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Childhood body mass index and subsequent physician-diagnosed asthma: a systematic review and meta-analysis of prospective cohort studies.

Abstract

BACKGROUND

Childhood asthma and obesity prevalence have increased in recent years suggesting a potential association. However, the direction of any association is poorly understood and the potential causal-relationship is unknown.

METHODS

We examined the association between overweight/obesity, defined by body mass index (BMI) <18 years of age, and subsequent physician-diagnosed incident asthma at least one year after BMI assessment. We sought to explore potential effect modification by sex. PubMed and Embase were searched using keywords and restricted to subjects aged 0-18 years. There were no date or language restrictions. From each study we extracted: authors, publication date, location, overweight/obesity definitions, asthma definitions, number of participants, recruitment duration, description of cohort, follow-up time, adjusted effect estimates (with 95% CI) and estimates of subgroup analysis.

RESULTS

Six prospective cohort studies which focused on children <18 years of age met criteria for inclusion. The combined risk ratio (RR) of overweight was associated with asthma (RR = 1.35; 95% CI = 1.15, 1.58). In boys, the combined RR of overweight on asthma was significant (RR = 1.41; 95% CI = 1.05, 1.88). For girls, when BMI was defined by Z-score, the combined RR of overweight on asthma was also significant (RR = 1.19; 95% CI = 1.06, 1.34). The combined risk ratio (RR) of obesity was associated with asthma in both boys and girls (RR = 1.50; 95% CI = 1.22, 1.83), in boys only (RR = 1.40; 95% CI = 1.01, 1.93) and in girls only (RR = 1.53; 95% CI = 1.09, 2.14).

CONCLUSIONS

Overweight and, especially, obese children are at increased risk of subsequent physician diagnosed asthma in comparison to normal weight children. Except for sex, no studies reported any other potential effect modifiers. The observed sex effects were inconsistent.

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  • Authors

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    Source

    BMC pediatrics 13: 2013 Aug 13 pg 121

    MeSH

    Asthma
    Body Mass Index
    Child
    Female
    Follow-Up Studies
    Global Health
    Humans
    Incidence
    Male
    Obesity
    Prospective Studies
    Risk Factors

    Pub Type(s)

    Journal Article
    Meta-Analysis
    Review
    Systematic Review

    Language

    eng

    PubMed ID

    23941287

    Citation

    Egan, Kathryn B., et al. "Childhood Body Mass Index and Subsequent Physician-diagnosed Asthma: a Systematic Review and Meta-analysis of Prospective Cohort Studies." BMC Pediatrics, vol. 13, 2013, p. 121.
    Egan KB, Ettinger AS, Bracken MB. Childhood body mass index and subsequent physician-diagnosed asthma: a systematic review and meta-analysis of prospective cohort studies. BMC Pediatr. 2013;13:121.
    Egan, K. B., Ettinger, A. S., & Bracken, M. B. (2013). Childhood body mass index and subsequent physician-diagnosed asthma: a systematic review and meta-analysis of prospective cohort studies. BMC Pediatrics, 13, p. 121. doi:10.1186/1471-2431-13-121.
    Egan KB, Ettinger AS, Bracken MB. Childhood Body Mass Index and Subsequent Physician-diagnosed Asthma: a Systematic Review and Meta-analysis of Prospective Cohort Studies. BMC Pediatr. 2013 Aug 13;13:121. PubMed PMID: 23941287.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Childhood body mass index and subsequent physician-diagnosed asthma: a systematic review and meta-analysis of prospective cohort studies. AU - Egan,Kathryn B, AU - Ettinger,Adrienne S, AU - Bracken,Michael B, Y1 - 2013/08/13/ PY - 2012/12/07/received PY - 2013/08/07/accepted PY - 2013/8/15/entrez PY - 2013/8/15/pubmed PY - 2015/4/22/medline SP - 121 EP - 121 JF - BMC pediatrics JO - BMC Pediatr VL - 13 N2 - BACKGROUND: Childhood asthma and obesity prevalence have increased in recent years suggesting a potential association. However, the direction of any association is poorly understood and the potential causal-relationship is unknown. METHODS: We examined the association between overweight/obesity, defined by body mass index (BMI) <18 years of age, and subsequent physician-diagnosed incident asthma at least one year after BMI assessment. We sought to explore potential effect modification by sex. PubMed and Embase were searched using keywords and restricted to subjects aged 0-18 years. There were no date or language restrictions. From each study we extracted: authors, publication date, location, overweight/obesity definitions, asthma definitions, number of participants, recruitment duration, description of cohort, follow-up time, adjusted effect estimates (with 95% CI) and estimates of subgroup analysis. RESULTS: Six prospective cohort studies which focused on children <18 years of age met criteria for inclusion. The combined risk ratio (RR) of overweight was associated with asthma (RR = 1.35; 95% CI = 1.15, 1.58). In boys, the combined RR of overweight on asthma was significant (RR = 1.41; 95% CI = 1.05, 1.88). For girls, when BMI was defined by Z-score, the combined RR of overweight on asthma was also significant (RR = 1.19; 95% CI = 1.06, 1.34). The combined risk ratio (RR) of obesity was associated with asthma in both boys and girls (RR = 1.50; 95% CI = 1.22, 1.83), in boys only (RR = 1.40; 95% CI = 1.01, 1.93) and in girls only (RR = 1.53; 95% CI = 1.09, 2.14). CONCLUSIONS: Overweight and, especially, obese children are at increased risk of subsequent physician diagnosed asthma in comparison to normal weight children. Except for sex, no studies reported any other potential effect modifiers. The observed sex effects were inconsistent. SN - 1471-2431 UR - https://www.unboundmedicine.com/medline/citation/23941287/full_citation L2 - https://bmcpediatr.biomedcentral.com/articles/10.1186/1471-2431-13-121 DB - PRIME DP - Unbound Medicine ER -