title: Childhood obesity in relation to poor asthma control and exacerbation: a meta-analysis.
abstract: To estimate the association between obesity and poor asthma control or risk of exacerbations in asthmatic children and adolescents, and to assess whether these associations are different by sex.A meta-analysis was performed on unpublished data from three North-European paediatric asthma cohorts (BREATHE, PACMAN (Pharmacogenetics of Asthma medication in Children: Medication with Anti-inflammatory effects) and PAGES (Pediatric Asthma Gene Environment Study)) and 11 previously published studies (cross-sectional and longitudinal studies). Outcomes were poor asthma control (based on asthma symptoms) and exacerbations rates (asthma-related visits to the emergency department, asthma-related hospitalisations or use of oral corticosteroids). Overall pooled estimates of the odds ratios were obtained using fixed- or random-effects models.In a meta-analysis of 46 070 asthmatic children and adolescents, obese children (body mass index ≥95th percentile) compared with non-obese peers had a small but significant increased risk of asthma exacerbations (OR 1.17, 95% CI 1.03-1.34; I2: 54.7%). However, there was no statistically significant association between obesity and poor asthma control (n=4973, OR 1.23, 95% CI 0.99-1.53; I2: 0.0%). After stratification for sex, the differences in odds ratios for girls and boys were similar, yet no longer statistically significant.In asthmatic children, obesity is associated with a minor increased risk of asthma exacerbations but not with poor asthma control. Sex does not appear to modify this risk.
authors: Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, Utrecht, The Netherlands.
authors: Fariba
authors: F
authors: Ahmadizar
authors: Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, Utrecht, The Netherlands Dept of Respiratory Medicine, University Medical Centre Utrecht, Utrecht, The Netherlands.
authors: Susanne J H
authors: SJ
authors: Vijverberg
authors: Dept of Paediatric Pulmonology and Allergology, Dept of Paediatrics, University Medical Centre Utrecht, Utrecht, The Netherlands.
authors: Hubertus G M
authors: HG
authors: Arets
authors: Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, Utrecht, The Netherlands.
authors: Anthonius
authors: A
authors: de Boer
authors: Division of Pulmonary and Sleep Medicine, Nemours Children's Hospital, Orlando, FL, USA.
authors: Jason E
authors: JE
authors: Lang
authors: Dept of Pediatric Pulmonology, College of Physicians and Surgeons, Columbia University, New York, NY, USA.
authors: Meyer
authors: M
authors: Kattan
authors: Population Pharmacogenetics Group, Biomedical Research Centre, University of Dundee, Dundee, UK.
authors: Colin N A
authors: CN
authors: Palmer
authors: Population Pharmacogenetics Group, Biomedical Research Institute, University of Dundee, Ninewells Hospital and Medical School, Dundee, UK Academic Dept of Paediatrics, Royal Alexandra Children's Hospital, Brighton and Sussex Medical School, Brighton, UK.
authors: Somnath
authors: S
authors: Mukhopadhyay
authors: Child Health, Royal Aberdeen Children's Hospital, Aberdeen, UK.
authors: Steve
authors: S
authors: Turner
authors: Division of Pharmacoepidemiology and Clinical Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, Utrecht, The Netherlands A.H.Maitland@uu.nl.
authors: Anke H
authors: AH
authors: Maitland-van der Zee
mesh_terms: D000280:Administration, Inhalation; D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage; D018927:Anti-Asthmatic Agents / Q000627:therapeutic use; D001249:Asthma / Q000150:complications / Q000503:physiopathology* / Q000628:therapy*; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D003430:Cross-Sectional Studies; D005260:Female; D006760:Hospitalization; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D063766:Pediatric Obesity / Q000150:complications / Q000503:physiopathology* / Q000628:therapy; D012306:Risk; D055815:Young Adult
chemical_list: D000305:Adrenal Cortex Hormones; D018927:Anti-Asthmatic Agents