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Being Overweight or Obese and the Development of Asthma.
Pediatrics 2018; 142(6)Ped

Abstract

OBJECTIVES

Adult obesity is linked to asthma cases and is estimated to lead to 250 000 new cases yearly. Similar incidence and attributable risk (AR) estimates have not been developed for children. We sought to describe the relationship between overweight and obesity and incident asthma in childhood and quantify AR statistics in the United States for overweight and obesity on pediatric asthma.

METHODS

The PEDSnet clinical data research network was used to conduct a retrospective cohort study (January 2009-December 2015) to compare asthma incidence among overweight and/or obese versus healthy weight 2- to 17-year-old children. Asthma incidence was defined as ≥2 encounters with a diagnosis of asthma and ≥1 asthma controller prescription. Stricter diagnostic criteria involved confirmation by spirometry. We used multivariable Poisson regression analyses to estimate incident asthma rates and risk ratios and accepted formulas for ARs.

RESULTS

Data from 507 496 children and 19 581 972 encounters were included. The mean participant observation period was 4 years. The adjusted risk for incident asthma was increased among children who were overweight (relative risk [RR]: 1.17; 95% confidence interval [CI]: 1.10-1.25) and obese (RR: 1.26; 95% CI: 1.18-1.34). The adjusted risk for spirometry-confirmed asthma was increased among children with obesity (RR: 1.29; 95% CI: 1.16-1.42). An estimated 23% to 27% of new asthma cases in children with obesity is directly attributable to obesity. In the absence of overweight and obesity, 10% of all cases of asthma would be avoided.

CONCLUSIONS

Obesity is a major preventable risk factor for pediatric asthma.

Authors+Show Affiliations

Nemours Children's Hospital, Nemours Children's Health System, Orlando, Florida; jason.lang@duke.org. Divisions of Allergy and Immunology and. Pulmonary Medicine, School of Medicine, Duke University and Duke Children's Hospital and Health Center, Durham, North Carolina.Department of Biomedical Research, Nemours Alfred I. DuPont Hospital for Children, Wilmington, Delaware.Department of Biomedical Research, Nemours Alfred I. DuPont Hospital for Children, Wilmington, Delaware.Centers for Health Care Delivery Science and.Pharmacogenomics and Translational Research, Nemours Children's Health System, Jacksonville, Florida.Nemours Children's Hospital, Nemours Children's Health System, Orlando, Florida.Department of Pediatrics, Washington University, St Louis, Missouri.Department of Pediatrics, School of Medicine, Anschutz Medical Campus, University of Colorado, Aurora, Colorado.Section of Pulmonary Medicine, Nationwide Children's Hospital and Department of Pediatrics, College of Medicine, The Ohio State University, Columbus, Ohio.Department of Pediatrics, Seattle Children's Hospital, Seattle, Washington; and.Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.

Pub Type(s)

Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

30478238

Citation

Lang, Jason E., et al. "Being Overweight or Obese and the Development of Asthma." Pediatrics, vol. 142, no. 6, 2018.
Lang JE, Bunnell HT, Hossain MJ, et al. Being Overweight or Obese and the Development of Asthma. Pediatrics. 2018;142(6).
Lang, J. E., Bunnell, H. T., Hossain, M. J., Wysocki, T., Lima, J. J., Finkel, T. H., ... Forrest, C. B. (2018). Being Overweight or Obese and the Development of Asthma. Pediatrics, 142(6), doi:10.1542/peds.2018-2119.
Lang JE, et al. Being Overweight or Obese and the Development of Asthma. Pediatrics. 2018;142(6) PubMed PMID: 30478238.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Being Overweight or Obese and the Development of Asthma. AU - Lang,Jason E, AU - Bunnell,H Timothy, AU - Hossain,Md Jobayer, AU - Wysocki,Tim, AU - Lima,John J, AU - Finkel,Terri H, AU - Bacharier,Leonard, AU - Dempsey,Amanda, AU - Sarzynski,Lisa, AU - Test,Matthew, AU - Forrest,Christopher B, PY - 2018/09/19/accepted PY - 2018/11/28/pubmed PY - 2019/6/7/medline PY - 2018/11/28/entrez JF - Pediatrics JO - Pediatrics VL - 142 IS - 6 N2 - OBJECTIVES: Adult obesity is linked to asthma cases and is estimated to lead to 250 000 new cases yearly. Similar incidence and attributable risk (AR) estimates have not been developed for children. We sought to describe the relationship between overweight and obesity and incident asthma in childhood and quantify AR statistics in the United States for overweight and obesity on pediatric asthma. METHODS: The PEDSnet clinical data research network was used to conduct a retrospective cohort study (January 2009-December 2015) to compare asthma incidence among overweight and/or obese versus healthy weight 2- to 17-year-old children. Asthma incidence was defined as ≥2 encounters with a diagnosis of asthma and ≥1 asthma controller prescription. Stricter diagnostic criteria involved confirmation by spirometry. We used multivariable Poisson regression analyses to estimate incident asthma rates and risk ratios and accepted formulas for ARs. RESULTS: Data from 507 496 children and 19 581 972 encounters were included. The mean participant observation period was 4 years. The adjusted risk for incident asthma was increased among children who were overweight (relative risk [RR]: 1.17; 95% confidence interval [CI]: 1.10-1.25) and obese (RR: 1.26; 95% CI: 1.18-1.34). The adjusted risk for spirometry-confirmed asthma was increased among children with obesity (RR: 1.29; 95% CI: 1.16-1.42). An estimated 23% to 27% of new asthma cases in children with obesity is directly attributable to obesity. In the absence of overweight and obesity, 10% of all cases of asthma would be avoided. CONCLUSIONS: Obesity is a major preventable risk factor for pediatric asthma. SN - 1098-4275 UR - https://www.unboundmedicine.com/medline/citation/30478238/Being_Overweight_or_Obese_and_the_Development_of_Asthma_ L2 - http://pediatrics.aappublications.org/cgi/pmidlookup?view=long&pmid=30478238 DB - PRIME DP - Unbound Medicine ER -