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Obesity associated with bronchodilator unresponsiveness in asthmatic minority children, adolescents

Obesity among black and Latino children and adolescents with asthma is linked with bronchodilator unresponsiveness, according to study data.

“This is the first study to show a negative association of obesity and bronchodilator responsiveness in minority children and adolescents,” Meghan E. McGarry, MD, of the department of pediatrics at the University of California, and colleagues wrote. “We also found that among the bronchodilator unresponsive group, obese subjects have worse asthma control and increased asthma morbidity than nonobese subjects.”

Meghan E. McGarry

The researchers conducted a cross-sectional study using data from the Study of African Americans, Asthma, Genes & Environment (n = 867) and the Genes-Environments & Admixture in Latino Americans (GALA II; n = 2, 096). Thirty-six percent of the cohort (aged 8 to 21 years) was considered obese (95th percentile or greater for BMI).

Because the study included data from two case-control studies, “it cannot establish a causal relationship between obesity and bronchodilator unresponsiveness,” the investigators wrote.

After controlling for factors such as age, baseline lung function and use of controller medication, however, the obese participants had a greater risk for being bronchodilator unresponsive (adjusted OR = 1.24; 95% CI, 1.03-1.49) than nonobese participants. The obese participants were 33% (aOR = 1.33; 95% CI, 1.05-1.7) more likely to be prescribed leukotriene receptor inhibitors than their counterparts in the bronchodilator unresponsive group.

Obese participants also were 34% more likely to report being awakened at night by their asthma symptoms than nonobese participants in the bronchodilator unresponsive group (aOR = 1.34; 95% CI, 1.09-1.65).

The researchers said they anticipate these associations to continue.

“This bronchodilator unresponsive obese phenotype is likely to become more common given the rising rates of obesity and the high prevalence of asthma during childhood, which is important from a public health perspective,” they wrote. “This group represents a unique opportunity to study characteristics associated with uncontrolled asthma in a minority pediatric population who exhibit a high burden of obesity and asthma.” – by Ryan McDonald

Disclosure: The researchers report no relevant financial disclosures.