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Updated: May 5, 2026
Assessment of Child Anthropometry in a Large Epidemiologic Study
Published on: February 2, 2017
Obesity and adiposity indicators, asthma, and atopy in Puerto Rican children
Erick Forno1, Edna Acosta-Pérez2, John M Brehm1
1Division of Pediatric Pulmonary Medicine, Allergy, and Immunology, Children's Hospital of Pittsburgh of UPMC, University of Pittsburgh, Pittsburgh, Pa.
Insights
Adiposity indicators like BMI are linked to childhood asthma in Puerto Rican children. Atopy, such as allergic rhinitis, significantly mediates this obesity-asthma link.
Area of Science:
- Pediatric Allergy and Immunology
- Environmental Health
- Obesity Research
Background:
- The relationship between childhood asthma and obesity indicators beyond Body Mass Index (BMI) remains under-explored.
- The specific role of atopy in the context of
- obese asthma
- is not well understood.
Purpose of the Study:
- To investigate associations between various adiposity indicators, asthma, and atopy in Puerto Rican children.
- To determine if atopy acts as a mediator in the relationship between obesity and asthma.
Main Methods:
- Cross-sectional study involving Puerto Rican children with (n=351) and without (n=327) asthma.
- Measurement of Body Mass Index (BMI), body fat percentage, waist circumference, and waist-to-hip ratio.
- Mediation analysis to quantify the contribution of atopy to the adiposity-asthma association.
Main Results:
- Increased odds of asthma were associated with higher BMI, body fat percentage, and waist circumference.
- Atopy significantly mediated the adiposity-asthma link, with allergic rhinitis explaining 22-53% of the association.
- Sensitization to cockroach allergen mediated 13-42% of asthma-related outcomes, including lung function and emergency department visits.
Conclusions:
- Adiposity indicators are significantly associated with asthma, its severity, control, and atopy in Puerto Rican children.
- Atopy plays a crucial role in mediating the impact of adiposity on asthma outcomes.
- Further longitudinal research is recommended to elucidate the causal pathways between adiposity distribution, atopy, and childhood "obese asthma".
Background:
Whether adiposity indicators other than body mass index (BMI) should be used in studies of childhood asthma is largely unknown. The role of atopy in "obese asthma" is also unclear.
Objectives:
To examine the relationship among adiposity indicators, asthma, and atopy in Puerto Rican children, and to assess whether atopy mediates the obesity-asthma association.
Methods:
In a study of Puerto Rican children with (n = 351) and without (n = 327) asthma, we measured BMI, percent of body fat, waist circumference, and waist-to-hip ratio. The outcomes studied included asthma, lung function, measures of atopy, and, among cases, indicators of asthma severity or control. We performed mediation analysis to assess the contribution of atopy to the relationship between adiposity and asthma.
Results:
BMI, percent of body fat, and waist circumference were associated with increased odds of asthma. Among cases, all 3 measures were generally associated with lung function, asthma severity/control, and atopy; however, there were differences depending on the adiposity indicator analyzed. Atopy considerably mediated the adiposity-asthma association in this population: allergic rhinitis accounted for 22% to 53% of the association with asthma, and sensitization to cockroach mediated 13% to 20% of the association with forced vital capacity and 29% to 42% of the association with emergency department visits for asthma.
Conclusions:
Adiposity indicators are associated with asthma, asthma severity/control, and atopy in Puerto Rican children. Atopy significantly mediates the effect of adiposity on asthma outcomes. Longitudinal studies are needed to further investigate the causal role, if any, of adiposity distribution and atopy on "obese asthma" in childhood.
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