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Obesity, inflammation, and asthma severity in childhood: data from the National Health and Nutrition Examination Survey 2001-2004.
Ann Allergy Asthma Immunol. 2009 Nov; 103(5):381-5.AA

Abstract

BACKGROUND

The prevalences of asthma and obesity in children have increased significantly during the past 2 decades. The basis for the relationship between pediatric asthma and obesity is not well established.

OBJECTIVES

To explore the association between obesity and asthma severity in children and adolescents and to test whether obesity-induced inflammation, as characterized by serum C-reactive protein (CRP), is associated with increased severity of asthma.

METHODS

Retrospective cohort analysis of interview, physical examination, and laboratory test data from participants younger than 20 years in 2 rounds of the National Health and Nutrition Examination Survey (2001-2002 and 2003-2004). We also performed generalized ordered logistic regression to evaluate the effect of body mass index (BMI) z score and CRP level on asthma severity, controlling for the impact of age, sex, race, income, insurance, and tobacco smoke exposure.

RESULTS

Of the 77 million individuals younger than 20 years represented by this weighted sample, 19% met the study-defined criteria for asthma; most cases were defined as mild (11%) or moderate (6%); 2% had severe asthma. In multivariable models, elevated BMI z scores (odds ratio, 1.12; 95% confidence interval, 1.05-1.21) were associated with worse asthma severity. Elevated CRP level was associated with obesity (P < .001) and asthma severity (odds ratio, 1.33; 95% confidence interval, 1.16-1.52).

CONCLUSIONS

Higher BMI z scores and elevated serum CRP levels are associated with increased asthma severity. These findings highlight the importance of controlling for inflammation when considering the role of obesity and provide support for the hypothesis that obesity-induced inflammation may contribute to greater asthma severity.

Authors+Show Affiliations

Division of Pediatric Pulmonary and Sleep Medicine, Duke Children's Hospital, Durham, North Carolina 27710, USA. peter.michelson@duke.eduNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19927535

Citation

Michelson, Peter H., et al. "Obesity, Inflammation, and Asthma Severity in Childhood: Data From the National Health and Nutrition Examination Survey 2001-2004." Annals of Allergy, Asthma & Immunology : Official Publication of the American College of Allergy, Asthma, & Immunology, vol. 103, no. 5, 2009, pp. 381-5.
Michelson PH, Williams LW, Benjamin DK, et al. Obesity, inflammation, and asthma severity in childhood: data from the National Health and Nutrition Examination Survey 2001-2004. Ann Allergy Asthma Immunol. 2009;103(5):381-5.
Michelson, P. H., Williams, L. W., Benjamin, D. K., & Barnato, A. E. (2009). Obesity, inflammation, and asthma severity in childhood: data from the National Health and Nutrition Examination Survey 2001-2004. Annals of Allergy, Asthma & Immunology : Official Publication of the American College of Allergy, Asthma, & Immunology, 103(5), 381-5. https://doi.org/10.1016/S1081-1206(10)60356-0
Michelson PH, et al. Obesity, Inflammation, and Asthma Severity in Childhood: Data From the National Health and Nutrition Examination Survey 2001-2004. Ann Allergy Asthma Immunol. 2009;103(5):381-5. PubMed PMID: 19927535.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Obesity, inflammation, and asthma severity in childhood: data from the National Health and Nutrition Examination Survey 2001-2004. AU - Michelson,Peter H, AU - Williams,Larry W, AU - Benjamin,Daniel K, AU - Barnato,Amber E, PY - 2009/11/26/entrez PY - 2009/11/26/pubmed PY - 2009/12/16/medline SP - 381 EP - 5 JF - Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology JO - Ann Allergy Asthma Immunol VL - 103 IS - 5 N2 - BACKGROUND: The prevalences of asthma and obesity in children have increased significantly during the past 2 decades. The basis for the relationship between pediatric asthma and obesity is not well established. OBJECTIVES: To explore the association between obesity and asthma severity in children and adolescents and to test whether obesity-induced inflammation, as characterized by serum C-reactive protein (CRP), is associated with increased severity of asthma. METHODS: Retrospective cohort analysis of interview, physical examination, and laboratory test data from participants younger than 20 years in 2 rounds of the National Health and Nutrition Examination Survey (2001-2002 and 2003-2004). We also performed generalized ordered logistic regression to evaluate the effect of body mass index (BMI) z score and CRP level on asthma severity, controlling for the impact of age, sex, race, income, insurance, and tobacco smoke exposure. RESULTS: Of the 77 million individuals younger than 20 years represented by this weighted sample, 19% met the study-defined criteria for asthma; most cases were defined as mild (11%) or moderate (6%); 2% had severe asthma. In multivariable models, elevated BMI z scores (odds ratio, 1.12; 95% confidence interval, 1.05-1.21) were associated with worse asthma severity. Elevated CRP level was associated with obesity (P < .001) and asthma severity (odds ratio, 1.33; 95% confidence interval, 1.16-1.52). CONCLUSIONS: Higher BMI z scores and elevated serum CRP levels are associated with increased asthma severity. These findings highlight the importance of controlling for inflammation when considering the role of obesity and provide support for the hypothesis that obesity-induced inflammation may contribute to greater asthma severity. SN - 1081-1206 UR - https://www.unboundmedicine.com/medline/citation/19927535/Obesity_inflammation_and_asthma_severity_in_childhood:_data_from_the_National_Health_and_Nutrition_Examination_Survey_2001_2004_ DB - PRIME DP - Unbound Medicine ER -