Overweight and obese children with early-onset asthma had distinct symptoms and experienced poorer asthma control compared with lean children, according to recent study results.
Researchers conducted a cross-sectional study of 21 lean children (20% to 65% BMI; mean age, 12.8 years; 67% boys) and 35 overweight and obese children (≥85% BMI; mean age, 12.5 years; 57% boys) with persistent, early-onset asthma. Patient history, qualitative and quantitative asthma symptom characterization and lung function were determined during two to three visits. Multivariable linear and logistic regression were used to determine the association between weight status and symptoms.
Similar lung function was displayed by both cohorts. The overweight and obese children reported more than three times frequent rescue treatments compared with lean children (3.7 vs. 1.1 treatments/week; P=.0002), while experiencing lower fraction of exhaled nitric acid (30 vs. 62.6 ppb; P=.037) and reduced methacholine responsiveness (PC20FEV1 1.87 vs. 0.45 mg/mL; P<.012).
“Weight status affected the child’s primary symptom reported with loss of asthma control (Fisher exact test; P=.003),” the researchers wrote.
Shortness of breath was more often reported by the overweight/obese cohort (OR=11.8; 95% CI, 1.41-98.7), while cough was reported less often by those children (OR=0.26; 95% CI, 0.08-0.82). Overweight and obese children had higher gastroesophageal reflux disease scores compared with thin children (9.6 vs. 23.2; P=.003), which appeared to affect asthma symptoms.
“Greater shortness of breath and beta-agonist use appears to be partially mediated via esophageal reflux symptoms,” the researchers concluded. “Overweight children with asthma may falsely attribute exertional dyspnea and esophageal reflux to asthma, leading to excess rescue medication use.
“Until systematic weight loss interventions become more feasible, respiratory physicians may serve their patients better by considering and discussing alternative causes of dyspnea in self-management plans and discussing when [short-acting beta-agonist] use is warranted for obese patients with asthma.”
Posts
0 comentários:
Post a Comment