title: Obesity and adiposity indicators, asthma, and atopy in Puerto Rican children.
abstract: BACKGROUND
  Whether adiposity indicators other than body mass index (BMI) should be used in studies of childhood asthma is largely unknown. The role of atopy in "obese asthma" is also unclear.
  
  
  OBJECTIVE
  To examine the relationship among adiposity indicators, asthma, and atopy in Puerto Rican children, and to assess whether atopy mediates the obesity-asthma association.
  
  
  METHODS
  In a study of Puerto Rican children with (n = 351) and without (n = 327) asthma, we measured BMI, percent of body fat, waist circumference, and waist-to-hip ratio. The outcomes studied included asthma, lung function, measures of atopy, and, among cases, indicators of asthma severity or control. We performed mediation analysis to assess the contribution of atopy to the relationship between adiposity and asthma.
  
  
  RESULTS
  BMI, percent of body fat, and waist circumference were associated with increased odds of asthma. Among cases, all 3 measures were generally associated with lung function, asthma severity/control, and atopy; however, there were differences depending on the adiposity indicator analyzed. Atopy considerably mediated the adiposity-asthma association in this population: allergic rhinitis accounted for 22% to 53% of the association with asthma, and sensitization to cockroach mediated 13% to 20% of the association with forced vital capacity and 29% to 42% of the association with emergency department visits for asthma.
  
  
  CONCLUSIONS
  Adiposity indicators are associated with asthma, asthma severity/control, and atopy in Puerto Rican children. Atopy significantly mediates the effect of adiposity on asthma outcomes. Longitudinal studies are needed to further investigate the causal role, if any, of adiposity distribution and atopy on "obese asthma" in childhood.
authors.affiliation: Division of Pediatric Pulmonary Medicine, Allergy, and Immunology, Children's Hospital of Pittsburgh of UPMC, University of Pittsburgh, Pittsburgh, Pa.
authors.forename: Erick
authors.initials: E
authors.lastname: Forno
authors.affiliation: Department of Pediatrics, Behavioral Sciences Research Institute, University of Puerto Rico, San Juan, Puerto Rico.
authors.forename: Edna
authors.initials: E
authors.lastname: Acosta-Pérez
authors.affiliation: Division of Pediatric Pulmonary Medicine, Allergy, and Immunology, Children's Hospital of Pittsburgh of UPMC, University of Pittsburgh, Pittsburgh, Pa.
authors.forename: John M
authors.initials: JM
authors.lastname: Brehm
authors.affiliation: Division of Pediatric Pulmonary Medicine, Allergy, and Immunology, Children's Hospital of Pittsburgh of UPMC, University of Pittsburgh, Pittsburgh, Pa.
authors.forename: Yueh-Ying
authors.initials: YY
authors.lastname: Han
authors.affiliation: Department of Pediatrics, Behavioral Sciences Research Institute, University of Puerto Rico, San Juan, Puerto Rico.
authors.forename: María
authors.initials: M
authors.lastname: Alvarez
authors.affiliation: Department of Pediatrics, Behavioral Sciences Research Institute, University of Puerto Rico, San Juan, Puerto Rico.
authors.forename: Angel
authors.initials: A
authors.lastname: Colón-Semidey
authors.affiliation: Department of Pediatrics, Behavioral Sciences Research Institute, University of Puerto Rico, San Juan, Puerto Rico.
authors.forename: Glorisa
authors.initials: G
authors.lastname: Canino
authors.affiliation: Division of Pediatric Pulmonary Medicine, Allergy, and Immunology, Children's Hospital of Pittsburgh of UPMC, University of Pittsburgh, Pittsburgh, Pa. Electronic address: juan.celedon@chp.edu.
authors.forename: Juan C
authors.initials: JC
authors.lastname: Celedón
mesh_terms: D050154:Adiposity; D000293:Adolescent; D001249:Asthma / Q000150:complications / Q000473:pathology / Q000503:physiopathology; D015992:Body Mass Index; D002648:Child; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D008297:Male; D009765:Obesity / Q000150:complications / Q000473:pathology / Q000503:physiopathology; D011647:Puerto Rico; D012129:Respiratory Function Tests; D065631:Rhinitis, Allergic; D012221:Rhinitis, Allergic, Perennial / Q000150:complications / Q000473:pathology / Q000503:physiopathology; D055105:Waist Circumference; D049629:Waist-Hip Ratio
keywords: Childhood asthma; adiposity; body mass index; obesity; obesity and asthma; obesity and atopy; percent of body fat