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Multicenter Study
. 2018 Apr;141(4):1459-1467.e2.
doi: 10.1016/j.jaci.2017.09.043. Epub 2017 Dec 19.

Overweight/obesity status in preschool children associates with worse asthma but robust improvement on inhaled corticosteroids

Jason E Lang  1 , Anne M Fitzpatrick  2 , David T Mauger  3 , Theresa W Guilbert  4 , Daniel J Jackson  5 , Robert F Lemanske Jr  6 , Fernando D Martinez  7 , Robert C Strunk  8 , Robert S Zeiger  9 , Wanda Phipatanakul  10 , Leonard B Bacharier  8 , Jacqueline A Pongracic  11 , Fernando Holguin  12 , Michael D Cabana  13 , Ronina A Covar  14 , Hengameh H Raissy  15 , Monica Tang  16 , Stanley J Szefler  17 ; National Institutes of Health/National Heart, Lung and Blood Institute AsthmaNet
Affiliations
Multicenter Study

Overweight/obesity status in preschool children associates with worse asthma but robust improvement on inhaled corticosteroids

Jason E Lang et al. J Allergy Clin Immunol. 2018 Apr.

Abstract

Background: Overweight/obesity (OW) is linked to worse asthma and poorer inhaled corticosteroid (ICS) response in older children and adults.

Objective: We sought to describe the relationships between OW and asthma severity and response to ICS in preschool children.

Methods: This post hoc study of 3 large multicenter trials involving 2- to 5-year-old children compared annualized asthma symptom days and exacerbations among normal weight (NW) (body mass index: 10th-84th percentiles) versus OW (body mass index: ≥85th percentile) participants. Participants had been randomized to daily ICS, intermittent ICS, or daily placebo. Simple and multivariable linear regression was used to compare body mass index groups.

Results: Within the group not treated with a daily controller, OW children had more asthma symptom days (90.7 vs 53.2, P = .020) and exacerbations (1.4 vs 0.8, P = .009) thanNW children did. Within the ICS-treated groups, OW and NW children had similar asthma symptom days (daily ICS: 47.2 vs 44.0 days, P = .44; short-term ICS: 61.8 vs 52.9 days, P = .46; as-needed ICS: 53.3 vs 47.3 days, P = .53), and similar exacerbations (daily ICS: 0.6 vs 0.8, P = .10; short-term ICS: 1.1 vs 0.8 days, P = .25; as-needed ICS: 1.0 vs 1.1, P = .72). Compared with placebo, daily ICS in OW led to fewer annualized asthma symptom days (90.7 vs 41.2, P = .004) and exacerbations (1.4 vs 0.6, P = .006), while similar protective ICS effects were less apparent among NW.

Conclusions: In preschool children off controller therapy, OW is associated with greater asthma impairment and exacerbations. However, unlike older asthmatic patients, OW preschool children do not demonstrate reduced responsiveness to ICS therapy.

Keywords: Asthma; children; exacerbation; infants; obesity; overweight.

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Figures

Figure 1.
Figure 1.
Annualized Asthma Symptom Days among four BMI-percentile groups. Each panel indicates the study and treatment. Box plots represent medians and intra-quartile ranges. Whiskers represent 95th percentile ranges and points denote outliers. BMI-percentile grouping did not affect asthma symptom days, p-values were non-significant (NS) for all panels A-E comparing BMI-percentiles 10–84 vs. 85–100.
Figure 2.
Figure 2.
Annualized exacerbations requiring oral steroid bursts among four BMI-percentile groups. Each panel indicates the study and treatment. Box plots represent medians and interquartile ranges. Whiskers represent 95th percentile ranges and points denote outliers. BMI-percentile grouping did not affect asthma exacerbations with the exception of MIST daily ICS. P-values were non-significant (NS) in panels (A, C, D, E) comparing BMI-percentile groups 10–84 vs. 85–100.
Figure 3.
Figure 3.
Exacerbations and asthma symptom days among four BMI-percentile groups. Box plots (a, b) represent medians and intra-quartile ranges. Whiskers represent 95th% ranges. BMI-percentile grouping did not affect AD or exacerbations among ICS-treated, p>0.05; OW participants treated with placebo demonstrated significantly greater AD and exacerbations compared to NW (p=0.01 for both comparison). P-values in all panels compare BMI-percentiles 10–84 vs. 85–100.
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References

    1. Akinbami LJ, Moorman JE, Bailey C, Zahran HS, King M, Johnson CA, et al. Trends in asthma prevalence, health care use, and mortality in the United States, 2001–2010. NCHS data brief. 2012(94):1–8. - PubMed
    1. Moorman JE, Akinbami LJ, Bailey CM, Zahran HS, King ME, Johnson CA, et al. National surveillance of asthma: United States, 2001–2010. Vital & health statistics Series 3, Analytical and epidemiological studies / [US Dept 2012(35):1–67. - PubMed
    1. NAEPP. Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma (Full Report 2007). NHLBI/NIH, US Department of Health and Human Services; 2007. August 28, 2007. Contract No.: NIH Publication No. 07–4051.
    1. Michelson PH, Williams LW, Benjamin DK, Barnato AE. 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
    1. Luder E, Melnik TA, DiMaio M. Association of being overweight with greater asthma symptoms in inner city black and Hispanic children. J Pediatr. 1998;132(4):699–703. - PubMed

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