The mediating pathways linking obesity and asthma are unknown; so a recent study published in European Respiratory Journal aimed to determine the mediating pathways and to search for the most prominent pathological mechanism between central obesity and childhood asthma.
The data for the current research was sourced from the Taiwan Children Health Study; data collected 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.
The researchers examined the associations between central obesity, possible mediators and asthma by using linear models and structural equation models.
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.
The authors conclude that the decline in pulmonary function, in comparison with atopy and airway inflammation, is the most prominent pathological mechanism from central obesity to childhood asthma.
In view of the great burden of obesity and asthma, the findings from this research have important implications for disease-prevention policies. Pulmonary function screening should be applied to obese children to predict asthma risk. Improving pulmonary function is the best strategy to prevent asthma related to central obesity.