Being overweight increases susceptibility to indoor pollutants among urban children with asthma

J Allergy Clin Immunol. 2013 Apr;131(4):1017-23, 1023.e1-3. doi: 10.1016/j.jaci.2012.12.1570. Epub 2013 Feb 10.

Abstract

Background: Both being overweight and exposure to indoor pollutants, which have been associated with worse health of asthmatic patients, are common in urban minority populations. Whether being overweight is a risk factor for the effects of indoor pollutant exposure on asthma health is unknown.

Objectives: We sought to examine the effect of weight on the relationship between indoor pollutant exposure and asthma health in urban minority children.

Methods: One hundred forty-eight children (age, 5-17 years) with persistent asthma were followed for 1 year. Asthma symptoms, health care use, lung function, pulmonary inflammation, and indoor pollutants were assessed every 3 months. Weight category was based on body mass index percentile.

Results: Participants were predominantly African American (91%) and had public health insurance (85%). Four percent were underweight, 52% were normal weight, 16% were overweight, and 28% were obese. Overweight or obese participants had more symptoms associated with exposure to fine particulate matter measuring less than 2.5 μm in diameter (PM2.5) than normal-weight participants across a range of asthma symptoms. Overweight or obese participants also had more asthma symptoms associated with nitrogen dioxide (NO2) exposure than normal-weight participants, although this was not observed across all types of asthma symptoms. Weight did not affect the relationship between exposure to coarse particulate matter measuring between 2.5 and 10 μm in diameter and asthma symptoms. Relationships between indoor pollutant exposure and health care use, lung function, or pulmonary inflammation did not differ by weight.

Conclusion: Being overweight or obese can increase susceptibility to indoor PM2.5 and NO2 in urban children with asthma. Interventions aimed at weight loss might reduce asthma symptom responses to PM2.5 and NO2, and interventions aimed at reducing indoor pollutant levels might be particularly beneficial in overweight children.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adolescent
  • Air Pollutants / immunology
  • Air Pollution, Indoor / analysis
  • Asthma / complications
  • Asthma / ethnology
  • Asthma / immunology*
  • Asthma / pathology
  • Baltimore / epidemiology
  • Black or African American*
  • Body Mass Index
  • Child
  • Child, Preschool
  • Environmental Exposure
  • Female
  • Follow-Up Studies
  • Humans
  • Inflammation / immunology
  • Inflammation / pathology
  • Lung / immunology*
  • Lung / pathology
  • Male
  • Nitrogen Dioxide / immunology
  • Obesity / complications
  • Obesity / ethnology
  • Obesity / immunology*
  • Obesity / pathology
  • Overweight / complications
  • Overweight / ethnology
  • Overweight / immunology*
  • Overweight / pathology
  • Particulate Matter / immunology
  • Respiratory Function Tests
  • Urban Population

Substances

  • Air Pollutants
  • Particulate Matter
  • Nitrogen Dioxide