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Assessment of Child Anthropometry in a Large Epidemiologic Study
Published on: February 2, 2017
Mediators linking obesity to childhood asthma
Yang-Ching Chen1,2,3,4, Yen-Tsung Huang5, Wen-Harn Pan6
1Department of Family Medicine, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan.
Insights
Childhood obesity increases asthma risk, primarily through reduced physical fitness, impaired lung function, and early puberty. Interventions targeting these factors can mitigate this risk.
Area of Science:
- Pediatric Health
- Respiratory Medicine
- Genetics
Background:
- Obesity and asthma share a strong association in children, yet the underlying causal mechanisms require elucidation.
- Key potential mediators include pulmonary function, airway inflammation, physical fitness, sleep-disordered breathing (SDB), and pubertal timing.
Purpose of the Study:
- To investigate the causal pathways linking childhood obesity to asthma.
- To quantify the mediating roles of pulmonary function, physical fitness, and early puberty in this association.
Main Methods:
- A Mendelian randomization (MR) study incorporating mediation analysis on data from 5965 children (Taiwan Children Health Study).
- Utilized MR two-stage least-squares and sensitivity analyses, complemented by prospective cohort analyses to establish temporal causality.
Main Results:
- Obesity-associated asthma risk is significantly mediated by impaired pulmonary function (61.63%), low physical fitness (73.76%), and early puberty (27.66%).
- Obesity negatively impacts lung function (FEV1/FVC) and physical fitness but is positively associated with early puberty.
- Conversely, improved lung function and physical fitness reduce asthma risk, while SDB and early puberty increase it.
Conclusions:
- Physical fitness and pulmonary function are critical mediators of obesity-induced asthma risk in children.
- Interventions aimed at enhancing physical fitness and lung function hold promise for reducing childhood asthma prevalence in obese populations.
Background:
Obesity and asthma are highly associated, but the mechanisms underlying the association remain unknown. We examined five mediators linking obesity with childhood asthma: (1) pulmonary function impairment, (2) airway inflammation, (3) physical fitness, (4) sleep-disordered breathing (SDB), and (5) early puberty.
Methods:
A Mendelian randomization (MR) study with mediation analysis of data obtained from 5965 children as part of the Taiwan Children Health Study. Observational analysis, MR two-stage least-squares method, and MR sensitivity analysis were carried out to investigate each causal pathway. Prospective cohort analyses were used to strengthen the findings.
Results:
The increased asthma risk associated with obesity was found to be mostly mediated through impaired pulmonary function, low physical fitness, and early puberty. In the MR analysis, body mass index was negatively associated with FEV1/FVC and physical fitness index (β = -2.17 and -0.71; 95% CI, -3.92 to -0.42 and -1.30 to -0.13, respectively) and positively associated with early puberty (OR, 1.09; 95% CI, 1.02-1.17). High FEV1/FVC and physical fitness index reduced asthma risk (OR, 0.98 and 0.93; 95% CI, 0.97-0.99 and 0.88-0.98, respectively), whereas SDB and early puberty increased the risk of asthma (OR, 1.03 and 1.22; 95% CI, 1.01-1.05 and 1.05-1.42, respectively). Temporal causality was strengthened in prospective cohort analyses. The three main mediators were low physical fitness, impaired pulmonary function, and early puberty, with mediation proportions of 73.76%, 61.63%, and 27.66%, respectively.
Conclusions:
Interventions promoting physical fitness and pulmonary function might effectively reduce obesity-induced asthma risk.
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