Background:
Increased asthma and obesity prevalence are independently associated with health disparities. This study sought to examine the relationship between these two conditions, particularly within the pediatric population at a major inner city teaching hospital.
Methods:
Patients aged 3 to 18 with a diagnosis of bronchial asthma and at least one hospital encounter for an acute asthma attack, were examined over a period of 2 years. A total of 229 patients were identified. The major outcomes were the number of Emergency Department visits and inpatient Hospital admissions. BMI percentiles for age was the major exposure. Multiple logistic regression models that adjusted for gender, ethnicity and age were performed.
Results:
Compared to a prevalence of obesity of 13-15% amongst low income families in the same community, the prevalence of obesity among asthmatics in this study was higher, 27%. In addition, the odds of increased hospital utilization through Emergency Department visits and admission for inpatient management amongst obese patients was higher when compared to patients of healthy weight (OR;1.09, 95% CI; 0.32- 3.66 and OR; 1.43, 95% CI; 0.36- 5.66).
Conclusions:
The higher prevalence of obesity among asthmatics in comparison to the corresponding general population indicates a potential association between obesity and the development of childhood asthma; an association that may also predict disease severity through both emergency room utilization and hospitalization. Though odds ratios showed an elevated risk for disease severity amongst obese patients, the lack of statistical significance may be due to sample size effect. This study draws attention to obesity-associated asthma; a potentially distinct clinical phenotype and an emerging concern in health disparities translational research.