Overweight/obesity and childhood asthma

Abstract

Childhood asthma and obesity have been increasing in recent decades worldwide. Many studies have reported an increased risk of development of asthma in overweight/obese adults and children. The complex association of overweight/obesity with asthma might be explain by the influence of genetic and epigenetic factors, external factors and mechanical factors with impaired lung function and GERD. Obesity affects lung function in obese asthmatics with decrease in FRC and ERV. In obese children a significantly decreased ratio of FEV1/FVC has been documented. Obesity is associated with low-grade systemic inflammation, giving rise to this idea obesity is a “proinflammatory state”. Adipose tissue secretes leptin, adiponectin, IL-6 and TNF-α, which may have significant effects in development of systemic and airway inflammation. AHR is also present in obese adults suffering from asthma, but data in children are inconsistent. In conclusion, there is evidence to associate asthma with obesity in children, but the data are still conflicting. Pediatric obese asthma is a distinct asthma phenotype, characterized by more severe form, steroid resistance, which requires a specialized treatment plan. As the number of obese children is expected to increase in the next decades, research on pathogenetic mechanisms, will improve the management of this chronic diseases.