Abstract
Background: The causal link between body mass index (BMI) or obesity and asthma in children is still being debated. Analyses of large longitudinal studies with a sufficient number of incident cases and in which the time-dependent processes of both excess weight and asthma development can be validly analyzed are lacking. Objective: We sought to investigate whether the course of BMI predicts incident asthma in childhood. Methods: Data from 12,050 subjects of 8 European birth cohorts on asthma and allergies were combined. BMI and doctor-diagnosed asthma were modeled during the first 6 years of life with latent growth mixture modeling and discrete time hazard models. Subpopulations of children were identified with similar standardized BMI trajectories according to age-and sex-specific "World Health Organization (WHO) child growth standards" and "WHO growth standards for school aged children and adolescents" for children up to age 5 years and older than 5 years, respectively (BMI-SDS). These types of growth profiles were analyzed as predictors for incident asthma. Results: Children with a rapid BMI-SDS gain in the first 2 years of life had a higher risk for incident asthma up to age 6 years than children with a less pronounced weight gain slope in early childhood. The hazard ratio was 1.3 (95% CI, 1.1-1.5) after adjustment for birth weight, weight-for-length at birth, gestational age, sex, maternal smoking in pregnancy, breastfeeding, and family history of asthma or allergies. A rapid BMI gain at 2 to 6 years of age in addition to rapid gain in the first 2 years of life did not significantly enhance the risk of asthma. Conclusion: Rapid growth in BMI during the first 2 years of life increases the risk of asthma up to age 6 years.
Original language | English |
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Pages (from-to) | 1528-1536 |
Journal | Journal of Allergy and Clinical Immunology |
Volume | 131 |
Issue number | 6 |
DOIs | |
Publication status | Published - Jun 2013 |
Keywords
- Body mass index
- rapid growth
- asthma
- child
- latent growth mixture model
- European birth cohorts
- Global Allergy and Asthma European Network