Overweight/obesity status in preschool children associates with worse asthma but robust improvement on inhaled corticosteroids.
Document Type
Article
Publication Date
4-1-2018
Abstract
BACKGROUND: Overweight/obesity (OW) is linked to worse asthma and poorer inhaled corticosteroid (ICS) response in older children and adults.
OBJECTIVE: We sought to describe the relationships between OW and asthma severity and response to ICS in preschool children.
METHODS: This post hoc study of 3 large multicenter trials involving 2- to 5-year-old children compared annualized asthma symptom days and exacerbations among normal weight (NW) (body mass index: 10th-84th percentiles) versus OW (body mass index: ≥85th percentile) participants. Participants had been randomized to daily ICS, intermittent ICS, or daily placebo. Simple and multivariable linear regression was used to compare body mass index groups.
RESULTS: Within the group not treated with a daily controller, OW children had more asthma symptom days (90.7 vs 53.2, P = .020) and exacerbations (1.4 vs 0.8, P = .009) thanNW children did. Within the ICS-treated groups, OW and NW children had similar asthma symptom days (daily ICS: 47.2 vs 44.0 days, P = .44; short-term ICS: 61.8 vs 52.9 days, P = .46; as-needed ICS: 53.3 vs 47.3 days, P = .53), and similar exacerbations (daily ICS: 0.6 vs 0.8, P = .10; short-term ICS: 1.1 vs 0.8 days, P = .25; as-needed ICS: 1.0 vs 1.1, P = .72). Compared with placebo, daily ICS in OW led to fewer annualized asthma symptom days (90.7 vs 41.2, P = .004) and exacerbations (1.4 vs 0.6, P = .006), while similar protective ICS effects were less apparent among NW.
CONCLUSIONS: In preschool children off controller therapy, OW is associated with greater asthma impairment and exacerbations. However, unlike older asthmatic patients, OW preschool children do not demonstrate reduced responsiveness to ICS therapy.
Publication Title
The Journal of allergy and clinical immunology
ISSN
1097-6825
Volume
141
Issue
4
First Page
1459
Last Page
1467
Recommended Citation
Lang, Jason E; Anne M Fitzpatrick; David T Mauger; Theresa W Guilbert; Daniel J Jackson; Robert F Lemanske; Fernando D Martinez; Robert C Strunk; Robert S Zeiger; Wanda Phipatanakul; Leonard B Bacharier; Jacqueline A Pongracic; Fernando Holguin; Michael D Cabana; Ronina A Covar; Hengameh H Raissy; Monica Tang; and Stanley J Szefler.
"Overweight/obesity status in preschool children associates with worse asthma but robust improvement on inhaled corticosteroids.."
The Journal of allergy and clinical immunology
