title: Sex differences in the association between neck circumference and asthma.
abstract: The association between obesity and asthma control/quality of life commonly relies on body mass index (BMI) as the anthropomorphic measure. Due to limitations of BMI and the existence of alternative measures, such as neck circumference (NC), we examined the association between NC and asthma control/quality of life, with particular attention to male-female differences.
  
  
  
  The AsthMaP-2 Project is an observational study of youth with physician-diagnosed asthma. NC was stratified according to age- and sex-specific cutoffs and associated with asthma control (via Asthma Control Test [ACT]) and quality of life (via Integrated Therapeutics Group [ITG]-Asthma Short Form).
  
  
  
  The mean ± SD age was 11.9 ± 3.6 years, and 53% were male (N = 116). The mean BMI percentile was at the 71 ± 28 percentile. Thirty-one participants (27%) met criteria for high NC. Males with high NC had significantly worse asthma control (P = 0.02) and lower quality of life than those with low NC. No similar association was found for females and the proportion of variability in ACT and ITG was best explained by BMI percentile. Conversely, for males, the proportion of variability in these scores explained by NC was larger than BMI percentile alone (Cohen's f(2)  = 0.04-0.09, a small to medium effect size).
  
  
  
  Among male youth with asthma, combined use of NC and BMI percentile explained asthma control and quality of life better than BMI alone. Future studies of asthma should include measurement of NC and other anthropogenic measures of regional adiposity to clarify sex differences in asthma. Pediatr Pulmonol. 2016; 51:893-900. © 2016 Wiley Periodicals, Inc.
authors.affiliation: Center for Genetic Medicine Research, Children's National Health System, Washington, DC.
authors.forename: Lisa
authors.initials: L
authors.lastname: Maltz
authors.affiliation: George Washington University School of Medicine and Health Sciences, Washington, DC.
authors.forename: Ethan L
authors.initials: EL
authors.lastname: Matz
authors.affiliation: Center for Genetic Medicine Research, Children's National Health System, Washington, DC.|Department of Integrative Systems Biology, George Washington University School of Medicine and Health Sciences, Washington, DC.
authors.forename: Heather
authors.initials: H
authors.lastname: Gordish-Dressman
authors.affiliation: Center for Genetic Medicine Research, Children's National Health System, Washington, DC.|Department of Integrative Systems Biology, George Washington University School of Medicine and Health Sciences, Washington, DC.|Department of Pediatrics, George Washington University School of Medicine and Health Sciences, Washington, DC.|Division of Pulmonary and Sleep Medicine, Children's National Health System, Washington, DC.
authors.forename: Dinesh K
authors.initials: DK
authors.lastname: Pillai
authors.affiliation: Department of Pediatrics, George Washington University School of Medicine and Health Sciences, Washington, DC.|Division of Emergency Medicine, Children's National Health System, Washington, DC.
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Teach
authors.affiliation: Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
authors.forename: Carlos A
authors.initials: CA
authors.lastname: Camargo
authors.affiliation: Center for Genetic Medicine Research, Children's National Health System, Washington, DC.|Department of Integrative Systems Biology, George Washington University School of Medicine and Health Sciences, Washington, DC.
authors.forename: Monica J
authors.initials: MJ
authors.lastname: Hubal
authors.affiliation: Center for Genetic Medicine Research, Children's National Health System, Washington, DC.
authors.forename: Simran
authors.initials: S
authors.lastname: Behniwal
authors.affiliation: Center for Genetic Medicine Research, Children's National Health System, Washington, DC.
authors.forename: Guy D
authors.initials: GD
authors.lastname: Prosper
authors.affiliation: Center for Genetic Medicine Research, Children's National Health System, Washington, DC.
authors.forename: Nicole
authors.initials: N
authors.lastname: Certner
authors.affiliation: Center for Genetic Medicine Research, Children's National Health System, Washington, DC.
authors.forename: Raman
authors.initials: R
authors.lastname: Marwah
authors.affiliation: Center for Genetic Medicine Research, Children's National Health System, Washington, DC.|Department of Microbiology, College of Medicine, Howard University, Washington, DC.
authors.forename: Douglas M
authors.initials: DM
authors.lastname: Mansell
authors.affiliation: Center for Genetic Medicine Research, Children's National Health System, Washington, DC.
authors.forename: Fisayo
authors.initials: F
authors.lastname: Nwachukwu
authors.affiliation: Center for Genetic Medicine Research, Children's National Health System, Washington, DC.
authors.forename: Risa
authors.initials: R
authors.lastname: Lazaroff
authors.affiliation: George Washington University School of Medicine and Health Sciences, Washington, DC.
authors.forename: Yodit
authors.initials: Y
authors.lastname: Tsegaye
authors.affiliation: Center for Genetic Medicine Research, Children's National Health System, Washington, DC.|Department of Integrative Systems Biology, George Washington University School of Medicine and Health Sciences, Washington, DC.|Department of Pediatrics, George Washington University School of Medicine and Health Sciences, Washington, DC.|Division of Emergency Medicine, Children's National Health System, Washington, DC.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Freishtat
mesh_terms: D050154:Adiposity; D000293:Adolescent; D001249:Asthma / Q000150:complications / Q000175:diagnosis / Q000517:prevention & control*; D015992:Body Mass Index; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D009333:Neck / Q000033:anatomy & histology*; D009765:Obesity / Q000150:complications; D011788:Quality of Life; D012737:Sex Factors; D055815:Young Adult
keywords: adiposity; body mass index; pediatric obesity; pediatrics