Obesity can influence children’s and adolescents’ airway hyperresponsiveness differently

Abstract

BackgroundLiterature is still arguing about a possible relationship between airway hyperresponsiveness (AHR) and body mass index (BMI). This study aimed at evaluating the influence of BMI on AHR and pulmonary function in children and adolescents that performed a methacholine test for suggestive asthma symptoms.Methods799 consecutive children/adolescents (535 M; mean age: 15 ± 3 yrs; median FEV1% predicted: 101.94% [93.46-111.95] and FEV1/FVC predicted: 91.07 [86.17-95.38]), were considered and divided into underweight, normal, overweight and obese. Different AHR levels were considered as moderate/severe (PD20 ≤ 400 μg) and borderline (PD20 > 400 μg).Results536 children/adolescents resulted hyperreactive with a median PD20 of 366 μg [IQR:168–1010.5]; 317 patients were affected by moderate/severe AHR, whereas 219 showed borderline hyperresponsiveness. Obese subjects aged > 13 years showed a lower (p = 0.026) median PD20 (187μg [IQR:110–519]) compared to overweight (377 μg [IQR:204–774]) and normal-weight individuals’ values (370.5 μg [IQR:189–877]). On the contrary, median PD20 observed in obese children aged ≤ 13 years (761 μg [IQR:731–1212]) was higher (p = 0.052) compared to normal-weight children’s PD20 (193 μg [IQR:81–542]) and to obese adolescents’ values (aged > 13 years) (p = 0.019). Obesity was a significant AHR risk factor (OR:2.853[1.037-7.855]; p = 0.042) in moderate/severe AHR adolescents. Females showed a higher AHR risk (OR:1.696[1.046-2.751] p = 0.032) compared to males. A significant relationship was found between BMI and functional parameters (FEV1, FVC, FEV1/FVC) only in hyperreactive females.ConclusionsObesity seems to influence AHR negatively in female but not in male adolescents and children. In fact, AHR is higher in obese teenagers, in particular in those with moderate/severe hyperresponsiveness, and may be mediated by obesity-associated changes in baseline lung function.

A Study of Prevalence of Obesity in Patients of Bronchial Asthma Attending The Chest Department At Rims,Imphal,Manipur.India.

“…More than half of the patients were females (54%) and this finding is consistent with studies by Agrawal S et al 11 , Forte GC et al 32 and Sposato B et al 28 . And most of these females were housewives which may have been due to greater exposure to fumes and dust at home where chulas are used for cooking.…”

Obesity and asthma

“…65,66 Similarly, it is not clear whether obesity leads to changes in airway hyperresponsiveness (AHR) in children, with some studies reporting higher 67 and others lower AHR. 68…”

Isotonic Saline Nebulization and Lung Function in Children With Mild Respiratory Ailments

“…Nonetheless, many asthmatic patients with normal FEV1 have lower mid-airflow rates pointing to the possibility of ongoing airway inflammation, which calls for a search for alternative methods to assess lung function in asthma, particularly in connection with obesity. On the other side, there are studies showing that obesity in children has an impact on bronchial hyperreactivity, assessed by methacholine challenge, which increases more in females than in males (Sposato et al 2013).…”