Asthma in children with obesity: justified treatment? A retrospective evaluation of the prevalence of the use of asthma medication (β2-mimetica and/or inhaled corticosteroids) in an overweight/obese pediatric population (TEAMwORk)

Bogaart, N.E. (2017) Asthma in children with obesity: justified treatment? A retrospective evaluation of the prevalence of the use of asthma medication (β2-mimetica and/or inhaled corticosteroids) in an overweight/obese pediatric population (TEAMwORk). thesis, Medicine.

Text BoogaartNE.pdf Restricted to Registered users only Download (888kB)

Abstract

Background: The prevalence of both asthma and obesity is increasing over the last decades, and therefore a possible association between these two chronic illnesses is suggested. In pediatric populations the influence of obesity on the control of asthmatic symptoms with medication, remains indistinct, and might be different than in adults. The aim of this study is to evaluate the prevalence of asthma medication use in an overweight/obese pediatric population, and to evaluate how the diagnosis of asthma was established clinically and/or through spirometry. In addition, the prevalence of a possible restrictive lung disease will be evaluated. Methods: A retrospective observational study was performed in patients with overweight/obesity with asthmatic symptoms, who visited the pediatric outpatient clinic of the St. Antonius Hospital, Nieuwegein/Utrecht, the Netherlands, between January 2013 and July 2016. Patients aged ≥ 4 and ≤18 years with overweight/obesity and asthmatic symptoms were included. Overweight was defined as BMI-SDS>1.1 and obesity as BMI-SDS>2.3. Asthmatic symptoms were defined as medication use and/or asthma diagnosis. Spirometry results were converted into z-scores through the Global Lung Function Initiative Excel calculator, and were found positive at a reversibility rate of ΔzFEV1≥12%. Restrictive lung disease was defined by a zFVC < LLN and a zFEV1<LLN. Results: Three hundred thirty-eight participants were included, of which 92.6% (313/338) used medication. The asthma diagnosis was demonstrated in 70.6% (221/313) of the participants with asthma medication use: 82.4% (182/221) made clinically, and 17.6% (39/221) through spirometry. Twenty-nine percent (92/313) received asthma treatment, without being diagnosed with asthma. Ninety two out of 313 (=29.4%) participants received asthma treatment, without being diagnosed with asthma. Conclusion: Our study in a pediatric cohort of overweight/obese children with asthmatic symptoms showed that 92.6% of the population uses medication, of which 29.4% are not diagnosed with asthma. Only in a few children the diagnosis of asthma was confirmed using spirometry, despite this being recommended in international guidelines. Further research is needed to evaluate whether asthmatic symptoms of the overweight/obese population is caused by a restrictive lung disease, or to other obesity-related causes.

Item Type:	Thesis (Thesis)
Supervisor name:	Brand, Prof. Dr. P.L.P pediatric pulmonologist
Supervisor name:	Vorst, Dr. M.M.J. van der pediatrician-clinical pharmacologi and Lentferink, Drs. Y.E. PHD student and Department of Pediatrics and St. Antonius Hospital Nieuwegein/Utrecht
Faculty:	Medical Sciences
Date Deposited:	25 Jun 2020 10:55
Last Modified:	25 Jun 2020 10:55
URI:	https://umcg.studenttheses.ub.rug.nl/id/eprint/1538

Actions (login required)

View Item