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Obesity is a risk factor for exercise‐induced bronchospasm in asthmatic adolescents

2020; Wiley; Volume: 55; Issue: 8 Linguagem: Inglês

10.1002/ppul.24875

8755-6863

A Almeida, Edil de Albuquerque Rodrigues Filho, Eduarda Lubambo Costa, Claudio Gonsalves de Albuquerque, Emanuel Sarinho, Décio Medeiros Peixoto, Ana Caroline Cavalcanti Dela Bianca, Marco Aurélio de Valois Correia, José Ângelo Rizzo,

Chronic Obstructive Pulmonary Disease (COPD) Research

Abstract Introduction Exercise‐induced bronchospasm (EIB) is common in young asthmatics and obesity is becoming an epidemic in this population. Both conditions can give rise to or worsen respiratory symptoms upon exercise and may interfere with recreational and sports activities. Objective To investigate the association between obesity and the risk and severity of EIB in asthmatic children and adolescents. Methods This study included data from asthmatic patients aged between 7 and 19 years undergoing treadmill running tests to evaluate EIB, defined as a reduction greater than or equal to 10% in forced expiratory volume in the first second (FEV 1 ) compared to baseline. Eutrophic, obese, and overweight individuals were categorized according to body mass index z‐score (eutrophic, −0.5 < z ≤ 1; overweight, 1 < z < 2; and obese, z ≥ 2). Results Of the 156 individuals studied (42% female), 58% were eutrophic, 22% overweight, and 19% obese. Seventy‐three individuals (47%) presented with EIB, with higher risk among obese (OR, 2.86; 95% CI, 1.00‐8.14; P = .05). Asthma severity was another independent risk factor for EIB (OR, 2.95; 95% CI, 1.36‐6.42; P = .006). The number of patients in whom FEV 1 returned to baseline values (difference less than 10% from baseline) at the 13th minute after challenge was lower in obese individuals compared to eutrophic and overweight ones ( P = .04). Baseline FEV 1 , gender, or age were not found to be risk factors for EIB in any of the groups. Conclusion Obese youngsters with asthma present a greater risk for EIB with slower recovery than their nonobese peers. Clinicians should be aware of this association, especially in those with more severe disease, for adequate recognition and treatment.