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Gender difference of childhood overweight and obesity in predicting the risk of incident asthma: a systematic review and meta-analysis

Authors

  • Y. C. Chen,

    1. Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
    2. Department of Family Medicine, Taipei City Hospital, ZhongXing Branch, Taipei, Taiwan
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  • G. H. Dong,

    1. Department of Biostatistics and Epidemiology, School of Public Health, China Medical University, Shenyang, China
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  • K. C. Lin,

    1. Department of Health Care Management, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan
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  • Y. L. Lee

    Corresponding author
    1. Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan
    • Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
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Address for correspondence: Professor YL Lee, #17 Xuzhou Rd, 516R, Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei 100, Taiwan.

E-mail: leolee@ntu.edu.tw

Summary

The aims of our meta-analysis were (i) to quantify the predictability of childhood overweight and obesity on the risk of incident asthma; and (ii) to evaluate the gender difference on this relationship. The selection criteria included prospective cohort paediatric studies which use age- and sex-specific body mass index (BMI) as a measure of childhood overweight and the primary outcome of incident asthma. A total of 1,027 studies were initially identified through online database searches, and finally 6 studies met the inclusion criteria. The combined result of reported relative risk from the 6 included studies revealed that overweight children conferred increased risks of incident asthma as compared with non-overweight children (relative risk, 1.19; 95% confidence interval [CI], 1.03–1.37). The relationship was further elevated for obesity vs. non-obesity (relative risk, 2.02; 95% CI, 1.16–3.50). A dose–responsiveness of elevated BMI on asthma incidence was observed (P for trend, 0.004). Obese boys had a significantly larger effect than obese girls (relative risk, boys: 2.47; 95% CI, 1.57–3.87; girls: 1.25; 95% CI, 0.51–3.03), with significant dose-dependent effect. Proposed mechanisms of gender difference could be through pulmonary mechanics, sleep disordered breathing and leptin. Further research might be needed to better understand the exact mechanism of gender difference on the obesity–asthma relationship.

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