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BMI predicts exercise induced bronchoconstriction in asthmatic boys
Wilma J van Veen1,2, Jean M M Driessen3,4, Elin T G Kersten1,2
1Department of Pediatrics, Medisch Spectrum Twente, Enschede, The Netherlands.
Pediatric Pulmonology
|July 12, 2017
Summary
Obesity and overweight significantly worsen exercise-induced bronchoconstriction (EIB) in children with asthma. Higher BMI z-scores increase EIB risk, even in normal-weight boys, highlighting the importance of weight management.
Area of Science:
- Pediatric Pulmonology
- Asthma Research
- Obesity and Health
Background:
- Exercise-induced bronchoconstriction (EIB) is a common and troublesome symptom in children with asthma.
- Obesity is increasingly recognized as a factor associated with asthma severity and EIB in pediatric populations.
Purpose of the Study:
- To investigate and quantify the impact of Body Mass Index (BMI) on the likelihood and severity of EIB in children diagnosed with asthma.
- To determine the relationship between BMI z-scores and the prevalence of EIB in asthmatic children.
Main Methods:
- A meta-analysis of six studies involving exercise challenge tests conducted according to international guidelines.
- Inclusion of 212 children aged 7-18 years with pediatrician-diagnosed mild-to-moderate asthma.
- Analysis of Body Mass Index (BMI) z-scores and their correlation with EIB occurrence and severity, measured by forced expiratory volume in 1 second (FEV1) decline.
Main Results:
- Nearly half (49%) of the children experienced positive EIB during exercise challenges (FEV1 fall ≥13%).
- Overweight and obese children exhibited significantly greater EIB severity (mean FEV1 fall 23.9%) compared to normal-weight children (17.9%).
- A BMI z-score of +1 was associated with a 2.9-fold increased risk of EIB prevalence. Each 0.1 increase in BMI z-score in boys correlated with a 1.4-fold increased risk.
Conclusions:
- The severity of EIB is substantially higher in overweight and obese children with asthma compared to their normal-weight counterparts.
- BMI z-score is a significant predictor of EIB incidence in asthmatic children, even within the normal weight range, particularly in boys.
- These findings underscore the critical role of weight management in mitigating EIB in pediatric asthma patients.
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