Pediatric allergy and respiratory disease (소아알레르기 및 호흡기학회지)

The Korean Academy of Pediatric Allergy and Respiratory Diseasse (대한소아알레르기호흡기학회)
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Effect of Obesity on Atopy and Bronchial Hyperresponsiveness in Children

소아 비만이 아토피와 기관지과민성에 미치는 영향

남영미;김지태;김경원;김은수;송태원;손명현;김규언

  • Published : 20060000
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Abstract

Effect of Obesity on Atopy and Purpose : The prevalence of asthma and allergic diseases is on the increase and that of obesity is on the continuous increase all over the world. There are recent studies on the association between asthma and obesity, which are still controversial. This study aimed at identifying the effect of obesity on atopy and bronchial hyperresponsiveness in children. Methods : This study was conducted with 443 subjects ranging from six to 15 years of age, and consisted of 283 boys and 160 girls. They went through pulmonary function tests and methacholine challenge tests with their eosinophil counts within blood, total serum IgE levels, serum eosinophil cationic protein(ECP) levels, heights, and weights measured. After determining body mass index(BMI), BMI percentiles were determined by using a BMI percentile curve based on gender and age. After the classification on the basis of the 85th, 90th, and 95th BMI percentiles, a comparison was made in frequencies of atopy, total serum IgE, eosiniphil counts within blood, and serum ECPs as well as in frequencies of bronchial hyperresponsiveness for the total group, the boys, and the girls, respectively. Results : Among the groups classified by BMI percentiles, there was no significant differences in total serum IgE, eosinophil counts within blood, and serum ECPs. There also was no significant differences in bronchial hyperresponsiveness or pulmonary functions among them. Effect of atopy and pulmonary function test variables on BMI did not show any statistical significance in boys, girls or the total group. Conclusion : There was domestically no association between obesity and atopy and bronchial hyperresponsiveness among children.

목 적 : 세계적으로 천식 및 알레르기 질환의 유병률이 증가하고 있으며 비만 또한 유병률이 지속적으로 증가하고 있다. 최근 천식과 비만 사이의 연관성에 관한 연구들이 있지만 아직 논란이 있다. 본 연구에서는 비만이 소아에서 아토피와 기관지과민성에 미치는 영향에 대해 알아보고자 하였다. 방 법 : 만 6세에서 15 세 사이의 443명을 대상으로 하였으며, 이중 남아는 283명, 여아는 160명 이었다. 대상 환아에서 폐기능 검사, 메타콜린 유발시험을 시행하였고, 혈액 내 호산구 수, 혈청 총 IgE 농도, 혈청 ECP 농도 및 키와 몸무게를 측정하였다. body mass index(BMI)를 구하여 각 성별, 연령에 따른 BMI 백분위수 곡선을 이용하여 BMI 백분위수를 구하였다. BMI 백분위수 85, 90, 95를 기준으로 분류하여 전체 대상 환아 및 남아, 여아 각각에서 아토피의 빈도, 혈청 총 IgE, 혈액 내 호산구 수, 혈청 ECP를 비교하였으며 기관지과민성 유무의 빈도를 비교하였다. 결 과 : BMI 백분위수로 분류한 군 사이에서 아토피의 변수인 혈청 총 IgE, 혈액 내 호산구 수, 혈청 ECP는 의미있는 차이를 나타내지 않았다. BMI 백분위수에 따른 군 사이에서 기관지과민성 및 폐기능을 비교해 보았을 때 유의한 차이를 보이지 않았다. 대상 환아를 남아와 여아로 재 분류하여 비교하였을 때에도 각 변수들은 유의한 차이를 보이지 않았다. 전체 대상환아, 남아, 여아로 분류하여 아토피 및 폐기능 검사변수가 BMI에 미치는 영향을 알아보았는데 유의한 차이를 보이지 않았다.

Keywords

References

  1. Hong YM, Moon KR, Seo JW, Sim JG, Yoo KW. Jeong BJ, et al. Guideline of diagnosis and treatment in childhood obesity. J Korean Pediatr Assoc 1999;42:1338-45
  2. Masoli M, Fabian D, Halt S, Beasley R. The global burden of asthma: executive summary of the GINA Dissemination Committee Report. Allergy 2004;59:469-78 https://doi.org/10.1111/j.1398-9995.2004.00526.x
  3. Figueroa-Munoz JI, Chin S, Rona RJ. Association between obesity and asthma in 4-11 year old children in the UK. Thorax 2001;56:133-7 https://doi.org/10.1136/thorax.56.2.133
  4. Mishra V. Effect of obesity on asthma among adult Indian women. Int J obes Relat Metab Disord 2004;28:1048-58 https://doi.org/10.1038/sj.ijo.0802700
  5. Jarvis D, Chinn S, Potts J, Burney P. Association of body mass index with respiratory symptoms and atopy. Clin Exp Allergy 2002;32:831-7 https://doi.org/10.1046/j.1365-2222.2002.01380.x
  6. Celedon JC, Palmer LJ, Litonjua AA, Weiss ST, Wang B, Fang Z, et al. Body mass index and asthma in adults in families of subjects with asthma in Anqing, China. Am J Respir Crit Care Med 2001;164:1835-40 https://doi.org/10.1164/ajrccm.164.10.2105033
  7. Stennius-Aarniala B, Poussa T, Kvarnstrom J, Gronlund EL, Ylikahri M, Mustrajoki P. Immediate and long effects of weight reduction in obese people with asthma. BMJ 2000;320:827-32 https://doi.org/10.1136/bmj.320.7238.827
  8. Aaron SD, Fergussion D, Dent R, Chen Y, Vandemheen KL, Dales RE. Effect of weight reduction on respiratory function and airway reactivity in obese women. Chest 2004;125:2046-52 https://doi.org/10.1378/chest.125.6.2046
  9. Schachter LM, Peat JK, Salome CM. Asthma and atopy in overweight children. Thorax 2003;58:1031-5 https://doi.org/10.1136/thorax.58.12.1031
  10. Shore SA, Fredberg JJ. Obesity, Smooth muscle, and airway hyperresponsiveness. J Allergy Clin Immunol 2005;115:925-7 https://doi.org/10.1016/j.jaci.2005.01.064
  11. Hong YM, Moon KR, Seo JW, Sim JG, Yoo KW. Jeong BJ, et al. Nationalwide study on body mass index, skinfold thickness, and arm circumference in Korean Children. J Korean Pediatr Assoc 1999;42:1186-206
  12. Cho KB, Park SB, Park SC, Lee DH, Lee SJ. Suh SJ. The prevalence and trend of obesity in children and adolescents. J Korean Pediatr Assoc 1989;32:597-604
  13. Pyun BY. Guideline for the management of children asthma. Pediatr Allergy Respir Dis (Korea) 2003;13:66-71
  14. Brenner JS, Kelly CS, Wenger AD, Brich SM, Morrow AL. Asthma and obesity in adolescents: is there an association? J asthma 2001;38:509-15 https://doi.org/10.1081/JAS-100105872
  15. Tantisira KG, Litonjua ST, Weiss ST, Fuhlbrigge AL. Association of body mass with pulmonary function in the Children Asthma Management Program(CAMP). Thorax 2003;58:1036-41 https://doi.org/10.1136/thorax.58.12.1036
  16. Huang SL, Shiao GM, Chou P. Association between body mass index and allergy in teenage girls in Taiwan. Clin Exp Allergy 1999;29:323-9 https://doi.org/10.1046/j.1365-2222.1999.00455.x
  17. Schchter LM, Salome CM, Peat JK, Woolcock AJ. Obesity is a risk for asthma and wheeze but not airway hyperresponsiveness. Thorax 2001;56:4-8 https://doi.org/10.1136/thorax.56.1.4
  18. Tantisira KG, Weiss ST. Complex interaction in complex traits: obesity and asthma. Thorax 2001;56:64-74
  19. Jang AS, Lee JH, Park SW, Shin MY, Kim DJ, Park CS. Severe airway hyperresponsiveness in school-aged boys with a high body mass index. Korean J Intern Med 2006;21:10-4 https://doi.org/10.3904/kjim.2006.21.1.10
  20. Kang H, Kang EK, Nah KM, Yoo Y, Koh YY. Comparison of obesity between children with asthma and healthy children. Pediatr Allergy Respir Dis(Korea) 2003;13:17-25
  21. Troisi RJ, Speizer FE, Willett WC, Trichopoulos D, Rosner B. Menopause, postmenopausal estrogen preparations, and the risk of adult-onset asthma. A prospective cohort study. Am J Respir Crit Care Med 1995;152:1183-8 https://doi.org/10.1164/ajrccm.152.4.7551368
  22. Yap JCH, Watson RA, Gilbey WS, Pride NB. Effects of posture on respiratory mechanics in obesity. J Appl Physiol 1995;79:1199-205 https://doi.org/10.1152/jappl.1995.79.4.1199
  23. Fredberg JJ. Frozen objects: small airways, big breaths, and asthma. J Allergy Clin Immunol 2000;106:615-24 https://doi.org/10.1067/mai.2000.109429
  24. Gump A, Haughney L, Fredberg J. Relaxation of activated airway smooth muscle: relative potency of isoproterenol vs. tidal stretch. J Appl Physiol 2001;90:2306-10 https://doi.org/10.1152/jappl.2001.90.6.2306
  25. Rajala MW, Scherer PE. Minireview: the adipocyte-at the crossroads of energy homeostasis, inflammation, and artheosclerosis. Endocrinology 2003;144:3765-73 https://doi.org/10.1210/en.2003-0580
  26. Nawrocki AR, Scherer PE. The delicate balance between fat and muscle; adipokine in metabolic disease and musculoskeletal inflammation. Curr Opin Phamacol 2004;4:281-9 https://doi.org/10.1016/j.coph.2004.03.003