Investigating Overweight/Obesity as a Susceptibility Factor for Secondhand Smoke in Childhood Asthma

调查超重/肥胖是儿童哮喘二手烟的易感因素

• 批准号: 9392616
• 负责人: Tianshi David Wu
• 金额: $ 7.91万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-09-01 至 2019-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9392616
• 关键词: Adverse effects; Air; Air Pollution; Anthropometry; Asthma; Baltimore; Biolectric Impedance; Biological; Biological Markers; Blood; Body fat; Body mass index; Child; Childhood Asthma; Clinical Research; Communities; Data; Data Analyses; Enrollment; Environment; Environmental Health; Environmental Monitoring; Environmental Tobacco Smoke; Epidemic; Etiology; Exposure to; Foundations; Funding; Future; Health; Home environment; Household; Immersion Investigative Technique; Indoor Air Pollution; Inflammation; Inflammatory; Intervention; Intervention Trial; Investigation; Low income; Measurement; Measures; Mediating; Minority; Morbidity - disease rate; National Health and Nutrition Examination Survey; National Institute of Environmental Health Sciences; Obesity; Observational Study; Outcome; Overweight; Oxidative Stress; Participant; Predisposition; Prevalence; Public Health; Refractory; Reporting; Research; Respiratory Signs and Symptoms; Serum; Solid; Source; Symptoms; Time; Training; United States; Vulnerable Populations; Weight; Work; base; biological adaptation to stress; cohort; environmental tobacco smoke exposure; evidence base; experience; health disparity; improved; inflammatory marker; inner city; obesity in children; operation; public health intervention; urinary; waist circumference

PROJECT SUMMARY Childhood asthma and obesity are pressing health epidemics in the United States that disproportionately impact children who are minorities and come from households with lower incomes. Asthma in obese children tends to be more severe and refractory to treatment. An emerging explanatory hypothesis is that these children may be more vulnerable to components of air pollution. Secondhand smoke is a dominant source of indoor air pollution, particularly in the inner city, where up to 80% of children with asthma are regularly exposed. The differential effects of secondhand smoke based on weight are not known. We hypothesize that secondhand smoke is preferentially deleterious to overweight or obese children with asthma, and that this relationship may correlate with differences in inflammation and oxidative stress. Because obesity is associated with basal elevations in inflammation and because asthma is associated with enhanced inflammation and oxidative stress, we believe that this is a plausible biologic mechanism. We have discovered compelling preliminary evidence from the National Health and Nutrition Examination Survey (NHANES) that children who are overweight or obese report greater symptoms when exposed to secondhand smoke as compared to normal weight children. This project extends the results of this analysis to a local level, in more well-characterized cohorts of children who have both symptom and blood biomarker assessment. This study will be performed in (1) two large observational cohorts of children with asthma, comparing those who are and are not exposed to secondhand smoke, and in (2) an interventional cohort of children with asthma who are all exposed to secondhand smoke and have subsequent reductions in secondhand smoke exposure through the use of an advanced air purifier, comparing differences in asthma improvement between those who are normal weight and overweight or obese. As body mass index is an imperfect marker for adiposity, this project will also examine if other different measures of adiposity, waist circumference and percentage body fat as estimated by bioelectrical impedance analysis, perform better than body mass index in identifying this vulnerable group.

项目总结 儿童哮喘和肥胖是美国迫在眉睫的健康流行病 对来自低收入家庭的少数族裔儿童的影响不成比例。哮喘 肥胖儿童的病情往往更为严重，难以治疗。一个新出现的解释假说是 这些孩子可能更容易受到空气污染成分的影响。二手烟是占主导地位的 室内空气污染源，特别是在市中心，那里高达80%的哮喘儿童是 定期曝光。二手烟对体重的不同影响尚不清楚。 我们假设二手烟对超重或肥胖的儿童有优先害处。 这种关系可能与炎症和氧化应激的差异有关。 因为肥胖与炎症的基础升高有关，也因为哮喘与 增强炎症和氧化应激，我们认为这是一种合理的生物机制。 我们发现了令人信服的初步证据，来自国家健康和营养 检查调查(NHANES)，超重或肥胖的儿童在以下情况下报告的症状更严重 与正常体重的儿童相比，暴露在二手烟中的儿童。该项目扩展了这一成果 在更多具有良好特征的症状和血液兼备的儿童队列中，对地方层面的分析 生物标记物评估。这项研究将在(1)两个大型观察队列儿童中进行 哮喘，比较接触二手烟和不接触二手烟的人，以及(2)干预性 所有暴露在二手烟中并随后患哮喘的儿童的队列 通过使用先进的空气净化器暴露于二手烟，比较哮喘的差异 那些正常体重和超重或肥胖的人之间的改善。 由于身体质量指数不是肥胖的完美标志，该项目还将研究其他不同的 用生物电阻抗估测肥胖、腰围和体脂百分比 分析，在识别这一弱势群体方面比体重指数表现得更好。