Nikos Stratakis1, Erika Garcia1, Aruna Chandran2, Tingju Hsu2, Akram Alshawabkeh3, Izzuddin M Aris4, Judy L Aschner5,6, Carrie Breton1, Allison Burbank7, Carlos A Camargo8, Kecia N Carroll9, Zhanghua Chen1, Erika C Claud10, Dana Dabelea11, Anne L Dunlop12, Amy J Elliott13, Assiamira Ferrara14, Jody M Ganiban15, James E Gern16, Diane R Gold17,18, William A Gower7, Irva Hertz-Picciotto19, Margaret R Karagas20, Catherine J Karr21, Barry Lester22, Leslie D Leve23, Augusto A Litonjua24, Yunin Ludena19, Cindy T McEvoy25, Rachel L Miller26, Noel T Mueller2, Thomas G O'Connor27, Emily Oken4, T Michael O'Shea7, Frederica Perera28, Joseph B Stanford29, Katherine Rivera-Spoljaric30, Andrew Rundle28, Leonardo Trasande31, Rosalind J Wright32, Yue Zhang33, Yeyi Zhu14, Kiros Berhane34, Frank Gilliland1, Lida Chatzi1. 1. From the Department of Preventive Medicine, University of Southern California, Los Angeles, CA. 2. Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. 3. Department of Civil and Environmental Engineering, Northeastern University, Boston, MA. 4. Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA. 5. Department of Pediatrics, Hackensack Meridian School of Medicine, Nutley, NJ. 6. The Albert Einstein College of Medicine, Bronx, NY. 7. Department of Pediatrics, University of North Carolina School of Medicine, Chapel Hill, NC. 8. Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA. 9. Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN. 10. Departments of Pediatrics and Medicine, The University of Chicago, Chicago, IL. 11. University of Colorado, Anschutz Medical Campus, Aurora, CO. 12. Nell Hodgson Woodruff School of Nursing and Department of Family & Preventive Medicine, Emory University, Atlanta, GA. 13. Avera Research Institute, Sioux Falls, SD. 14. Kaiser Permanente Northern California Division of Research, Oakland, CA. 15. Department of Psychology, The George Washington University, Washington, DC. 16. Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, WI. 17. Harvard T.H. Chan School of Public Health, Harvard University, Boston, MA. 18. Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA. 19. School of Medicine, University of California, Davis, Davis, CA. 20. Geisel School of Medicine, Dartmouth College, Hanover, NH. 21. Department of Pediatrics & Environmental and Occupational Health Sciences, University of Washington, Seattle, WA. 22. Department of Psychiatry and Human Behavior and Department of Pediatrics, Brown Alpert Medical School and Women and Infants Hospital, Providence, RI. 23. Department of Education, University of Oregon, Eugene, OR. 24. Division of Pediatric Pulmonary Medicine, Department of Pediatrics, University of Rochester Medical Center, Rochester, NY. 25. Department of Pediatrics, Oregon Health and Science University, Portland, OR. 26. Division of Clinical Immunology, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY. 27. Departments of Psychiatry, Psychology, Neuroscience and Obstetrics and Gynecology, University of Rochester, Rochester, NY. 28. Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY. 29. Department of Family and Preventive Medicine, University of Utah, Salt Lake City, UT. 30. Division of Allergy, Immunology, and Pulmonary Medicine, Department of Pediatrics, St. Louis Children's Hospital, Washington University School of Medicine, St. Louis, MO. 31. Departments of Pediatrics, Environmental Medicine and Population Health, New York University School of Medicine, New York, NY. 32. Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY. 33. Department of Internal Medicine, University of Utah, Salt Lake City, UT. 34. Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY.
Abstract
RATIONALE: Asthma and obesity often co-occur. It has been hypothesized that asthma may contribute to childhood obesity onset. OBJECTIVES: To determine if childhood asthma is associated with incident obesity and examine the role of asthma medication in this association. METHODS: We studied 8,716 children between ages 6 and 18.5 years who were nonobese at study entry participating in 18 US cohorts of the Environmental influences on Child Health Outcomes program (among 7,299 children with complete covariate data mean [SD] study entry age = 7.2 [1.6] years and follow up = 5.3 [3.1] years). MEASUREMENTS AND MAIN RESULTS: We defined asthma based on caregiver report of provider diagnosis. Incident obesity was defined as the first documented body mass index ≥95th percentile for age and sex following asthma status ascertainment. Over the study period, 26% of children had an asthma diagnosis and 11% developed obesity. Cox proportional hazards models with sex-specific baseline hazards were fitted to assess the association of asthma diagnosis with obesity incidence. Children with asthma had a 23% (95% confidence intervals [CI] = 4, 44) higher risk for subsequently developing obesity compared with those without asthma. A novel mediation analysis was also conducted to decompose the total asthma effect on obesity into pathways mediated and not mediated by asthma medication use. Use of asthma medication attenuated the total estimated effect of asthma on obesity by 64% (excess hazard ratios = 0.64; 95% CI = -1.05, -0.23). CONCLUSIONS: This nationwide study supports the hypothesis that childhood asthma is associated with later risk of obesity. Asthma medication may reduce this association and merits further investigation as a potential strategy for obesity prevention among children with asthma.
RATIONALE: Asthma and obesity often co-occur. It has been hypothesized that asthma may contribute to childhood obesity onset. OBJECTIVES: To determine if childhood asthma is associated with incident obesity and examine the role of asthma medication in this association. METHODS: We studied 8,716 children between ages 6 and 18.5 years who were nonobese at study entry participating in 18 US cohorts of the Environmental influences on Child Health Outcomes program (among 7,299 children with complete covariate data mean [SD] study entry age = 7.2 [1.6] years and follow up = 5.3 [3.1] years). MEASUREMENTS AND MAIN RESULTS: We defined asthma based on caregiver report of provider diagnosis. Incident obesity was defined as the first documented body mass index ≥95th percentile for age and sex following asthma status ascertainment. Over the study period, 26% of children had an asthma diagnosis and 11% developed obesity. Cox proportional hazards models with sex-specific baseline hazards were fitted to assess the association of asthma diagnosis with obesity incidence. Children with asthma had a 23% (95% confidence intervals [CI] = 4, 44) higher risk for subsequently developing obesity compared with those without asthma. A novel mediation analysis was also conducted to decompose the total asthma effect on obesity into pathways mediated and not mediated by asthma medication use. Use of asthma medication attenuated the total estimated effect of asthma on obesity by 64% (excess hazard ratios = 0.64; 95% CI = -1.05, -0.23). CONCLUSIONS: This nationwide study supports the hypothesis that childhood asthma is associated with later risk of obesity. Asthma medication may reduce this association and merits further investigation as a potential strategy for obesity prevention among children with asthma.
Authors: Jennifer Han; John Nguyen; Yuna Kim; Bob Geng; Gale Romanowski; Lawrence Alejandro; James Proudfoot; Ronghui Xu; Sydney Leibel Journal: J Asthma Date: 2018-04-19 Impact factor: 2.515
Authors: Zhanghua Chen; Muhammad T Salam; Tanya L Alderete; Rima Habre; Theresa M Bastain; Kiros Berhane; Frank D Gilliland Journal: Am J Respir Crit Care Med Date: 2017-05-01 Impact factor: 21.405
Authors: Robert J Kuczmarski; Cynthia L Ogden; Shumei S Guo; Laurence M Grummer-Strawn; Katherine M Flegal; Zuguo Mei; Rong Wei; Lester R Curtin; Alex F Roche; Clifford L Johnson Journal: Vital Health Stat 11 Date: 2002-05