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Childhood body mass index and wheezing disorders: a systematic review and meta‐analysis
Author(s) -
Mebrahtu Teumzghi F.,
Feltbower Richard G.,
Greenwood Darren C.,
Parslow Roger C.
Publication year - 2015
Publication title -
pediatric allergy and immunology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.269
H-Index - 89
eISSN - 1399-3038
pISSN - 0905-6157
DOI - 10.1111/pai.12321
Subject(s) - medicine , overweight , underweight , asthma , meta analysis , body mass index , childhood obesity , obesity , odds ratio , pediatrics , percentile , epidemiology , statistics , mathematics
Background It has been claimed that overweight/obesity, childhood asthma and wheezing disorders are associated, although the results of observational studies have remained inconsistent. We conducted a systematic review and meta‐analysis to investigate this. Methods An online search of published papers linking childhood asthma and wheezing with overweight/obesity up to May 2014 using EMBASE and MEDLINE medical research databases was carried out. Summary odds ratios ( OR ) were estimated using random‐effects models. Subgroup meta‐analyses were performed to assess the robustness of risk associations and between‐study heterogeneity. Results A total of 38 studies comprising 1,411,335 participants were included in our meta‐analysis. The summary OR s of underweight (<5th percentile), overweight (>85th to <95th percentile) and obesity (≥95th percentile) were 0.85 (95% CI: 0.75 to 0.97; p = 0.02), 1.23 (95% CI: 1.17 to 1.29; p < 0.001) and 1.46 (95% CI: 1.36 to 1.57, p < 0.001), respectively. Heterogeneity was significant and substantial in all three weight categories, and not accounted for by pre‐defined study characteristics. Conclusion Our results suggest that underweight is associated with a reduced risk of childhood asthma, and overweight and obesity are associated with an increased risk of childhood asthma. Although our findings assert that overweight/obesity and childhood asthma are associated, the causal pathway and temporal aspects of this relationship remain unanswered and deserve further epidemiological investigation.