AUTHOR=Shan Li-Shen , Zhou Qian-Lan , Shang Yun-Xiao 

TITLE=Bidirectional Association Between Asthma and Obesity During Childhood and Adolescence: A Systematic Review and Meta-Analysis

JOURNAL=Frontiers in Pediatrics

VOLUME=8

YEAR=2020

URL=https://www.frontiersin.org/journals/pediatrics/articles/10.3389/fped.2020.576858

DOI=10.3389/fped.2020.576858

ISSN=2296-2360

ABSTRACT=<p><bold>Objective:</bold> Co-occurrence of pediatric asthma and obesity has been widely reported, yet the causal directions between these two disorders are still not well-understood. The objective of this meta-analysis is to explore whether there is a possibility of a bidirectional association for these two disorders in children and adolescents.</p><p><bold>Methods:</bold> PubMed, Embase, Web of Science, and CENTRAL databases were searched up to August 2020. Cohort studies reporting the associations of obesity with risk of physician-diagnosed asthma or physician-diagnosed asthma with risk of obesity in children and adolescents were eligible for the review.</p><p><bold>Results:</bold> A total of 3,091 records were identified from the four databases, with final inclusion of nine. Six studies reported the association between obesity and risk of asthma; three studies reported the association between asthma and risk of childhood obesity. As evaluated by the Newcastle–Ottawa quality assessment scale, all studies were assessed as high-quality studies. There was a statistically significant association between obesity and increased risk of physician-diagnosed asthma in children and adolescents. The pooled RR was 1.39 (95% CI: 1.28, 1.50; <italic>p</italic> &lt; 0.001), with significant heterogeneity across studies (<italic>I</italic><sup>2</sup> = 81.7%; <italic>p</italic><sub>heterogeneity</sub> &lt; 0.001). The pooled RR in boys was 1.53 (95% CI: 1.17, 1.99; <italic>p</italic> = 0.002), but such a significant association was not observed in girls (RR = 1.17, 95% CI: 0.79, 1.72; <italic>p</italic> = 0.434). For the association of asthma with risk of childhood obesity, the pooled RR was 1.47 (95%CI: 1.25, 1.72; <italic>p</italic> &lt; 0.001) without statistical heterogeneity (<italic>I</italic><sup>2</sup> = 0%, <italic>p</italic><sub>heterogeneity</sub> = 0.652).</p><p><bold>Conclusion:</bold> There is a bidirectional association between obesity and asthma during childhood and adolescence, suggesting that childhood obesity drives an increase in the onset of asthma; meanwhile, childhood asthma may also increase risk of obesity for children and adolescents.</p>