Impact of obesity on asthma severity and control in school aged children

Background:Childhood asthma and obesity are significant public health problems. The prevalence of asthma and obesity in children have increased significantly during the past decades. The basis for the relationship between pediatric asthma and obesity is not well established.
Objective: our study aimed to find the relation between obesity and bronchial asthma and whether obesity may contribute to more severe asthma symptoms in asthmatic children at Qena University Hospital.
Patients and method(s): This was a cross-sectionalstudy of asthmatic school aged children who were admitted at pediatric department or attendedemergency department or the outpatient clinic of Qena University Hospital through the period from MAY 2018 to April 2019.They classified according to BMI to two groups, asthmatic obese and asthmatic non-obese. The included asthmatic children are subjected to full through history, clinical examination and pulmonary function tests.
Result(s):This  was a cross-sectional study which was carried out in Pediatric department of Qena university hospitaland included 60 asthmatic children with intermittent  to severe persistent asthma with age range  6-12 years through  the period from MAY 2018 to April 2019 and classified to two groups, 30cases asthmatic obese and 30 cases asthmatic non-obese, based on calculated BMI in both groups. The patients were diagnosed according to the global strategy for asthma management and prevention classification. The mean age in asthmatic obese patients was (8.94±1.99)versus (9.13±1.97) in asthmatic non-obese group with no significant difference between them (p-value =0.707). The percentage of moderate persistent asthma was statistically significantly higher in asthmatic obese than asthmatic non-obese group (53.3% versus 26.7%, p-value= 0.035), respectively. 13.3% of asthmatic obese had severe persistent asthma versus 0% in asthmatic non-obese group (p-value=0.038).46.7%of the asthmatic obese children received high dose of steroids versus 10%of asthmatic non-obese with statistically significant difference (p value =0.001).  The mean numbers of emergency visits in asthmatic obese were significantly higher than that in asthmatic non-obese (5.9±2.66versus 3.93±1.6), (p-value= 0.001), respectively. FEV₁, FVC, FEV₁/FVC, were not significantly different in asthmatic obese patients compared with asthmatic non-obese (p-value =0.742, 0.849, 0.751, respectively).
Conclusion:obesity was associated with significantly more severe asthma symptoms together with poor asthma control. Pulmonary function tests were not affected by increased BMI.