title: Mediating pathways from central obesity to childhood asthma: a population-based longitudinal study.
abstract: The mediating pathways linking obesity and asthma are largely unknown. We aimed to investigate the mediating pathways and to search for the most prominent pathological mechanism between central obesity and childhood asthma.In the Taiwan Children Health Study, we collected data on an open cohort of children aged 9-13 years. Children's respiratory outcomes, atopic conditions, obesity measures and pulmonary function were surveyed annually between 2010 and 2012. Exhaled nitric oxide fraction concentrations were recorded in 2012. Generalised estimating equations and general linear models were used to examine the associations between central obesity, possible mediators and asthma. Structural equation models were applied to investigate the pathways that mediate the link between central obesity and asthma.Central obesity (waist-to-hip ratio) most accurately predicted childhood asthma. In the active asthma model, the percentage of mediation was 28.6% for pulmonary function, 18.1% for atopy and 5.7% for airway inflammation. The percentage of mediation for pulmonary function was 40.2% in the lifetime wheeze model. Pulmonary function was responsible for the greatest percentage of mediation among the three mediators in both models.Decline in pulmonary function is the most important pathway in central obesity related asthma. Pulmonary function screening should be applied to obese children for asthma risk prediction.
authors.affiliation: Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan Health Centre, Office of Student Affairs, National Taiwan University, Taipei, Taiwan.
authors.forename: An-Hsuan
authors.initials: AH
authors.lastname: Chih
authors.affiliation: Taipei City Hospital, ZhongXing Branch, Taipei, Taiwan School of Nutrition and Health Sciences, Taipei Medical University, Taipei, Taiwan.
authors.forename: Yang-Ching
authors.initials: YC
authors.lastname: Chen
authors.affiliation: Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.
authors.forename: Yu-Kang
authors.initials: YK
authors.lastname: Tu
authors.affiliation: Dept of Family Medicine, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Kuo-Chin
authors.initials: KC
authors.lastname: Huang
authors.affiliation: Dept of Family Medicine, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Tai-Yuan
authors.initials: TY
authors.lastname: Chiu
authors.affiliation: Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan leolee@ntu.edu.tw.
authors.forename: Yungling Leo
authors.initials: YL
authors.lastname: Lee
mesh_terms: D001249:Asthma / Q000150:complications / Q000503:physiopathology*; D015992:Body Mass Index; D001835:Body Weight; D002648:Child; D015331:Cohort Studies; D003233:Conjunctivitis, Allergic / Q000150:complications; D003876:Dermatitis, Atopic / Q000150:complications; D045853:Exhalation; D005260:Female; D006801:Humans; D007249:Inflammation; D033183:Interdisciplinary Communication; D008137:Longitudinal Studies; D008168:Lung / Q000503:physiopathology; D008297:Male; D009569:Nitric Oxide / Q000737:chemistry; D056128:Obesity, Abdominal / Q000150:complications / Q000503:physiopathology*; D012129:Respiratory Function Tests; D012135:Respiratory Sounds; D065631:Rhinitis, Allergic / Q000150:complications; D012306:Risk; D011795:Surveys and Questionnaires; D013624:Taiwan; D016896:Treatment Outcome
chemical_list: D009569:Nitric Oxide