title: Airway Obstruction Worsens in Young Adults with Asthma Who Become Obese.
abstract: BACKGROUND
  Few studies have examined how developing obesity in early adulthood affects the course of asthma.
  
  
  OBJECTIVE
  We analyzed lung function and asthma impairment and risk among nonobese children with asthma, comparing those who were obese in young adulthood with those who remained nonobese.
  
  
  METHODS
  We carried out the post hoc analysis of 771 subjects with mild to moderate asthma who were not obese (pediatric definition, body mass index [BMI] < 95th percentile) when enrolled in the Childhood Asthma Management Program at ages 5-12 years. The subjects were then followed to age 20 years or more. For visits at ages 20 years or more, spirometry values as percent predicted and recent asthma symptom scores and prednisone exposure were compared between 579 subjects who were nonobese at all visits and 151 who were obese (adult definition of BMI ≥ 30 kg/m(2)) on at least 1 visit (median number of visits when obese = 4, IQR 2-7).
  
  
  RESULTS
  Compared with participants who were nonobese (BMI 23.4 ± 2.6 kg/m(2)), those who became obese (BMI 31.5 ± 3.8 kg/m(2)) had significant decreases in forced expiratory volume in the first second (FEV1)/forced vital capacity (FVC) (P < .0003) and FEV1 (P = .001), without differences in FVC (P = .15) during visits at ages 20 years or more. For each unit increase of BMI, FEV1 percent predicted decreased by 0.29 (P = .0009). The relationship between BMI and lung function was not confounded by sex or BMI at baseline. Asthma impairment (symptom scores) and risk (prednisone use) did not differ between the 2 groups.
  
  
  CONCLUSIONS
  Becoming obese in early adulthood was associated with increased airway obstruction, without impact on asthma impairment or risk.
authors.affiliation: Division of Allergy, Immunology, and Pulmonary Medicine, Department of Pediatrics, Washington University School of Medicine and St. Louis Children's Hospital, St. Louis, Mo. Electronic address: Strunk@kids.wustl.edu.
authors.forename: Robert C
authors.initials: RC
authors.lastname: Strunk
authors.affiliation: Department of Pediatrics, Pediatric Computing Facility, Washington University School of Medicine, St. Louis, Mo.
authors.forename: Ryan
authors.initials: R
authors.lastname: Colvin
authors.affiliation: Division of Allergy, Immunology, and Pulmonary Medicine, Department of Pediatrics, Washington University School of Medicine and St. Louis Children's Hospital, St. Louis, Mo.
authors.forename: Leonard B
authors.initials: LB
authors.lastname: Bacharier
authors.affiliation: The Channing Division of Network Medicine and the Division of Pulmonary/Critical Care Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Mass.
authors.forename: Anne
authors.initials: A
authors.lastname: Fuhlbrigge
authors.affiliation: Division of Pulmonary Medicine, Allergy, and Immunology, Department of Pediatrics, Children's Hospital of Pittsburgh and University of Pittsburgh, Pittsburgh, Pa.
authors.forename: Erick
authors.initials: E
authors.lastname: Forno
authors.affiliation: Division of Endocrinology, Department of Pediatrics, Washington University School of Medicine and St. Louis Children's Hospital, St. Louis, Mo.
authors.forename: Ana Maria
authors.initials: AM
authors.lastname: Arbelaez
authors.affiliation: The Channing Division of Network Medicine and the Division of Pulmonary/Critical Care Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, Mass.
authors.forename: Kelan G
authors.initials: KG
authors.lastname: Tantisira
mesh_terms: D000293:Adolescent; D000328:Adult; D000402:Airway Obstruction / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D001249:Asthma / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D015992:Body Mass Index; D019819:Budesonide / Q000008:administration & dosage / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D017835:Nedocromil / Q000008:administration & dosage / Q000009:adverse effects; D009765:Obesity / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D012129:Respiratory Function Tests; D012306:Risk; D055815:Young Adult
chemical_list: D017835:Nedocromil; D019819:Budesonide
keywords: Childhood asthma; Childhood obesity; Obese asthma; Pulmonary function