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Does adiposity mediate the relationship between socioeconomic position and non-allergic asthma in childhood?
  1. Kate Marie Lewis1,
  2. Hynek Pikhart2,
  3. Joana Morrison2
  1. 1 Population, Policy and Practice, UCL Great Ormond Street Institute of Child Health, London, UK
  2. 2 Research Department of Epidemiology and Public Health, University College London, London, UK
  1. Correspondence to Kate Marie Lewis, PPP, UCL Great Ormond Street Institute of Child Health, London WC1N 1EH, UK; kate.lewis.14{at}


Background Despite its high prevalence, early onset and chronic nature, the causes of asthma are not clearly established. The present study examined a plausible but untested relationship in the development of non-allergic asthma; an asthma phenotype closely linked to deprivation and other preventable risk factors. Our aim was to determine the mediating role of adiposity in the relationship between socioeconomic position in infancy and non-allergic asthma emergence in mid-childhood.

Methods To estimate the causal indirect effect of adiposity we applied the parametric g-computational procedure to 6203 singleton children from the UK Millennium Cohort Study. Adiposity was measured at age 7 by body mass index, waist circumference and waist circumference-to-height ratio. Children who developed non-allergic asthma between the age of 7 and 14 were compared with children without allergies or allergic asthma at these ages.

Results We found no evidence to suggest that adiposity is a mediator in the relationship between socioeconomic position and the development of non-allergic asthma in mid-childhood. After adjustment for risk factors, the direct effect of socioeconomic position remained; children in the lowest tertile of socioeconomic position had a 43% (OR 1.43, 95% CI 1.38 to 1.49) greater odds of developing non-allergic asthma compared with the highest tertile.

Conclusions Adiposity at age 7 does not mediate the relationship between socioeconomic position and non-allergic asthma. The results suggest that improving socioeconomic conditions and promoting healthy weight are both important in reducing the development of non-allergic asthma in early to mid-childhood.

  • BMI
  • bodyweight
  • cohort study
  • mediator
  • non-atopic asthma
  • obesity
  • socioeconomic position
  • waist circumference

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  • Contributors KML designed the study, cleaned and analysed the data, and drafted and revised the paper. JM supervised the study, revised the study design and revised the paper. HP revised the paper. All authors gave final approval to the article.

  • Funding This work was supported by the Medical Research Council (grant number MR/N013867/1).

  • Competing interests None declared.

  • Ethics approval Ethical approval was granted and consent gained for all waves of the MCS by those responsible for the study.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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