Longitudinal association of adiposity with wheezing and atopy at 22 years: the 1993 Birth Cohort, Pelotas, Brazil

Figures & data

Table 1 Characteristics of the 22-year follow-up sample

Variables	N (%)
Gender
Male	1,783 (46.8)
Female	2,027 (53.2)
Skin color
White	2,262 (63.3)
Black	538 (15.1)
Brown	637 (17.8)
Other	137 (3.8)
Asset index (quintiles)
First (poorest)	761 (20.0)
Second	761 (20.0)
Third	761 (20.0)
Fourth	761 (20.0)
Fifth (richest)	760 (20.0)
Education (years)
0–4	111 (2.9)
5–8	1,013 (26.6)
9–11	1,560 (41.0)
≥12	1,121 (29.5)
Maternal smoking during pregnancy	1,242 (32.6)
Maternal smoking at 11 years follow-up
Never	1,693 (46.9)
Former	787 (21.8)
Smoker	1,131 (31.3)
Paternal (or mothers partner) smoking at 11 years follow-up
Never	1,030 (37.2)
Former	707 (25.5)
Smoker	1,031 (37.3)
Hospitalization during the first 10 years of life	1,339 (37.1)
Parents history of asthma, wheezing, or bronchitis at 11 years follow-up	1,236 (34.8)
Household crowding at 18 years
≤3	1,359 (38.6)
4–5	1,569 (44.5)
≥6	595 (16.9)
Active at leisure and/or commuting at 18 and 22 years
None	648 (18.5)
Only at 18 years	569 (16.2)
Only at 22 years	749 (21.3)
Both ages	1,542 (44.0)
Smoker at 18 and 22 years
None	2,824 (80.3)
Only at 18 years	117 (3.3)
Only at 22 years	229 (6.5)
Both ages	347 (9.9)
BMI obese (≥ 30 kg/m^2) at 18 and 22 years
None	2,689 (79.9)
Only at 18 years	69 (2.1)
Only at 22 years	344 (10.2)
Both ages	262 (7.8)
Total fat mass – BOD POD % in the third tertile
None	1,905 (58.4)
Only at 18 years	302 (9.3)
Only at 22 years	287 (8.8)
Both ages	770 (23.6)
Total fat mass – DXA % in the third tertile
None	1,751 (58.7)
Only at 18 years	259 (8.7)
Only at 22 years	270 (9.1)
Both ages	704 (23.6)
Trunk fat mass – DXA % in the third tertile
None	1,741 (58.3)
Only at 18 years	271 (9.1)
Only at 22 years	280 (9.4)
Both ages	697 (23.3)
FMI in the third tertile
None	1,910 (58.6)
Only at 18 years	273 (8.4)
Only at 22 years	278 (8.5)
Both ages	801 (24.6)

Notes: The 1993 Pelotas Birth cohort (n=3,810). Maximum missing values for DXA variables (total n=3,325).

Abbreviations: BMI, body mass index; DXA, dual-energy X-ray absorptiometry; FMI, fat mass index.

Figure 1 Prevalence of self-reported wheezing and atopy symptoms in the last 12 months at 22 years by sex.

Note: The 1993 Pelotas Birth Cohort.

Table 2 Mean BMI and body composition variables at 18- and 22-year follow-up by sex

Variables	Males		Females
	18 years Mean (SD)	22 years Mean (SD)	18 years Mean (SD)	22 years Mean (SD)
BMI (kg/m^2)	23.3 (4.1)	25.1 (4.8)	23.5 (4.8)	25.6 (5.8)
Total fat mass (BOD POD %)	16.7 (8.7)	20.9 (9.8)	32.8 (7.8)	35.8 (8.5)
Total fat mass (DXA %)	16.8 (9.3)	20.8 (10.0)	34.9 (8.4)	38.0 (8.8)
Trunk fat mass (DXA %)	18.8 (10.5)	24.2 (11.5)	36.0 (9.3)	39.4 (9.7)
FMI (fat kg/height m^2)	4.2 (3.0)	5.6 (3.7)	8.0 (3.6)	9.5 (4.4)

Notes: The 1993 Pelotas Birth Cohort. BMI n=3,588; BOD POD n=3,559; DXA n=3,325.

Abbreviations: BMI, body mass index; DXA, dual-energy X-ray absorptiometry; FMI, fat mass index..

Table 3 Association between body composition at 18 and 22 years and wheezing and atopy

	“Wheezing in the last year”a		“Only wheezing in the last year” (without atopy)b		“Wheezing + atopy in the last year”b		“Only atopy in the last year”b
	Crude	Adjusted	Crude	Adjusted	Crude	Adjusted	Crude	Adjusted
18 years/22 years	OR (95% CI)	OR (95% CI)	OR (95% CI)	OR (95% CI)	OR (95% CI)	OR (95% CI)	OR (95% CI)	OR (95% CI)
BMI obese (≥30 kg/m^2)	P=0.006	P=0.013	P=0.028	P=0.043	P=0.025	P=0.015	P=0.188	P=0.942
None	1.00	1.00	1.00	1.00	1.00	1.00	1.00	1.00
Only at 18 years	1.26 (0.60, 2.67)	1.28 (0.53, 3.11)	0.90 (0.21, 3.79)	0.71 (0.09, 5.42)	1.63 (0.68, 3.92)	1.83 (0.68, 4.99)	1.20 (0.72, 2.03)	1.29 (0.69, 2.42)
Only at 22 years	1.20 (0.84, 1.73)	1.19 (0.75, 1.88)	0.96 (0.52, 1.79)	0.73 (0.30, 1.75)	1.26 (0.81, 1.96)	1.63 (0.96, 2.76)	0.87 (0.68, 1.12)	1.19 (0.87, 1.63)
Both	1.92 (1.35, 2.73)	2.00 (1.32, 3.03)	2.14 (1.27, 3.60)	2.42 (1.31, 4.45)	1.63 (1.03, 2.59)	1.67 (0.96, 2.88)	0.85 (0.63, 1.15)	0.86 (0.60, 1.25)
Total fat mass – BOD POD % in the third tertile	P=0.226	P=0.108	P=0.567	P=0.095	P=0.128	P=0.092	P=0.845	P=0.377
None	1.00	1.00	1.00	1.00	1.00	1.00	1.00	1.00
Only at 18 years	0.96 (0.63, 1.46)	0.85 (0.50, 1.47)	0.80 (0.39, 1.63)	0.90 (0.37, 2.20)	1.15 (0.69, 1.93)	0.89 (0.46, 1.74)	1.16 (0.89, 1.51)	1.11 (0.80, 1.53)
Only at 22 years	0.89 (0.57, 1.38)	0.97 (0.57, 1.65)	0.63 (0.29, 1.39)	0.45 (0.14, 1.49)	1.11 (0.66, 1.87)	1.33 (0.74, 2.41)	1.07 (0.81, 1.40)	1.08 (0.77, 1.50)
Both	1.28 (0.98, 1.67)	1.42 (1.04, 1.95)	1.21 (0.80, 1.83)	1.69 (1.03, 2.78)	1.31 (0.93, 1.83)	1.38 (0.93, 2.06)	0.97 (0.80, 1.17)	1.10 (0.88, 1.38)
Total fat mass – DXA % in the third tertile	P=0.238	P=0.048	P=0.396	P=0.053	P=0.080	P=0.021	P=0.666	P=0.371
None	1.00	1.00	1.00	1.00	1.00	1.00	1.00	1.00
Only at 18 years	1.01 (0.64, 1.58)	0.98 (0.56, 1.73)	1.00 (0.49, 2.06)	1.25 (0.53, 2.97)	1.04 (0.59, 1.85)	0.87 (0.42, 1.83)	1.06 (0.79, 1.41)	1.05 (0.75, 1.48)
Only at 22 years	1.10 (0.71, 1.68)	1.16 (0.68, 1.99)	0.58 (0.24, 1.34)	0.50 (0.15, 1.67)	1.25 (0.76, 2.05)	1.43 (0.79, 2.62)	0.70 (0.52, 0.95)	0.81 (0.57, 1.17)
Both	1.34 (1.01, 1.77)	1.58 (1.14, 2.20)	1.33 (0.86, 2.08)	1.88 (1.11, 3.19)	1.36 (0.95, 1.94)	1.60 (1.06, 2.42)	1.02 (0.84, 1.24)	1.16 (0.92, 1.47)
Trunk fat mass – DXA % in the third tertile	P=0.324	P=0.064	P=0.595	P=0.086	P=0.078	P=0.014	P=0.876	P=0.108
None	1.00	1.00	1.00	1.00	1.00	1.00	1.00	1.00
Only at 18 years	0.95 (0.60, 1.48)	0.93 (0.53, 1.63)	0.75 (0.35, 1.59)	0.90 (0.37, 2.22)	0.99 (0.57, 1.73)	0.84 (0.42, 1.70)	0.85 (0.64, 1.14)	0.78 (0.55, 1.11)
Only at 22 years	1.03 (0.67, 1.58)	1.13 (0.67, 1.91)	0.35 (0.13, 0.98)	0.30 (0.07, 1.28)	1.35 (0.83, 2.18)	1.59 (0.90, 2.83)	0.77 (0.58, 1.03)	0.89 (0.63, 1.26)
Both	1.29 (0.97, 1.71)	1.54 (1.11, 2.16)	1.30 (0.84, 2.01)	1.84 (1.09, 3.10)	1.34 (0.94, 1.93)	1.65 (1.08, 2.51)	1.07 (0.88, 1.30)	1.26 (1.00, 1.59)
FMI in the third tertile	P=0.317	P=0.113	P=0.452	P=0.133	P=0.228	P=0.126	P=0.197	P=0.816
None	1.00	1.00	1.00	1.00	1.00	1.00	1.00	1.00
Only at 18 years	0.96 (0.62, 1.48)	0.78 (0.43, 1.40)	1.05 (0.54, 2.02)	1.11 (0.48, 2.57)	0.83 (0.46, 1.48)	0.58 (0.26, 1.29)	0.87 (0.65, 1.15)	0.88 (0.62, 1.25)
Only at 22 years	1.02 (0.66, 1.56)	1.01 (0.60, 1.69)	0.82 (0.40, 1.67)	0.66 (0.25, 1.73)	1.01 (0.60, 1.71)	1.14 (0.62, 2.10)	0.78 (0.58, 1.03)	0.82 (0.58, 1.17)
Both	1.27 (0.98, 1.66)	1.39 (1.02, 1.90)	1.23 (0.81, 1.86)	1.59 (0.97, 2.62)	1.24 (0.89, 1.74)	1.36 (0.92, 2.01)	0.92 (0.76, 1.10)	1.06 (0.85, 1.33)

Notes: Atopy, self-reported rhinitis, and/or eczema symptoms in the last year previous to the 22 years interview. Adjusted by gender, skin color, asset index (quintiles), education (years), maternal smoking during pregnancy, parents smoking during infancy, hospitalization during infancy, parents history of asthma, wheezing or bronchitis, household crowding, smoking trajectory 18–22 years, and physical activity trajectory 18–22 years.

a Logistic regression.

b Multinomial logistic regression (reference category: no wheezing and/or atopy reported).

Abbreviations: BMI, body mass index; DXA, dualenergy X-ray absorptiometry; FMI, fat mass index.

Table S1 Association between persistent wheezing and body composition at 18 and 22 years

	Persistent wheezing (18 and 22 years/with or without atopy)a
	Crude	Adjusted
18 years/22 years	OR (95% CI)	OR (95% CI)
BMI obese (≥30 kg/m^2)	P=0.413	P=0.671
None	1.00	1.00
Only at 18 years	1.11 (0.34, 3.57)	1.50 (0.44, 5.05)
Only at 22 years	0.74 (0.37, 1.48)	0.77 (0.36, 1.64)
Both	1.50 (0.86, 2.61)	1.28 (0.66, 2.51)
Total fat mass – BOD POD % in the third tertile	P=0.923	P=0.937
None	1.00	1.00
Only at 18 years	1.11 (0.61, 2.02)	0.93 (0.43, 2.03)
Only at 22 years	0.88 (0.45, 1.73)	1.18 (0.57, 2.46)
Both	1.10 (0.72, 1.66)	1.12 (0.68, 1.83)
Total fat mass – DXA % in the third tertile	P=0.810	P=0.645
None	1.00	1.00
Only at 18 years	1.15 (0.60, 2.22)	0.99 (0.43, 2.26)
Only at 22 years	0.89 (0.44, 1.81)	0.89 (0.37, 2.15)
Both	1.20 (0.77, 1.85)	1.35 (0.82, 2.22)
Trunk fat mass – DXA % in the third tertile	P=0.764	P=0.472
None	1.00	1.00
Only at 18 years	1.26 (0.67, 2.37)	1.02 (0.45, 2.34)
Only at 22 years	1.21 (0.64, 2.28)	1.39 (0.66, 2.93)
Both	1.22 (0.78, 1.90)	1.46 (0.88, 2.42)
FMI in the third tertile	P=0.828	P=0.905
None	1.00	1.00
Only at 18 years	1.21 (0.66, 2.22)	1.08 (0.50, 2.32)
Only at 22 years	0.81 (0.40, 1.63)	0.84 (0.37, 1.90)
Both	1.04 (0.68, 1.58)	1.14 (0.70, 1.84)

Notes: The 1993 Pelotas Birth Cohort.

a Logistic regression (persistent wheezing: wheezing in the last 12 months reported at 18- and 22-year follow-ups – yes/no). Adjusted by gender, skin color, asset index (quintiles), education (years), maternal smoking during pregnancy, parents smoking during infancy, hospitalization during infancy, parents history of asthma, wheezing or bronchitis, household crowding, smoking trajectory 18–22 years, and physical activity trajectory 18–22 years.

Abbreviations: BMI, body mass index; DXA, dualenergy X-ray absorptiometry; FMI, fat mass index.