increased effects of smoking and obesity on asthma among female Canadians: the National Population Health Survey, 1994-1995. Am J Epidemiol. 1999;150:255–262.
    1. Asher MI, Keil U, Anderson HR, Beasley R, Crane J, Martinez F, Mitchell EA, Pearce N, Sibbald B, Stewart AW, Strachan D, Weiland SK, Williams HC. International study of asthma and allergies-ISAAC: rationale and methods. Eur Respir J. 1995;8:483–491.
    1. American Thoracic Society. Lung function testing: selection of reference values and interpretative strategies. Am Rev Respir Dis. 1991;144:1202–1218.
    1. Choi IS, Greville HW, Park KO. Addition of peak expiratory flow rate to the selection criteria of the representative spirometric result. Chonnam J Med Sci. 1990;3:23–28.
    1. Crockcroft DW, Murdock KY, Berscheid BA. Relationship between atopy and bronchial responsiveness to histamine in a random population. Ann Allergy. 1984;53:26–29.
    1. Chai H, Farr RS, Froehlich LA, Mathison DA, McLean JA, Rosenthal RR, Sheffer AL, Spector SL, Townley RG. Standardization of bronchial inhalation challenge procedures. J Allergy Clin Immunol. 1975;56:323–327.
    1. White EM, Wilson AC, Greene SA, McCowan C, Thomas GE, Cairns AY, Ricketts IW. Body mass index centile charts to assess fatness of British children. Arch Dis Child. 1995;72:38–41.
    1. Daniels SR, Khoury PR, Morrison JA. The utility of body mass index as a measure of body fatness in children and adolecents: differences by race and gender. Pediatrics. 1997;99:804–807.
    1. Picado C, Deulofeu R, Lleonart R, Agusti M, Casals E, Quinto L, Mullol J. Lipid and protein metabolism in asthma: effects of diet and corticosteroid therapy. Allergy. 1999;54:569–575.
    1. Peckham C, Butler N. A national study of asthma in childhood. J Epidemiol Community Health. 1978;32:79–85.
    1. Hamman RF, Halil T, Holland WW. Asthma in school children: demographic associations and peak expiratory flow rates compared with children with bronchitis. Br J Prev Soc Med. 1975;29:228–238.
    1. Miedema I, Feskens EJ, Heederik D, Kromhout D. Dietary determinants of long-term incidence of chronic nonspecific lung disease: the Zutphen study. Am J Epidemiol. 1993;138:37–45.
    1. Kang H, Kang EK, Nah KM, Yoo Y, Koh YY. Comparison of obesity between children with asthma and healthy children. Pediatr Allergy Respir Dis. 2003;13:17–25.
    1. Yemaneberhan H, Bekele Z, Venn A, Lewis S, Parry E, Britton J. Prevalence of wheeze and asthma and relation to atopy in urban and rural Ethiopia. Lancet. 1997;350:85–90.
    1. Gilliland FD, Berhane K, McConnell R, Gauderman WJ, Vora H, Rappaport EB, Avol E, Peters JM. Maternal smoking during pregnancy, environmental tobacco smoke exposure and childhood lung function. Thorax. 2000;55:271–276.
    1. Schwartz J, Timonen KL, Pekkanen J. Respiratory effects of environmental tobacco smoke in a panel study of asthmatic and symptomatic children. Am J Respir Crit Care Med. 2000;161:802–806.
    1. Crombie IK, Wright A, Irvine L, Clark RA, Slane PW. Does passive smoking increase the frequency of health service contacts in children with asthma? Thorax. 2001;56:9–12.

Source: PubMed

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