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Obesity disproportionately impacts lung volumes, airflow and exhaled nitric oxide in children
Tsung-Chieh Yao1,2,3, Hui-Ju Tsai4,5,6, Su-Wei Chang1,7
1Division of Allergy, Asthma, and Rheumatology, Department of Pediatrics, Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taoyuan, Taiwan.
Insights
Excess weight negatively impacts lung function and fraction of exhaled nitric oxide (FeNO) in children. This effect on FeNO is significant in atopic children but not in non-atopic children.
Area of Science:
- Pediatric Pulmonology
- Environmental Health
- Obesity Research
Background:
- Literature on obesity's impact on lung function and FeNO in children, especially non-European descent, is controversial.
- The modifying role of atopy in the obesity-lung function/FeNO relationship in children is unclear.
Purpose of the Study:
- To investigate the effect of excess weight on lung function and FeNO in Asian children.
- To explore potential effect modification by atopy on these relationships.
Main Methods:
- Investigated excess weight effects on lung function and FeNO.
- Studied a population sample of 1,717 children aged 5–18 years.
- Explored potential modifying effect of atopy.
Main Results:
- Positive associations found between BMI z-score and lung volumes (FVC, FEV1, PEF, FEF25-75).
- Negative associations observed between BMI z-score and FEV1/FVC ratio and FeNO.
- BMI z-score negatively associated with FeNO in atopic children, but not in non-atopic children.
Conclusions:
- Excess weight impacts lung volumes and airflow in children, irrespective of atopic status.
- Excess weight inversely affects FeNO in atopic children, but not in non-atopic children.
Background:
The current literature focusing on the effect of obesity and overweight on lung function and fraction of exhaled nitric oxide (FeNO) in children, particularly among healthy children of non-European descent, remains controversial. Furthermore, whether the relationship of obesity and overweight with lung function and FeNO in children is modified by atopy is unclear. The objective of this study was to examine the effect of excess weight on lung function parameters and FeNO among Asian children, with a particular focus on exploring the potential effect modification by atopy.
Methods:
We investigated the effect of excess weight on lung function and FeNO in a population sample of 1,717 children aged 5 to 18 years and explored the potential modifying effect of atopy.
Results:
There were positive associations of body mass index (BMI) z-score with forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), peak expiratory flow (PEF), and forced expiratory flow at 25-75% (FEF25-75) (all P<0.001), after controlling for confounders. The beta coefficient for FEV1 (0.084) was smaller than that for FVC (0.111). In contrast, a negative association was found between BMI z-score and FEV1/FVC ratio (P<0.001) and FeNO (P = 0.03). A consistent pattern of association for lung function variables was observed when stratifying by atopy. There was a negative association of BMI z-score with FeNO in atopic subjects (P = 0.006), but not in non-atopic subjects (P = 0.46).
Conclusions:
Excess weight disproportionately impacts lung volumes and airflow in children from the general population, independent of atopic status. Excess weight inversely affects FeNO in atopic but not in non-atopic children.