Asthma and body weight change: a 20-year prospective community study of young adults

Hasler, Gregor; Gergen, Peter J.; Ajdacic, Vladeta; Gamma, Alex; Eich, Dominique; Rössler, Wulf; Angst, Jules

doi:10.1038/sj.ijo.0803215

Cited by 47 publications

(39 citation statements)

References 38 publications

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“…Although most previous studies documented that obesity precedes and predicts the development of asthma (4,8,22), no unanimity exists. A recent prospective study following subjects from age 20 to 40 years showed that active asthma was associated with later weight gain and later obesity among women, whereas weight gain and obesity were not associated with later asthma (12). However, no association was found among men.…”

Section: Discussionmentioning

confidence: 95%

“…Although longitudinal studies have documented obesity as a risk factor for asthma incidence (8)(9)(10)(11), it is unclear whether children with asthma are at higher risk for the development of obesity. Several risk factors for obesity are more prevalent among children with asthma, including reduced physical activity (12) and potential adverse effects from corticosteroid medications (13). If asthma increases the risk for developing obesity, then a portion of the obesity epidemic in children may be related to the increased occurrence of asthma or the effects of a common etiologic factor.…”

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confidence: 99%

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Effects of Childhood Asthma on the Development of Obesity among School-aged Children

Chen

Salam

Alderete

et al. 2017

Am J Respir Crit Care Med

115

104

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Rationale: Asthma and obesity often occur together in children. It is unknown whether asthma contributes to the childhood obesity epidemic.Objectives: We aimed to investigate the effects of asthma and asthma medication use on the development of childhood obesity.Methods: The primary analysis was conducted among 2,171 nonobese children who were 5-8 years of age at study enrollment in the Southern California Children's Health Study (CHS) and were followed for up to 10 years. A replication analysis was performed in an independent sample of 2,684 CHS children followed from a mean age of 9.7 to 17.8 years.Measurements and Main Results: Height and weight were measured annually to classify children into normal, overweight, and obese categories. Asthma status was ascertained by parent-or self-reported physician-diagnosed asthma.Cox proportional hazards models were fitted to assess associations of asthma history with obesity incidence during follow-up. We found that children with a diagnosis of asthma at cohort entry were at 51% increased risk of developing obesity during childhood and adolescence compared with children without asthma at baseline (hazard ratio, 1.51; 95% confidence interval, 1.08-2.10) after adjusting for confounders. Use of asthma rescue medications at cohort entry reduced the risk of developing obesity (hazard ratio, 0.57; 95% confidence interval, 0.33-0.96). In addition, the significant association between a history of asthma and an increased risk of developing obesity was replicated in an independent CHS sample.Conclusions: Children with asthma may be at higher risk of obesity. Asthma rescue medication use appeared to reduce obesity risk independent of physical activity.

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Section: Discussionmentioning

confidence: 95%

mentioning

confidence: 99%

Effects of Childhood Asthma on the Development of Obesity among School-aged Children

Chen

Salam

Alderete

et al. 2017

Am J Respir Crit Care Med

115

104

View full text Add to dashboard Cite

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“…C-reactive protein, leptin and adiponectin) were not investigated in this study. In addition, adolescents with higher BMI may have physiological impairments in lung function, more gastro-esophageal reflux, and sleep apnea, and thereby may be misclassified as asthmatics [10,11,32]. Future prospective studies will be necessary to clarify the relationship between obesity, inflammation and asthma.…”

Section: Discussionmentioning

confidence: 99%

Association between Obesity and the Prevalence of Allergic Diseases, Atopy, and Bronchial Hyperresponsiveness in Korean Adolescents

Yoo

Kim

Lee

et al. 2010

Int Arch Allergy Immunol

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Background: Although several mechanisms underlying the asthma-obesity connection have been proposed, debates still remain. This study was to determine whether overweight is associated with a higher prevalence of atopy, asthma symptoms, airway obstruction, bronchial hyperresponsiveness (BHR) or biomarkers of inflammation in a sample of Korean adolescents. Methods: We conducted a cross-sectional survey involving questionnaires, skin tests, spirometry and methacholine challenge tests among 717 adolescents from Seoul (South Korea). Overweight status was defined as a BMI greater than the local age- and gender-specific 85th percentile. Results: Overweight subjects more frequently reported ever having wheezing (24.6 vs. 14.0%, p = 0.001) and wheezing in the previous 12 months (11.5 vs. 6.3%, p = 0.02) than normal-weight subjects, especially in boys. Atopy was more common among overweight adolescents than among those of normal weight (61.5 vs. 49.2%, p = 0.002), especially in boys (65.0 vs. 52.8%, p = 0.005). Overweight subjects had higher total WBC counts and eosinophil counts, especially boys. The presence of BHR was more common only among overweight girls (32.8 vs. 18.0%, p = 0.028). Overweight status was a significant risk factor for the presence of atopy (odds ratio = 1.49; 95% CI 1.06–2.10), after adjusting for various confounders by logistic regression analysis. Conclusions: An association was found between overweight status and both atopy and an increased prevalence of wheezing in adolescent Korean boys. These findings suggest that being overweight in puberty may be one of several risk factors responsible for atopy, BHR, and asthma symptoms.

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“…27). Epidemiological evidence from several studies suggests a correlation between body mass index and asthma (28)(29)(30)(31)(32). Using quantitative real time RT-PCR, Western blot analysis, and enzyme immunoassay, we found that activated Th2 cells selectively expressed the gene PMCH.…”

Section: T H1 and Th2 Cells Are The Two Main Subsets Of Cd4mentioning

confidence: 99%

Human Th2 cells selectively express the orexigenic peptide, pro-melanin-concentrating hormone

Sandig

McDonald

Gilmour

et al. 2007

Proc. Natl. Acad. Sci. U.S.A.

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The subsets have different roles in the clearance of pathogens, and their unregulated activation leads to distinct immune pathologies. Th1 cells express IFN␥ and are crucial for the phagocytic immune response against intracellular pathogens, such as Mycobacterium tuberculosis, but their aberrant activation is implicated in autoimmunity (2). Human Th2 cells express IL-4, IL-5, and IL-13 and orchestrate an immune response characterized by eosinophilia and IgE class-switching to fight extracellular pathogens (2). Th2 cell activation is also central to the pathogenesis of allergic diseases, such as asthma, in which the Th2 cytokines play important roles (3-5).PMCH encodes a prohormone, pro-melanin-concentratinghormone (PMCH) of 165 aa which is proteolytically processed to form several peptides including the orexigenic peptide melanin concentrating hormone (MCH) (6). PMCH was first implicated in the regulation of appetite by the finding that the gene is up-regulated in obese, leptin-deficient mice (7). Further studies demonstrated that intracerebroventricular administration of MCH into rats increases feeding (8) and that weight gain occurs after chronic infusion of the peptide into the lateral ventricle (9), strongly suggesting that the peptide stimulates appetite. In addition, mice deficient in MCH are lean and hypophagic (10), and animals overexpressing the gene are obese (11). Several groups cloned the G protein-coupled receptor for MCH (MCHR1) (12-15), and MCHR1-deficient mice are resistant to diet-induced obesity (16,17). A second receptor, MCHR2, was later identified in humans by its homology to MCHR1 (18-23). MCHR2 is not present in the rodent genomes, but orthologs have been identified in ferret, dog and rhesus monkey, in addition to the human gene (24). PMCH therefore has an important role in increasing appetite (25), and a small molecule antagonist of MCHR1 has been shown to reduce feeding and weight gain in rats fed a high fat diet ad libitum (26).The prevalence of both asthma and obesity are increasing in the western world, and a link between the two conditions has been proposed and debated (reviewed in ref. 27). Epidemiological evidence from several studies suggests a correlation between body mass index and asthma (28-32). Using quantitative real time RT-PCR, Western blot analysis, and enzyme immunoassay, we found that activated Th2 cells selectively expressed the gene PMCH. Activated Th2 cells secreted MCH-containing proteins, and ex vivo Th2 but not Th1 cells also expressed the gene. We hypothesize that expression of PMCH by Th2 cells in vivo in the asthmatic lung may link asthma and obesity. ResultsIn Vitro-Differentiated Th2 Cells Selectively Express PMCH. Naïve human CD4 ϩ T cells were cultured in either Th1 (IL-12 and anti-IL-4) or Th2 (IL-4 and anti-IFN␥), inducing conditions for up to 28 days with weekly restimulations (33). After differentiation the cells were highly polarized as shown by intracellular cytokine staining ( Fig. 1 A and B), with 95% of the Th1 cells producing IFN␥ on stimulation, ...

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Asthma and body weight change: a 20-year prospective community study of young adults

Cited by 47 publications

References 38 publications

Effects of Childhood Asthma on the Development of Obesity among School-aged Children

Effects of Childhood Asthma on the Development of Obesity among School-aged Children

Association between Obesity and the Prevalence of Allergic Diseases, Atopy, and Bronchial Hyperresponsiveness in Korean Adolescents

Human Th2 cells selectively express the orexigenic peptide, pro-melanin-concentrating hormone

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