Overweight children report qualitatively distinct asthma symptoms: Analysis of validated symptom measures

Abstract

Background Past studies of asthma in overweight/obese children have been inconsistent. The reason overweight/obese children commonly report worse asthma control remains unclear. Objective To determine qualitative differences in symptoms between lean and overweight/obese children with early-onset, atopic asthma. Methods We conducted a cross-sectional analytic study of lean (20% to 65% body mass index) and overweight/obese (≤85% body mass index) 10-to 17-year-old children with persistent, early-onset asthma. Participants completed 2 to 3 visits to provide a complete history, qualitative and quantitative asthma symptom characterization, and lung function testing. We determined associations between weight status and symptoms using multivariable linear and logistic regression methods. Results Overweight/obese and lean asthmatic children displayed similar lung function. Despite lower fraction of exhaled nitric oxide (30.0 vs 62.6 ppb; P =.037) and reduced methacholine responsiveness (PC20FEV1 1.87 vs 0.45 mg/mL; P