Association between body mass index and asthma severity in Arab pediatric population: A retrospective study

Autoři: Narjes Saheb Sharif-Askari aff001;  Hanan Abdulgader Sharif aff002;  Fatemeh Saheb Sharif-Askari aff001;  Qutayba Hamid aff002;  Salah Abusnana aff002;  Rifat Hamoudi aff001
Působiště autorů: Sharjah Institute for Medical Research, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates aff001;  College of Medicine, University of Sharjah, Sharjah, United Arab Emirates aff002
Vyšlo v časopise: PLoS ONE 14(12)
Kategorie: Research Article


Increased body mass index (BMI) has been associated with an increased prevalence of asthma in children, however the association between BMI status and asthma severity has been less well defined. The aim of this study was to describe the association between childhood obesity and asthma severity, frequency of hospital and emergency department visits as well as pattern of aeroallergen sensitization. A retrospective study was conducted at pediatric outpatient clinics in University Hospital Sharjah. All consecutive patients aged 6 years and above, with confirmed diagnosis of asthma visiting the outpatient pediatric clinics during 2018 were included in this study. Sources of information were the patient’s medical file, laboratory data, pharmacy data, as well as reports from the pediatric in charge. This study included 164 children with asthma. 63% of asthma patients were male. The vast majority of patients were from Arab ethnicities (n = 154, 94%), majority had mild asthmatic conditions (n = 133, 81%), and one-third were either overweight or obese (n = 52, 32%). Overweight or obese asthmatic children with BMI percentile of equal or more than 85% was associated with more asthma severity (odds ratio [OR]: 3.27, 95% confidence interval [CI]: 1.42–7.54; P = 0.005), as well as more frequent asthma related hospital visits (OR: 2.53, 95% CI: 1.22–5.26; P = 0.013). Overweight asthmatic children with BMI between the 85th and 94th percentiles and obese asthmatic children with BMI equal to or greater than 95th percentile are associated with more severe asthma phenotype and more frequent hospital and emergency department visits.

Klíčová slova:

Asthma – Body Mass Index – Critical care and emergency medicine – Childhood obesity – Mites – Obesity – Pediatrics – Skin tests


1. Abarca-Gómez L, Abdeen ZA, Hamid ZA, Abu-Rmeileh NM, Acosta-Cazares B, Acuin C, et al. Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: a pooled analysis of 2416 population-based measurement studies in 128·9 million children, adolescents, and adults. The Lancet. 2017;390(10113):2627–42.

2. de Onis M, Blössner M, Borghi E. Global prevalence and trends of overweight and obesity among preschool children. The American Journal of Clinical Nutrition. 2010;92(5):1257–64. doi: 10.3945/ajcn.2010.29786 20861173

3. Al Junaibi A, Abdulle A, Sabri S, Hag-Ali M, Nagelkerke N. The prevalence and potential determinants of obesity among school children and adolescents in Abu Dhabi, United Arab Emirates. International Journal Of Obesity. 2012;37:68. doi: 10.1038/ijo.2012.131 22890490

4. Al-haddad FH, Little BB, Abdul Ghafoor AGM. Childhood obesity in United Arab Emirates schoolchildren: A national study. Annals of Human Biology. 2005;32(1):72–9. doi: 10.1080/03014460400027425 15788356

5. Ellulu MS, Patimah I, Khaza'ai H, Rahmat A, Abed Y. Obesity and inflammation: the linking mechanism and the complications. Arch Med Sci. 2017;13(4):851–63. Epub 2016/03/31. doi: 10.5114/aoms.2016.58928 28721154

6. World Health Organization. World Health Report. 2011. Asthma Fact Sheet pdf [Accessed 05/01/ 19].

7. Forno E, Lescher R, Strunk R, Weiss S, Fuhlbrigge A, Celedón JC, et al. Decreased response to inhaled steroids in overweight and obese asthmatic children. The Journal of allergy and clinical immunology. 2011;127(3):741–9. doi: 10.1016/j.jaci.2010.12.010 21377042

8. Pavord ID, Mathieson N, Scowcroft A, Pedersini R, Isherwood G, Price D. The impact of poor asthma control among asthma patients treated with inhaled corticosteroids plus long-acting β2-agonists in the United Kingdom: a cross-sectional analysis. npj Primary Care Respiratory Medicine. 2017;27(1):17. doi: 10.1038/s41533-017-0014-1 28270657

9. Peters SP, Ferguson G, Deniz Y, Reisner C. Uncontrolled asthma: A review of the prevalence, disease burden and options for treatment. Respiratory Medicine. 2006;100(7):1139–51. doi: 10.1016/j.rmed.2006.03.031 16713224

10. Hom J, Morley EJ, Sasso P, Sinert R. Body mass index and pediatric asthma outcomes. Pediatric emergency care. 2009;25(9):569–71. Epub 2009/09/17. doi: 10.1097/PEC.0b013e3181b4f639 19755889

11. Ginde AA, Santillan AA, Clark S, Camargo CA Jr. Body mass index and acute asthma severity among children presenting to the emergency department. Pediatric Allergy and Immunology. 2010;21(3):480–8. doi: 10.1111/j.1399-3038.2009.00911.x 19548965

12. Michelson PH, Williams LW, Benjamin DK, Barnato AE. Obesity, inflammation, and asthma severity in childhood: data from the National Health and Nutrition Examination Survey 2001–2004. Annals of allergy, asthma & immunology: official publication of the American College of Allergy, Asthma, & Immunology. 2009;103(5):381–5. Epub 2009/11/26.

13. Musaad SM, Patterson T, Ericksen M, Lindsey M, Dietrich K, Succop P, et al. Comparison of anthropometric measures of obesity in childhood allergic asthma: central obesity is most relevant. The Journal of allergy and clinical immunology. 2009;123(6):1321–7.e12. Epub 2009/05/15. doi: 10.1016/j.jaci.2009.03.023 19439348

14. Nahhas M, Bhopal R, Anandan C, Elton R, Sheikh A. Investigating the association between obesity and asthma in 6- to 8-year-old Saudi children: a matched case-control study. NPJ primary care respiratory medicine. 2014;24:14004–. doi: 10.1038/npjpcrm.2014.4 24899344

15. Alsowaidi S, Abdulle A, Bernsen R, Zuberbier T. Allergic rhinitis and asthma: a large cross-sectional study in the United Arab Emirates. International archives of allergy and immunology. 2010;153(3):274–9. Epub 2010/05/21. doi: 10.1159/000314368 20484926

16. al-Maskari F, Bener A, al-Kaabi A, al-Suwaidi N, Norman N, Brebner J. Asthma and respiratory symptoms among school children in United Arab Emirates. Allergie et immunologie. 2000;32(4):159–63. Epub 2000/07/20. 10900696

17. Bener A, Abdulrazzaq YM, Debuse P, al-Mutawwa J. Prevalence of asthma among Emirates school children. European journal of epidemiology. 1994;10(3):271–8. Epub 1994/06/01. doi: 10.1007/bf01719349 7859837

18. Black MH, Smith N, Porter AH, Jacobsen SJ, Koebnick C. Higher Prevalence of Obesity Among Children With Asthma. Obesity. 2012;20(5):1041–7. doi: 10.1038/oby.2012.5 22252049

19. Quinto KB, Zuraw BL, Poon KY, Chen W, Schatz M, Christiansen SC. The association of obesity and asthma severity and control in children. The Journal of allergy and clinical immunology. 2011;128(5):964–9. Epub 2011/08/09. doi: 10.1016/j.jaci.2011.06.031 21820711

20. National Asthma Education and Prevention Program: Expert panel report III: Guidelines for the diagnosis and management of asthma. Bethesda, MD: National Heart, Lung, and Blood Institute, 2007. (NIH publication no. 08–4051). (Accessed on June 15, 2018).

21. Heinzerling L, Mari A, Bergmann K-C, Bresciani M, Burbach G, Darsow U, et al. The skin prick test—European standards. Clinical and translational allergy. 2013;3(1):3–. doi: 10.1186/2045-7022-3-3 23369181

22. Alsowaidi S, Abdulle A, Bernsen R. Prevalence and risk factors of asthma among adolescents and their parents in Al-Ain (United Arab Emirates). Respiration; international review of thoracic diseases. 2010;79(2):105–11. Epub 2009/05/15. doi: 10.1159/000219248 19439923

23. Gray N, Howard A, Zhu J, Feldman LY, To T. Association Between Inhaled Corticosteroid Use and Bone Fracture in Children With Asthma. JAMA pediatrics. 2018;172(1):57–64. Epub 2017/11/14. doi: 10.1001/jamapediatrics.2017.3579 29131874

24. Maalej S, Yaacoub Z, Fakhfekh R, Yaalaoui S, Kheder AB, Drira I. Association of obesity with asthma severity, control and quality of life. Tanaffos. 2012;11(1):38–43. 25191399

25. Mosen DM, Schatz M, Magid DJ, Camargo CA Jr., The relationship between obesity and asthma severity and control in adults. The Journal of allergy and clinical immunology. 2008;122(3):507–11.e6. Epub 2008/09/09. doi: 10.1016/j.jaci.2008.06.024 18774387

26. Black MH, Zhou H, Takayanagi M, Jacobsen SJ, Koebnick C. Increased Asthma Risk and Asthma-Related Health Care Complications Associated With Childhood Obesity. American Journal of Epidemiology. 2013;178(7):1120–8. doi: 10.1093/aje/kwt093 23924576

27. Stingone JA, Ramirez OF, Svensson K, Claudio L. Prevalence, demographics, and health outcomes of comorbid asthma and overweight in urban children. The Journal of asthma: official journal of the Association for the Care of Asthma. 2011;48(9):876–85. Epub 2011/10/01.

28. Peters JI, McKinney JM, Smith B, Wood P, Forkner E, Galbreath AD. Impact of obesity in asthma: evidence from a large prospective disease management study. Annals of allergy, asthma & immunology: official publication of the American College of Allergy, Asthma, & Immunology. 2011;106(1):30–5. Epub 2011/01/05.

29. Cibella F, Cuttitta G, La Grutta S, Melis MR, Bucchieri S, Viegi G. A cross-sectional study assessing the relationship between BMI, asthma, atopy, and eNO among schoolchildren. Annals of allergy, asthma & immunology: official publication of the American College of Allergy, Asthma, & Immunology. 2011;107(4):330–6. Epub 2011/10/04.

30. Forno E, Acosta-Perez E, Brehm JM, Han YY, Alvarez M, Colon-Semidey A, et al. Obesity and adiposity indicators, asthma, and atopy in Puerto Rican children. The Journal of allergy and clinical immunology. 2014;133(5):1308–14, 14.e1-5. Epub 2013/12/03. doi: 10.1016/j.jaci.2013.09.041 24290290

31. Van Gysel D, Govaere E, Verhamme K, Doli E, De Baets F. Body mass index in Belgian schoolchildren and its relationship with sensitization and allergic symptoms. Pediatric allergy and immunology: official publication of the European Society of Pediatric Allergy and Immunology. 2009;20(3):246–53. Epub 2008/09/19.

32. Dixon AE, Poynter ME. Mechanisms of Asthma in Obesity. Pleiotropic Aspects of Obesity Produce Distinct Asthma Phenotypes. American journal of respiratory cell and molecular biology. 2016;54(5):601–8. Epub 2016/02/18. doi: 10.1165/rcmb.2016-0017PS 26886277

33. Boulet LP. Obesity and atopy. Clinical and experimental allergy: journal of the British Society for Allergy and Clinical Immunology. 2015;45(1):75–86. Epub 2014/10/18.

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2019 Číslo 12
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