Associations between central obesity and asthma in children and adolescents: a case–control study

Abstract

Introduction: Evidence supports a significant yet weak association between high-body weight and asthma in children. However, most studies investigating the obesity–asthma link use Body Mass Index (BMI) to evaluate body fatness. The relationship between body fat distribution and asthma remains largely unknown, especially in children. This pediatric case–control investigation examined associations between central obesity/high-body weight and asthma diagnosis. Methods: Five-hundred and fourteen children (217 physician diagnosed asthma cases and 297 healthy controls) of 5–11 years were recruited. Height, weight and waist circumference were measured. Asthma symptoms, past medical history, personal lifestyle, socioeconomic status, diet and physical activity history were also collected. Results: A higher proportion of children with asthma were centrally obese [(≥90th waist percentile) 15.2 vs. 9.4%, p<0.0001; (≥90th waist-to-height ratio percentile) 39.6 vs. 24.2%, p<0.0001)]. Regression analyses revealed that centrally obese children were more likely to have asthma (high-waist circumference (OR = 1.99, 95% CI: 1.07-3.68) and high-waist circumference to height ratio (OR = 2.24, 95% CI: 1.47-3.40), following adjustment for various confounders. Overweight/obese participants (BMI defined) were more likely to be asthmatic [odds ratio (OR) = 1.52, 95% confidence interval (CI): 1.03-2.70)] when compared to controls. Conclusions: Presence of central obesity and high-body weight (at least overweight) as assessed by waist circumference, waist-to-height ratio, and BMI are associated with asthma diagnosis. More studies are needed, especially in children and adolescents, to confirm these findings and better understand how body fat distribution impacts the obesity–asthma relationship.

• Asthma
• body mass index
• central obesity
• children
• obesity
• overweight
• waist circumference
• waist-to-height ratio

Acknowledgements

The authors thank all faculty, students of Athens University, Harokopio University and all clinical staff of Penteli Children’s Hospital and the municipal multi-clinic centers in Galatsi and Pefki for their invaluable assistance.

Declaration of interest

The authors have no conflict of interest. CP was supported by a post-doctoral grant, Greek State Scholarship Foundation. MC was supported by a scholarship grant, Onassis Foundation.