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Adiposity, fractional exhaled nitric oxide, and asthma in U.S. children

Yueh-Ying Han1, Erick Forno, Juan C Celedón

  • 1Division of Pediatric Pulmonary Medicine, Allergy, and Immunology, Children's Hospital of Pittsburgh of UPMC, University of Pittsburgh, Pittsburgh, Pennsylvania.

American Journal of Respiratory and Critical Care Medicine
|June 13, 2014
PubMed

Insights

Childhood obesity is linked to asthma, but allergic airway inflammation plays a key role. Higher body fat is associated with asthma in children with low fractional exhaled nitric oxide (FeNO) and worse asthma control in those with high FeNO.

Area of Science:

  • Pediatric Allergy and Immunology
  • Respiratory Medicine
  • Obesity Research

Background:

  • The relationship between childhood overweight/obesity and asthma is complex and not fully understood.
  • The role of allergic airway inflammation, specifically eosinophilic inflammation, as a mediator is unclear.

Purpose of the Study:

  • To investigate the associations between adiposity, asthma, and fractional exhaled nitric oxide (FeNO) in a U.S. pediatric population.
  • To determine if FeNO modifies the relationship between obesity and asthma outcomes.

Main Methods:

  • Cross-sectional analysis of 2,681 children aged 6-17 years from the National Health and Nutrition Examination Survey (2007-2010).
  • Adiposity assessed using body mass index (BMI), percent body fat (PBF), and waist circumference (WC).
  • Fractional exhaled nitric oxide (FeNO) measured as a biomarker of eosinophilic airway inflammation.

Main Results:

  • Adiposity indicators (BMI, PBF, WC) were associated with asthma in children with low FeNO.
  • Among children with asthma, adiposity was linked to worse asthma severity or control in those with high FeNO.
  • In children without asthma, adiposity was associated with altered lung function (FEV1, FVC, FEV1/FVC).

Conclusions:

  • Adiposity is associated with asthma in children with low fractional exhaled nitric oxide (FeNO).
  • In children with asthma, adiposity indicators correlate with poorer asthma control and severity, particularly in those with elevated FeNO levels.
Abstract

Keywords:
NHANESadiposityairway inflammationasthmaobesity

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