Obesity and adiposity indicators, asthma, and atopy in Puerto Rican children
Obesity and adiposity indicators, asthma, and atopy in Puerto Rican children
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DOI：
10.1016/j.jaci.2013.09.041
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发表时间：
2014-05-01
影响因子：
14.2
通讯作者：
Celedon, Juan C.
中科院分区：
文献类型：
--
作者：
Forno, Erick;Acosta-Perez, Edna;Celedon, Juan C.
背景：在儿童哮喘研究中是否应使用体重指数（BMI）以外的肥胖指标尚不清楚。特应性在“肥胖症”中的作用也不清楚。目的：研究波多黎各儿童肥胖指标、哮喘和特应性之间的关系，并评估特应性是否介导肥胖-哮喘关联。方法：在一项针对波多黎各哮喘儿童（n = 351）和非哮喘儿童（n = 327）的研究中，我们测量了BMI、体脂百分比、腰围，和腰臀比例研究的结果包括哮喘、肺功能、特应性指标，以及哮喘严重程度或控制情况的指标。我们进行了中介分析，以评估的贡献，特应性肥胖和asthma.Results之间的关系：BMI，体脂百分比，腰围与哮喘的几率增加。在病例中，所有3项指标通常与肺功能、哮喘严重程度/控制和特应性相关;然而，根据分析的肥胖指标，存在差异。在这一人群中，过敏性鼻炎在很大程度上介导了肥胖与哮喘的关联：过敏性鼻炎占哮喘关联的22%至53%，对蟑螂的敏感性介导了13%至20%与用力肺活量的关联，29%至42%与哮喘急诊室就诊的关联。肥胖指标与波多黎各儿童的哮喘、哮喘严重程度/控制和特应性相关。特应性显著介导肥胖对哮喘预后的影响。需要进行纵向研究以进一步调查肥胖分布和特应性对儿童期"肥胖性哮喘“的因果作用（如果有的话）。
Background: Whether adiposity indicators other than body mass index (BMI) should be used in studies of childhood asthma is largely unknown. The role of atopy in "obeseasthma'' is also unclear.Objectives: To examine the relationship among adiposity indicators, asthma, and atopy in Puerto Rican children, and to assess whether atopy mediates the obesity-asthma association.Methods: In a study of Puerto Rican children with (n = 351) and without (n = 327) asthma, we measured BMI, percent of body fat, waist circumference, and waist-to-hip ratio. The outcomes studied included asthma, lung function, measures of atopy, and, among cases, indicators of asthma severity or control. We performed mediation analysis to assess the contribution of atopy to the relationship between adiposity and asthma.Results: BMI, percent of body fat, and waist circumference were associated with increased odds of asthma. Among cases, all 3 measures were generally associated with lung function, asthma severity/control, and atopy; however, there were differences depending on the adiposity indicator analyzed. Atopy considerably mediated the adiposity-asthma association in this population: allergic rhinitis accounted for 22% to 53% of the association with asthma, and sensitization to cockroach mediated 13% to 20% of the association with forced vital capacity and 29% to 42% of the association with emergency department visits for asthma.Conclusions: Adiposity indicators are associated with asthma, asthma severity/control, and atopy in Puerto Rican children. Atopy significantly mediates the effect of adiposity on asthma outcomes. Longitudinal studies are needed to further investigate the causal role, if any, of adiposity distribution and atopy on `` obese asthma'' in childhood.