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Assessment of Child Anthropometry in a Large Epidemiologic Study
Published on: February 2, 2017
Differing associations of BMI and body fat with asthma and lung function in children
Ran Wang1, Adnan Custovic, Angela Simpson
1Manchester Academic Health Science Centre, University of Manchester, University Hospital of South Manchester, NHS Foundation Trust, Manchester, UK.
Insights
Childhood asthma and obesity are linked, but body fat percentage (PBF) and truncal fat (PTF) show stronger associations than BMI, especially in girls. Different measures of body fat impact lung function differently in boys and girls.
Area of Science:
- Pediatric Pulmonology
- Pediatric Endocrinology
- Obesity Research
Background:
- Evidence suggests a weak association between childhood asthma and obesity.
- Body Mass Index (BMI) is commonly used to assess adiposity but has limitations.
- More precise measures of body fat may offer better insights into asthma-obesity links.
Purpose of the Study:
- To investigate the association between different adiposity markers and respiratory health in children.
- To compare the utility of BMI, percent body fat (PBF), and percent truncal fat (PTF) in predicting asthma and wheeze.
- To explore potential gender differences in the relationship between adiposity and asthma.
Main Methods:
- 11-year-old children from a population-based study underwent measurements of weight, height, PBF, and PTF using bioelectrical impedance.
- Participants were assessed for asthma and wheeze through spirometry, skin prick testing, and parental questionnaires.
- Children were classified as normal or overweight based on BMI and PBF cut-offs to analyze associations with respiratory outcomes.
Main Results:
- BMI z-score, PBF, and PTF were positively associated with current wheeze and asthma.
- Associations between adiposity and asthma were significant in girls for PBF and PTF, with a notable gender interaction.
- Overweight defined by PBF showed stronger links to wheezing and asthma than BMI; BMI correlated with lung function in girls, while body fat correlated with reduced lung function in boys.
Conclusions:
- All measured adiposity markers (BMI, PBF, PTF) correlate with childhood wheeze, asthma, and lung function.
- The effects of BMI and PBF differ, and gender significantly influences the relationship between adiposity and respiratory health.
- PBF and PTF may be more sensitive indicators of asthma risk than BMI, particularly in differentiating effects between genders.
Background:
Current evidence suggests that in children there is a significant, albeit weak, association between asthma and obesity. Studies generally use body mass index (BMI) in evaluating body adiposity, but there are limitations to its use.
Method:
Children from a population-based study attending follow-up (age 11 years) were weighed, measured and had percent body (PBF) and truncal (PTF) fat assessed using bioelectrical impedance. They were skin prick tested and completed spirometry. Parents completed a validated respiratory questionnaire. Children were defined as normal or overweight according to BMI and PBF cut-offs. We tested the association between these adiposity markers with wheeze, asthma, atopy, and lung-function.
Results:
Six hundred forty-six children (339 male) completed follow-up. BMI z-score, PBF, and PTF were all positively associated with current wheeze (odds ratio [95% CI]: 1.27 [1.03, 1.57], P = 0.03; 1.05 [1.00, 1.09], P = 0.03; 1.04 [1.00, 1.08], P = 0.04, respectively). Similar trends were seen with asthma. However, when examining girls and boys separately, significant positive associations were found with PBF and PTF and asthma but only in girls (gender interaction P = 0.06 and 0.04, respectively). Associations between being overweight and wheezing and asthma were stronger when overweight was defined by PBF (P = 0.007, 0.03) than BMI (P > 0.05). Higher BMI was significantly associated with an increase in FEV(1) and FVC, but only in girls. Conversely, increasing body fat (PBF and PTF) was associated with reduced FEV(1) and FVC, but only in boys. No associations between adiposity and atopy were found.
Conclusion:
All adiposity measures were associated with wheeze, asthma, and lung function. However, BMI and PBF did not have the same effects and girls and boys appear to be affected differently.
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