title: Associations between central obesity and asthma in children and adolescents: a case-control study.
abstract: BACKGROUND
  Evidence supports a significant yet weak association between high-body weight and asthma in children. However, most studies investigating the obesity-asthma link use Body Mass Index (BMI) to evaluate body fatness. The relationship between body fat distribution and asthma remains largely unknown, especially in children. This pediatric case-control investigation examined associations between central obesity/high-body weight and asthma diagnosis.
  
  
  METHODS
  Five-hundred and fourteen children (217 physician diagnosed asthma cases and 297 healthy controls) of 5-11 years were recruited. Height, weight and waist circumference were measured. Asthma symptoms, past medical history, personal lifestyle, socioeconomic status, diet and physical activity history were also collected.
  
  
  RESULTS
  A higher proportion of children with asthma were centrally obese [(≥90th waist percentile) 15.2 vs. 9.4%, p<0.0001; (≥90th waist-to-height ratio percentile) 39.6 vs. 24.2%, p<0.0001)]. Regression analyses revealed that centrally obese children were more likely to have asthma (high-waist circumference (OR = 1.99, 95% CI: 1.07-3.68) and high-waist circumference to height ratio (OR = 2.24, 95% CI: 1.47-3.40), following adjustment for various confounders. Overweight/obese participants (BMI defined) were more likely to be asthmatic [odds ratio (OR) = 1.52, 95% confidence interval (CI): 1.03-2.70)] when compared to controls.
  
  
  CONCLUSIONS
  Presence of central obesity and high-body weight (at least overweight) as assessed by waist circumference, waist-to-height ratio, and BMI are associated with asthma diagnosis. More studies are needed, especially in children and adolescents, to confirm these findings and better understand how body fat distribution impacts the obesity-asthma relationship.
authors.affiliation: Department of Nursing, National and Kapodistrian University of Athens , Athens , Greece .
authors.forename: Constantina
authors.initials: C
authors.lastname: Papoutsakis
authors.forename: Maria
authors.initials: M
authors.lastname: Chondronikola
authors.forename: Georgios
authors.initials: G
authors.lastname: Antonogeorgos
authors.forename: Eleni
authors.initials: E
authors.lastname: Papadakou
authors.forename: Vasiliki
authors.initials: V
authors.lastname: Matziou
authors.forename: Maria
authors.initials: M
authors.lastname: Drakouli
authors.forename: Evanthia
authors.initials: E
authors.lastname: Konstantaki
authors.forename: Anastasios
authors.initials: A
authors.lastname: Papadimitriou
authors.forename: Kostas N
authors.initials: KN
authors.lastname: Priftis
mesh_terms: D000367:Age Factors; D001249:Asthma / Q000453:epidemiology*; D015992:Body Mass Index; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D004032:Diet; D015444:Exercise; D005260:Female; D015438:Health Behavior; D006801:Humans; D008019:Life Style; D008297:Male; D056128:Obesity, Abdominal / Q000453:epidemiology*; D050177:Overweight / Q000453:epidemiology; D063766:Pediatric Obesity / Q000453:epidemiology*; D012307:Risk Factors; D012737:Sex Factors; D012959:Socioeconomic Factors; D055105:Waist Circumference
keywords: Asthma; body mass index; central obesity; children; obesity; overweight; waist circumference; waist-to-height ratio