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Determinants of severe exercise‐induced bronchoconstriction in Nigerian children with asthma
Author(s) -
Kuti Bankole Peter,
Kuti Demilade Kehinde,
Teague Williams G.
Publication year - 2020
Publication title -
pediatric pulmonology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.866
H-Index - 106
eISSN - 1099-0496
pISSN - 8755-6863
DOI - 10.1002/ppul.24609
Subject(s) - medicine , asthma , bronchoconstriction , odds ratio , vital capacity , confidence interval , pediatrics , bronchial hyperresponsiveness , lung function , respiratory disease , lung , diffusing capacity
Background/Purpose Asthmatics with severe exercise‐induced bronchoconstriction (EIB) are at high risk of exacerbations. The purpose of this study was to determine the prevalence, phenotypic, and laboratory determinants of severe EIB in Nigerian children with asthma. Methods Children with controlled asthma (n = 101) underwent characterization and free‐running exercise bronchoprovocation at a center in Nigeria. Lung function was measured before, then 5, 10, 15, and 30 minutes after 6 to 8 minutes exercise. Severe EIB was defined as ≥50% decrease in forced expired volume in 1 second (FEV 1 ) from preexercise. Serum vitamin D and total antioxidant capacity were measured chromatographically. Factors predicting severe EIB were tested by logistic regression. Result The sample was enriched in children with corticosteroid‐naïve, mild intermittent asthma (71%). Thirteen percent had no EIB, 22% had severe and 65% nonsevere EIB. Children with severe EIB had higher preexercise FVC (105% vs 96%; P = .03) and FEV 1 (98% vs 90%; P = .07), greater obesity (13.6% vs 1.3%; P = .02), more allergic rhinitis (AR) (63.6% vs 35.4%; P = .03), but less exposure to household pets (31.8% vs 72.2%; P = .003) compared to children with nonsevere EIB. Significant determinants (odds ratios/confidence intervals) for severe EIB were obesity = 12.3 (1.2‐125.1), AR = 3.18 (1.19‐8.52), blood eosinophilia = 1.005 (1.001‐1.009), and hypovitaminosis D = 0.87 (0.81‐0.93). Conclusion In Nigerian children with asthma, severe EIB is common and associated with remediable comorbidities including type 2 pattern inflammation and vitamin D deficiency.