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One Quarter of New Pediatric Asthma Cases of Obesity

Recent research shows that an estimated 23% to 27% of new cases of asthma in children are directly caused by obesity.

Dr. Duke University School of Medicine in the Department of Allergy and Immunology and Chest Diseases. . In the absence of overweight and obesity, 10% of all cases of US pediatric asthma can be avoided, J says Jason E. Lang. Duke Children's Hospital and Health Center in Durham, North Carolina and colleagues.

Findings published online today pediatrics.

Obesity has previously been associated with new cases of asthma in adults, and researchers estimate that obesity causes about 250,000 new adult cases per year. The current study is the first to measure the incidence and risk in large, diverse national pediatric populations.

Lang and colleagues used the PEDSnet clinical data research network to compare the incidence of asthma in healthy children between 2 and 17 years of age in overweight and / or obese children. The researchers analyzed data from 507,496 children and 19,581,972 encounters between January 2009 and December 2015. The researchers matched a child with a healthy weight to a 1: 1 ratio of overweight or obese children. Children were also matched for demographic characteristics and insurance status. The average observation period is 4 years.

Incidence was defined as at least two encounters with asthma diagnosis and at least one asthma control device prescription.

In general, the risk of asthma adjusted for overweight children (relative risk [RR]1.17; 95% confidence interval [CI], 1.10 – 1.25) and obese children (RR, 1.26; 95% CI, 1.18-1.41). Obese children were also at higher risk for spirometry-confirmed asthma in obese children (RR, 1.29; 95% CI, 1.16 – 1.42).

Several Preventive Measures for Asthma

The authors state that the findings are important because there are several preventive measures to reduce childhood asthma.

These data suggest that reducing obesity in children would “significantly reduce the burden of public health Bu.

A companion editorial Deepa Rastogi, MBBS, MS of the Children's Hospital in Montefiore, from Albert Einstein College in New York City, New York, says another reason why these findings are so important. The prevalence of pediatric asthma is estimated to be around 10% for many years despite advances in early diagnosis, management and reduction of environmental factors. At the same time, obesity rates are around 20% and rises among some groups, and these new data show how it can increase pediatric asthma rates.

"[W]They indicate an increase of 5% in childhood asthma due to obesity, suggesting that obesity-induced asthma will be a fundamental type of childhood asthma. Ob

Rastogi points out that the power of the study includes data from the PEDSnet database, eight major American pediatric health systems, and provides a broad perspective on races, ethnic origin and various definitions of asthma.

The mapping of children for demographic characteristics and insurance situations has separated the potential confusion of these variables.

In the light of the findings, Rastogi recommends that clinicians measure waist circumference and measure metabolic abnormalities in the evaluation of pediatric patients with obesity and better identify those at risk of developing pulmonary complications.

"Because of the normative values ​​for the waist circumference and the evidence for the classification of metabolic abnormalities in children. [one or more] These obesity-related complications should be actively screened for asthma, he said.

Further investigations should investigate why some obese children develop asthma and why some are not and why they should be obese. as a result asthma as a result Obesity This information, Rastogi said, would help develop new targeted therapies.

Children aged between 2-17 years were included in the study at baseline or before, at least 85 years of age and sex adjusted body mass index and no recorded asthma or wheezing. .

The study did not include children who were diagnosed with asthma 18 months after the initial diagnosis and who had not been diagnosed with asthma. Children were also excluded if cystic fibrosis documented ciliary dyskinesia, childhood cancer, inflammatory bowel disease, or bronchopulmonary dysplasia.

The study was funded by the Institute of Patient-Centered Research and institutional development funds from the Nemours Children's Hospital and the Nemours Child Health System.

One author serves on advisory boards for Merck, Sanofi Pasteur and Pfizer, and works as a consultant for Pfizer, but does not receive funding from them.

Other study authors and Rastogi did not disclose any relevant financial relationship.

pediatrics. Online November 26, 2018 is published. Full text, Editorial

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