Being Overweight or Obese and the Development of Asthma
Being Overweight or Obese and the Development of Asthma
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DOI：
10.1542/peds.2018-2119
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发表时间：
2018-12-01
期刊：
影响因子：
8
通讯作者：
Forrest, Christopher B.
中科院分区：
文献类型：
--
作者：
Lang, Jason E.;Bunnell, H. Timothy;Forrest, Christopher B.
目的：成人肥胖与哮喘病例有关，估计每年会导致250000新病例。还没有为儿童制定类似的发病率和归因风险(AR)估计。我们试图描述儿童超重和肥胖与哮喘发病的关系，并量化美国儿童哮喘超重和肥胖的AR统计数据。方法：采用PEDS net临床数据研究网络进行一项回顾性队列研究(2009年1月至2015年12月)，比较超重和/或肥胖与2-17岁健康体重儿童的哮喘发病率。哮喘发病率被定义为<gt；=2次被诊断为哮喘且<gt；=1张哮喘控制药处方。更严格的诊断标准涉及肺活量测定的确认。我们使用多变量泊松回归分析来估计哮喘发病率和风险比，并接受ARS的公式。结果：纳入了来自507496名儿童和19581972次接触的数据。参与者的平均观察期为4年。超重(相对危险度：1.17；95%可信区间：1.10-1.25)和肥胖(相对危险度：1.26；95%可信区间：1.18-1.34)的儿童发生哮喘的调整风险增加。在肥胖儿童中，肺活量测定证实的哮喘的调整风险增加(RR：1.29；95%CI：1.16-1.42)。据估计，肥胖儿童中23%至27%的新哮喘病例直接可归因于肥胖。在没有超重和肥胖的情况下，10%的哮喘病例将被避免。结论：肥胖是儿童哮喘的主要可预防危险因素。
OBJECTIVES: Adult obesity is linked to asthma cases and is estimated to lead to 250000 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 507496 children and 19581972 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.