Comparison of anthropometric measures of obesity in childhood allergic asthma: Central obesity is most relevant

doi:10.1016/j.jaci.2009.03.023

Journal of Allergy and Clinical Immunology

Volume 123, Issue 6, June 2009, Pages 1321-1327.e12

https://doi.org/10.1016/j.jaci.2009.03.023 Get rights and content

Background

Established indicators of central obesity include waist circumference, waist/height ratio, and the conicity index. Studies using such measures (as opposed to body mass index [BMI] percentiles) to characterize the association between obesity and asthma are lacking, despite the fact that these measures have been shown to be most relevant for many other chronic diseases.

Objectives

We sought to examine measures assessing the distribution of obesity in the context of childhood allergic rhinitis and asthma and to elucidate the association of obesity, including central obesity, with allergic asthma in children.

Methods

Children with allergic rhinitis with (cases) or without (control subjects) asthma were recruited. BMI percentiles were derived by using national growth charts. Waist circumference, waist/height ratio, and conicity index values were obtained.

Results

Central obesity was associated with asthma, asthma severity, lower lung function, and reduced atopy in asthmatic subjects.

Conclusion

Measures of central obesity are more associated with the presence of asthma and asthma severity in children with allergic rhinitis when compared with standard BMI measures.

Section snippets

Subjects

Children aged 5 to 18 years were sequentially recruited from the outpatient allergy/immunology clinics at Cincinnati Children's Hospital Medical Center (n = 1123). Exclusion criteria included (1) comorbid lung condition, (2) chronic disease other than allergic disorders, and (3) dependency on an immunosuppressive agent for a medical condition other than asthma. Detailed questionnaires to collect medical information were completed by the parent/guardian accompanying the child during the clinic

Characteristics of study subjects

The total study population consisted of 1123 children, aged 5 to 18 years, and just over half (n = 584) of the children were given diagnoses of allergic rhinitis (Table I). Of the children with allergic rhinitis, 54.79% had asthma (cases) and 45.21% did not have asthma (control subjects). No statistical differences in sex, parental education, household member smoking, or annual household income were found between the cases and control subjects. There were significantly more African American

Discussion

Central obesity is the most critical determinant of obesity-related morbidity in many diseases. However, studies directly comparing obesity measures that assess central obesity with BMI measures are lacking in terms of childhood asthma and allergic rhinitis. We directly compared obesity measures in children with allergic rhinitis with or without asthma. Our results demonstrate that measures that account for fat distribution and central obesity classify obesity differently than BMI. In fact,

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: Supported by National Institutes of Health grant U19A170235-01 (G. K. Khurana Hershey) and University of Cincinnati and Molecular Epidemiology in Children's Environmental Health Institutional National Institute of Environmental Health Sciences grant T32 ES10957 (S. M. A. Musaad).

: Disclosure of potential conflict of interest: The authors have declared that they have no conflict of interest.

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Asthma and lower airway diseaseComparison of anthropometric measures of obesity in childhood allergic asthma: Central obesity is most relevant

Background

Objectives

Methods

Results

Conclusion

Section snippets

Subjects

Characteristics of study subjects

Discussion

Respir Med

Chest

J Nutr

J Pediatr

J Clin Epidemiol

Am J Clin Nutr

J Allergy Clin Immunol

Chest

Respir Med

Respir Med

Prevalence of overweight and obesity in the united states, 1999-2004

JAMA

Surveillance for asthma-United States, 1980-1999

MMWR Morb Mortal Wkly Rep

Complex interactions in complex traits: obesity and asthma

Thorax

Symposium on obesity and asthma—November 2, 2006

Can Respir J

Time trends in obesity among adults with asthma in the United States: findings from three national surveys

J Asthma

Body mass index in relation to adult asthma among 135,000 Norwegian men and women

Am J Epidemiol

The relationship between asthma and obesity in children: is it real or a case of over diagnosis?

J Asthma

Obesity increases the risk of incident asthma among adults

Eur Respir J

Overweight, obesity, and incident asthma: a meta-analysis of prospective epidemiologic studies

Am J Respir Crit Care Med

Body-mass index as a predictor of incident asthma in a prospective cohort of children

Pediatr Pulmonol

The relation of breastfeeding and body mass index to asthma and atopy in children: a prospective cohort study to age 6 years

Am J Public Health

Associations of BMI, TV-watching time, and physical activity on respiratory symptoms and asthma in 5th grade schoolchildren in Taipei, Taiwan

J Asthma

Asthma and lower airway disease
Comparison of anthropometric measures of obesity in childhood allergic asthma: Central obesity is most relevant