Obesity and Obesity Related Co-Morbidities in a Referral Population of Children With Asthma

Objective: Although there is mounting evidence that childhood obesity is a risk factor for incident asthma, it remains unclear if there is a distinct "asthma-obesity" phenotype. This study characterized body composition, obesity related co-morbidities, and traditional risk factors for asthma in a cohort of children referred for asthma management in a pulmonary clinic. We hypothesized that children with asthma and obesity would have distinct risk factors and co-morbidities, particularly with respect to metabolic and sleep abnormalities. Participants and Methods: One hundred sixteen asthmatic children ages 4-18 years underwent comprehensive measurements of common asthma risk factors as well as measurements of obesity-related morbidities, including lung function tests, atopy, and assessments of sleep (overnight oximetry and actigraphy), physical activity (accelerometry), and metabolism. Characteristics of children who were obese (BMI >= 95th percentile) were compared to those who were not obese (BMI <95th percentile). Results: Obesity was present in 44% of participants. Obese participants had similar rates of atopy and family history of atopy, lung function, and asthma control at enrolment as their non-obese peers. A significantly higher proportion of obese participants had metabolic syndrome (23% vs. 0%) and habitual snoring (60% vs. 33%) compared to non-obese participants; insufficient sleep and nocturnal desaturations tended to be more prevalent among obese subjects. Conclusions: Obesity and obesity related co-morbidities were common in a referral population of children with asthma. The specific influence of metabolic abnormalities on asthma morbidity and management is still uncertain and likely will need to be addressed in prospective studies. Pediatr Pulmonol. 2009; 44:877-884. (C) 2009 Wiley-Liss, Inc.