Obesity-related pediatric asthma: relationships between pulmonary function and clinical outcomes
Sheena Starr1, Matthew Wysocki2, Jesenya D DeLeon2
1Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, New York, USA.
Insights
Children with obesity-related asthma showed worse clinical outcomes, including hospitalizations and oral steroid use, linked to reduced pulmonary function. Pulmonary function measures are crucial for managing pediatric obesity-related asthma.
Area of Science:
- Pediatric Pulmonology
- Asthma Research
- Obesity and Health
Background:
- Asthma is a common chronic respiratory disease in children.
- Obesity is increasingly recognized as a significant factor influencing asthma severity and outcomes.
- Understanding the interplay between obesity, pulmonary function, and asthma control is critical for effective management.
Purpose of the Study:
- To investigate the association between pulmonary function and clinical asthma outcomes in children with obesity-related asthma compared to those with asthma only.
- To determine if pulmonary function measures correlate with asthma control and exacerbations in these pediatric populations.
Main Methods:
- Cross-sectional analysis of 218 children (ages 7-15) divided into obesity-related asthma and asthma-only groups.
- Pulmonary function assessed using spirometry: percent predicted forced expiratory volume in the first second (FEV1) and FEV1/forced vital capacity (FVC) ratio.
- Structural equation modeling used to analyze associations between pulmonary function, asthma control, and clinical outcomes.
Main Results:
- Lower percent predicted FEV1 and FEV1/FVC ratio were significantly associated with increased hospitalizations and oral steroid bursts in the obesity-related asthma group.
- These associations were not observed in the asthma-only group.
- Pulmonary function measures were not associated with self-reported asthma control in either group.
Conclusions:
- Pulmonary function, specifically FEV1 and FEV1/FVC, is linked to asthma exacerbations (hospitalizations, oral steroid use) in children with obesity-related asthma.
- Self-reported asthma control did not correlate with pulmonary function in either group.
- Incorporating pulmonary function assessments is vital for optimizing the treatment of pediatric obesity-related asthma.
Objective:
We hypothesized that children with obesity-related asthma would have worse self-reported asthma control, report an increased number of asthma symptoms and have lower FEV1/FVC associated with worse clinical asthma outcomes compared to children with asthma only.
Methods:
Cross sectional analyses examined two hundred and eighteen (obesity-related asthma = 109, asthma only = 109) children, ages 7-15 that were recruited from clinics and hospitals within the Bronx, NY. Pulmonary function was assessed by forced expiratory volume in the first second (percent predicted FEV1) and the ratio of FEV1 to the forced vital capacity of the lungs (FEV1/FVC). Structural equation modeling examined if pulmonary function was associated with asthma control and clinical outcomes between groups.
Results:
Lower percent predicted FEV1 was associated with increased hospitalizations (p = 0.03) and oral steroid bursts in the past 12 months (p = 0.03) in the obesity-related asthma group but not in the asthma only group. FEV1/FVC was also associated with increased hospitalizations (p = 0.02) and oral steroid bursts (p = 0.008) in the obesity-related asthma group but not the asthma only group. Lower FEV1/FVC was associated with the number of asthma symptoms endorsed in the asthma only group but not in the obesity-related asthma group. Percent predicted FEV1 and FEV1/FVC was not associated with asthma control in either group.
Conclusions:
Pulmonary function was associated with oral steroid bursts and hospitalizations but not self-reported asthma control, suggesting the importance of incorporating measures of pulmonary function into the treatment of pediatric obesity-related asthma.
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