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Fang C, Jiang Z, Su X, Fan W. The association between body mass index and asthma in children: a cross‑sectional study from NHANES 1999 to 2020. Sci Rep 2025; 15:9448. [PMID: 40108226 PMCID: PMC11923108 DOI: 10.1038/s41598-025-92619-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2024] [Accepted: 03/03/2025] [Indexed: 03/22/2025] Open
Abstract
The relationship between body mass index (BMI) and the risk of asthma in the pediatric population is not fully understood. This study aimed to investigate the association between BMI and asthma in a large nationally representative sample. The study included 35,603 pediatric participants from the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2020. The association between BMI and asthma was examined using various statistical models, including logistic regression, piece-wise linear regression, and subgroup analyses, adjusting for potential confounding factors. When analyzing BMI as a continuous variable, a one-unit increase in BMI was associated with a 4% higher odds of asthma. A clear dose-response relationship was observed, where individuals in the higher BMI quartiles had progressively higher odds of asthma compared to those in the lowest quartile. Smooth curve fitting revealed a not entirely linear relationship, with a steeper increase in asthma risk at lower BMIs (below an inflection point of 21 kg/m²) compared to higher BMIs. Subgroup analyses consistently showed a positive association between BMI and asthma across different age, gender, race, socioeconomic, and smoking-related factors. Sensitivity analyses, including multiple imputation for missing data and alternative BMI metrics, confirmed the stability of the results. This study provides robust evidence for a positive and not entirely linear association between BMI and the risk of asthma in the pediatric population. These findings enhance the existing literature and underscore the necessity of considering BMI in both asthma research and clinical practice.
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Affiliation(s)
- Cuiyun Fang
- Department of Nursing, Liyang People's Hospital, Liyang, China
| | - Zhongli Jiang
- Department of Pediatrics, Liyang People's Hospital, Liyang, China
| | - Xiaoxue Su
- Department of Pediatrics, Liyang People's Hospital, Liyang, China
| | - Wei Fan
- Department of Pediatrics, Liyang People's Hospital, Liyang, China.
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Hu Z, Song X, Hu K, Ruan Y, Zeng F. Association between sleep duration and asthma in different weight statuses (CHNS 2009-2015). Sleep Breath 2021; 25:493-502. [PMID: 32335852 DOI: 10.1007/s11325-020-02081-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 03/28/2020] [Accepted: 04/04/2020] [Indexed: 11/26/2022]
Abstract
PURPOSE Inadequate sleep duration affects asthma and weight. The associations among sleep duration, asthma, and different weight statuses in the Chinese population need to be further determined. METHODS The study included 32,776 Chinese adults from the China Health and Nutrition Survey during 2009-2015. Self-reported sleep duration was classified into three groups: ≤ 6 h (short), 7 to 8 h (optimal), and ≥ 9 h (long). Age, sex, smoking, drinking alcohol, and residence location were adjusted as potential confounding factors in a generalized estimating equations model. RESULTS The prevalence of asthma in the Chinese population was approximately 1.17% (383/32,776). Asthmatics were associated with shorter sleep duration and higher indices of central obesity (mean waist circumference, waist to height ratio, and conicity index) than the population without asthma. After adjusting for potential confounding factors, odds ratios (ORs) indicated positive associations between sleep duration and asthma (short vs optimal, adjusted OR = 1.74, 95%CI 1.33, 2.26; and long vs optimal, adjusted OR = 1.51, 95%CI 1.18, 1.93). When stratified by weight status, the participants with central obesity showed highest prevalence of asthma among the three sleep duration groups. With the adjustment of confounding factors, underweight and obesity grouped by waist to height ratio and conicity index remained associated with higher risk of asthma among short and long sleepers than in optimal sleepers. CONCLUSIONS Short and long sleepers with central obesity and underweight status were associated with significantly higher prevalence of asthma than optimal sleepers in Chinese adults.
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Affiliation(s)
- Zhigang Hu
- Department of Respiratory and Critical Care Medicine, Renmin Hospital of Wuhan University, Zhangzhidong Road No. 99, Wuhan, 430060, China
- Department of Respiratory and Critical Care Medicine, The first College of Clinical Medicine science, China Three Gorges University, No. 183 Yiling Road, Yichang, 443003, People's Republic of China
- Department of Respiratory and Critical Care Medicine, Yichang Central People's Hospital, Yichang, China
| | - Xinyu Song
- Department of Respiratory and Critical Care Medicine, The first College of Clinical Medicine science, China Three Gorges University, No. 183 Yiling Road, Yichang, 443003, People's Republic of China
- Department of Respiratory and Critical Care Medicine, Yichang Central People's Hospital, Yichang, China
| | - Ke Hu
- Department of Respiratory and Critical Care Medicine, Renmin Hospital of Wuhan University, Zhangzhidong Road No. 99, Wuhan, 430060, China.
| | - Yushu Ruan
- Department of Respiratory and Critical Care Medicine, The first College of Clinical Medicine science, China Three Gorges University, No. 183 Yiling Road, Yichang, 443003, People's Republic of China
- Department of Respiratory and Critical Care Medicine, Yichang Central People's Hospital, Yichang, China
| | - Fanjun Zeng
- Department of Respiratory and Critical Care Medicine, The first College of Clinical Medicine science, China Three Gorges University, No. 183 Yiling Road, Yichang, 443003, People's Republic of China
- Department of Respiratory and Critical Care Medicine, Yichang Central People's Hospital, Yichang, China
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Bereman MS, Beri J, Enders JR, Nash T. Machine Learning Reveals Protein Signatures in CSF and Plasma Fluids of Clinical Value for ALS. Sci Rep 2018; 8:16334. [PMID: 30397248 PMCID: PMC6218542 DOI: 10.1038/s41598-018-34642-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Accepted: 10/23/2018] [Indexed: 11/14/2022] Open
Abstract
We use shotgun proteomics to identify biomarkers of diagnostic and prognostic value in individuals diagnosed with amyotrophic lateral sclerosis. Matched cerebrospinal and plasma fluids were subjected to abundant protein depletion and analyzed by nano-flow liquid chromatography high resolution tandem mass spectrometry. Label free quantitation was used to identify differential proteins between individuals with ALS (n = 33) and healthy controls (n = 30) in both fluids. In CSF, 118 (p-value < 0.05) and 27 proteins (q-value < 0.05) were identified as significantly altered between ALS and controls. In plasma, 20 (p-value < 0.05) and 0 (q-value < 0.05) proteins were identified as significantly altered between ALS and controls. Proteins involved in complement activation, acute phase response and retinoid signaling pathways were significantly enriched in the CSF from ALS patients. Subsequently various machine learning methods were evaluated for disease classification using a repeated Monte Carlo cross-validation approach. A linear discriminant analysis model achieved a median area under the receiver operating characteristic curve of 0.94 with an interquartile range of 0.88–1.0. Three proteins composed a prognostic model (p = 5e-4) that explained 49% of the variation in the ALS-FRS scores. Finally we investigated the specificity of two promising proteins from our discovery data set, chitinase-3 like 1 protein and alpha-1-antichymotrypsin, using targeted proteomics in a separate set of CSF samples derived from individuals diagnosed with ALS (n = 11) and other neurological diseases (n = 15). These results demonstrate the potential of a panel of targeted proteins for objective measurements of clinical value in ALS.
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Affiliation(s)
- Michael S Bereman
- Department of Biological Sciences, North Carolina State University, Raleigh, NC, 27695, USA. .,Department of Chemistry, North Carolina State University, Raleigh, NC, 27695, USA. .,Center for Human Health and the Environment, North Carolina State University, Raleigh, NC, 27695, USA.
| | - Joshua Beri
- Department of Chemistry, North Carolina State University, Raleigh, NC, 27695, USA
| | - Jeffrey R Enders
- Center for Human Health and the Environment, North Carolina State University, Raleigh, NC, 27695, USA
| | - Tara Nash
- Center for Human Health and the Environment, North Carolina State University, Raleigh, NC, 27695, USA
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Beghé B, Fabbri LM, Contoli M, Papi A. Update in Asthma 2016. Am J Respir Crit Care Med 2017; 196:548-557. [PMID: 28530112 DOI: 10.1164/rccm.201702-0318up] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Bianca Beghé
- 1 Department of Medical and Surgical Sciences, University of Modena Reggio Emilia, Modena, Italy
| | - Leonardo M Fabbri
- 2 Research Centre on Asthma and Chronic Obstructive Pulmonary Disease, Department of Medical Sciences, University of Ferrara, Ferrara, Italy; and.,3 Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Marco Contoli
- 2 Research Centre on Asthma and Chronic Obstructive Pulmonary Disease, Department of Medical Sciences, University of Ferrara, Ferrara, Italy; and
| | - Alberto Papi
- 2 Research Centre on Asthma and Chronic Obstructive Pulmonary Disease, Department of Medical Sciences, University of Ferrara, Ferrara, Italy; and
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Bédard A, Serra I, Dumas O, Basagaña X, Clavel-Chapelon F, Le Moual N, Sanchez M, Siroux V, Varraso R, Garcia-Aymerich J. Time-Dependent Associations Between Body Composition, Physical Activity, and Current Asthma in Women: A Marginal Structural Modeling Analysis. Am J Epidemiol 2017; 186:21-28. [PMID: 28453608 DOI: 10.1093/aje/kwx038] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Accepted: 07/14/2016] [Indexed: 01/03/2023] Open
Abstract
The role of obesity in adult asthma is well-known and has been partly attributed to a confounding role of physical inactivity. However, the interrelationships between obesity, physical activity, and asthma have been incompletely addressed, probably because their time-dependent and bidirectional nature represents a methodologically challenging research question. We aimed to estimate the independent causal effects of body mass index (BMI; weight (kg)/height (m)2) and physical activity on current asthma using marginal structural models (MSMs). MSMs were applied to 15,353 adult women from a 2011 case-control study of asthma (Asthma-E3N) nested within the French E3N study (Etude Epidémiologique auprès de Femmes de la Mutuelle Générale de l'Education Nationale). Three time periods (1997-2000-2002, 2000-2002-2005, and 2002-2005-2011) were defined, where exposures (BMI and physical activity) were measured at time t, outcome (current asthma) was measured at time t + 1, and covariates were measured at time t - 1 or at baseline. A strong significant and positive dose-response relationship between BMI and current asthma was observed (odds ratios were 0.90 (95% confidence interval (CI): 0.79, 1.03), 1.29 (95% CI: 1.17, 1.42), and 1.87 (95% CI: 1.60, 2.18) for the BMI groups <20.0, 25.0-29.9, and ≥30.0, respectively, versus the normal-weight group (BMI 20.0-24.9)). We found no association between physical activity and current asthma. Our results suggest an independent causal deleterious effect of overweight and obesity on current asthma, whereas no independent causal effect of physical activity was found.
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Chronic Comorbidities Contribute to the Burden and Costs of Persistent Asthma. Mediators Inflamm 2015; 2015:819194. [PMID: 26783384 PMCID: PMC4691464 DOI: 10.1155/2015/819194] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Accepted: 11/25/2015] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND We aimed to study the prevalence of chronic comorbidities in asthma patients and the costs of health care use associated with asthma with comorbidities. MATERIAL AND METHODS We analysed the prevalence of the four most common chronic diseases in asthma patients in 2008-2014 in Finland. Prevalence of coronary artery disease, diabetes and dyslipidaemia, hypertension, epilepsy, inflammatory bowel disease, rheumatic diseases, and severe psychiatric disease was studied by register of the Social Insurance Institution of Finland. The costs of health care services were collected from the registries maintained by the National Institute for Health and Welfare (THL). RESULTS Prevalence of asthma was 4.6% in 2014. Diabetes was among the four most common comorbidities in all the age groups. The other common comorbidities were hypertension (≥46 years; 12.9-37.6%), severe psychiatric disorders (age groups of 16-59 years; 1.4-3.5%), and ischaemic heart disease (≥60 years; 10-25%). In patients with both asthma and diabetes, the costs of hospitalization were approximately 169% compared with patients with asthma alone. CONCLUSIONS Prevalence of asthma increases by tenfold when aging. The comorbidity diversity and rate are age-dependent. Prevalence of diabetes as comorbidity in asthma has increased. Costs of hospitalizations in asthma approximately double with chronic comorbidities.
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