Body fat mass distribution and interrupter resistance, fractional exhaled nitric oxide, and asthma at school-age

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Abstract

Background:

Obesity and asthma often coexist. We hypothesized that detailed body fat distribution measures might be more strongly associated than body mass index (BMI) with childhood asthma.

Objective:

We examined the associations of total body and abdominal fat measures with respiratory resistance (Rint), fractional exhaled nitric oxide (Feno), and risks of wheezing and asthma in school-aged children.

Methods:

In a population-based prospective cohort study among 6178 children aged 6 years, we measured BMI, fat mass index, android/gynoid ratio, and preperitoneal and subcutaneous fat mass by physical examinations, dual-energy x-ray absorptiometry, and ultrasound, respectively. We performed Rint and Feno measurements, and assessed physician-diagnosed wheezing and asthma by questionnaires.

Results:

A higher BMI was associated with a higher Rint (Zscore [95% CI], 0.06 [0.01-0.12]) and increased risk of wheezing (odds ratio [95% CI], 1.07 [1.00-1.14], perZscore BMI increase), but not with Feno or asthma. A high fat mass index was associated with a higher Rint (Zscore [95% CI], 0.40 [0.13-0.68]). A high android/gynoid fat mass ratio was associated with a lower Feno (Sym% [95% CI], −9.8 [−16.3 to −3.4]), whereas a high preperitoneal fat mass was associated with a higher Feno (Sym% [95% CI], 6.5 [0.1-12.9]). Subcutaneous fat mass was not associated with any respiratory outcome.

Conclusions:

Studying detailed body fat distribution measures might provide better insight into the obesity-asthma paradigm.

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