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BACKGROUND: In 2012, asthma affected 25.5 million adults and children in the United States. This chronic respiratory illness is one of the most common childhood conditions in the US, with 9.3% of children nationwide currently affected. In 2007, asthma-related medical costs were estimated to be $56 billion. Additionally, elevated pediatric BMI and asthma severity have been associated in the current literature. The objective of this study was to analyze data from a pediatric pool of asthmatic patients in Nevada to determine whether elevated BMI was associated with asthma prevalence and severity in this population.
METHODS: The dataset included 66 original variables including asthma severity measures/exacerbation triggers, and BMI, as well as possible sensitization to more than 60 allergens. Data were analyzed to determine links between asthma symptom severity and BMI. Analysis included frequencies, correlations, and chi-square tests to measure the number of emergency department (ED) visits and overnight hospitalizations in the past year due to asthma, and frequency of oral steroid courses in the past year. ANOVA was performed to measure the association between BMI and pulmonary function measures.
RESULTS: This study included 98 children aged 1-15 years (median=6.0), of whom 62.2% were male, and 59.2% were white. Eighty-three children (84.6%) had moderate or severe asthma; 30 children (30.6%) required one or more ED visits in the past year due to asthma. Additionally, 8.2% of the population required at least one overnight hospitalization in the past year. Oral steroid use was also required in nearly half of the population (n=45 [45.9%]). Increased number of courses of oral steroids was positively correlated with elevated BMI (p=0.038). A statistically significant difference was found with forced expiratory flow 25-75% (FEF25-75) between overweight (mean FEF25-75=92.17, SD±16.42) and obese children (mean=70.64, SD±14.74). This association was not present between under/healthy weight (mean=77.57, SD±22.02) and overweight or obese children (F=3.595, p=0.033).
CONCLUSIONS: The results of this analysis show that greater usage of oral steroids is associated with elevated BMI in this population. These data also demonstrate lowest lung function in the children with the highest BMI. Children who require hospitalization/ED visits contribute to the high cost of asthma treatment. In addition, as BMI increases in this population, these children are more likely to have lower lung function. Our preliminary findings support further investigation of the association between overweight/obese children and asthma severity, and the need for potential dietary and activity intervention among those with persistent asthma.