Obesity-related pediatric asthma: relationships between pulmonary function and clinical outcomes

Abstract

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.

Keywords:

• Asthma control
• oral steroids
• body mass index
• health disparities
• healthcare utilization

Disclosure statement

The authors report no conflict of interest. No funders had any role in the design and conduct of the study.

Funding

This study was funded by the American Lung Association (SB-20474-N;PI: J Feldman), the National Institute of Child and Human Development (R03HD053355; PI: J Feldman), National Heart, Blood, and Lung Institute (R01HL141849; PI: D Rastogi) and (R03HL144534; PI: D Rastogi).