Childhood obesity in relation to poor asthma control and exacerbations: A meta-analysis

Fariba Ahmadizar, Susanne J H Vijverberg, Hubertus G. M. Arets, Anthonius de Boer, Jason E Lang, Meyer Kattan, Colin Palmer, Somnath Mukhopadhyay, Steve Turner, Anke Hilse Maitland-van der Zee

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To estimate the association between obesity and poor asthma control or risk of exacerbations in asthmatic children and adolescents, and to assess whether these associations are different by sex.

A meta-analysis was performed on unpublished data from three North-European paediatric asthma cohorts (BREATHE, PACMAN (Pharmacogenetics of Asthma medication in Children: Medication with Anti-inflammatory effects) and PAGES (Pediatric Asthma Gene Environment Study)) and 11 previously published studies (cross-sectional and longitudinal studies). Outcomes were poor asthma control (based on asthma symptoms) and exacerbations rates (asthma-related visits to the emergency department, asthma-related hospitalisations or use of oral corticosteroids). Overall pooled estimates of the odds ratios were obtained using fixed- or random-effects models.

In a meta-analysis of 46 070 asthmatic children and adolescents, obese children (body mass index ≥95th percentile) compared with non-obese peers had a small but significant increased risk of asthma exacerbations (OR 1.17, 95% CI 1.03–1.34; I2: 54.7%). However, there was no statistically significant association between obesity and poor asthma control (n=4973, OR 1.23, 95% CI 0.99–1.53; I2: 0.0%). After stratification for sex, the differences in odds ratios for girls and boys were similar, yet no longer statistically significant.

In asthmatic children, obesity is associated with a minor increased risk of asthma exacerbations but not with poor asthma control. Sex does not appear to modify this risk.
Original languageEnglish
Pages (from-to)1063-1073
Number of pages11
JournalEuropean Respiratory Journal
Issue number4
Early online date30 Sept 2016
Publication statusPublished - 1 Oct 2016


  • body mass index
  • overweight
  • children
  • asthma severity


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