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Anthropometric Measures of Obesity and the Association with Asthma and Other Allergic Disorders: Cincinnati Children’s Allergy and Immunology Clinic Cohort

Musaad, Salma MA

Abstract Details

2007, PhD, University of Cincinnati, Medicine : Epidemiology (Environmental Health).

Pediatric studies of associations among obesity, asthma and allergic sensitization are inconclusive. Body mass index (BMI) is commonly used to classify study participants as obese. BMI, however, does not reflect central fat distribution, a known risk factor for metabolic disorders. This research tested the hypothesis that central fat distribution increases risk for asthma and allergic sensitization, measured using the skin prick test for aeroallergens. Measures of central fat distribution included waist circumference, waist to height ratio (WHtR) and conicity index. Childhood studies rarely utilize these alternative measures for characterizing the relationship between obesity and asthma or allergic sensitization.

In this study, alternative measures of obesity were compared with BMI percentiles; the association between obesity and asthma in children with allergic rhinitis was investigated; the association between obesity and allergic sensitization in children with and without asthma, rhinitis and eczema was explored. To account for the effects of several obesity measures on the above outcomes, a structural equation model was developed.

Results show that BMI percentiles are discordant with 18-46% of children classified as obese using the alternative measures. A high WHtR or conicity index increases likelihood for asthma in children with allergic rhinitis. Prevalence of a high WHtR consistently increases from allergic rhinitis to mild asthma to moderate/severe asthma.

Sensitization to aeroallergens appears to protect against an asthma diagnosis (OR=0.6; 95% CI=0.4-0.9), but is positively associated with rhinitis (OR=8.1; 95% CI=4.9-13.5) and eczema (OR=1.9; 95% CI=1.0-3.4). In children with rhinitis, those with a moderate WHtR are twice as likely to have increasing positive skin prick tests (OR=1.9; 95% CI=1.1-3.3) compared to low WHtR. In children with asthma, obesity appears to protect against increasing positive skin prick tests per BMI percentiles (OR=0.5; 95% CI=0.3-0.9) or waist circumference (OR=0.3; 95% CI=0.1-0.9). This finding suggests that the pathway for asthma is different in children with central obesity.

Alternative measures that better account for fat distribution are superior to BMI percentiles for characterizing the relationship between childhood obesity with asthma and with allergic sensitization in the context of asthma, rhinitis and eczema.

Dr. Kim Dietrich (Advisor)
113 p.

Recommended Citations

Citations

  • Musaad, S. M. (2007). Anthropometric Measures of Obesity and the Association with Asthma and Other Allergic Disorders: Cincinnati Children’s Allergy and Immunology Clinic Cohort [Doctoral dissertation, University of Cincinnati]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1192570691

    APA Style (7th edition)

  • Musaad, Salma. Anthropometric Measures of Obesity and the Association with Asthma and Other Allergic Disorders: Cincinnati Children’s Allergy and Immunology Clinic Cohort. 2007. University of Cincinnati, Doctoral dissertation. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=ucin1192570691.

    MLA Style (8th edition)

  • Musaad, Salma. "Anthropometric Measures of Obesity and the Association with Asthma and Other Allergic Disorders: Cincinnati Children’s Allergy and Immunology Clinic Cohort." Doctoral dissertation, University of Cincinnati, 2007. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1192570691

    Chicago Manual of Style (17th edition)