Table 3.

Highlighted studies on obesity and asthma exacerbations

Reference	Study population	Study design	Main findings	Notes
Quinto et al28	32,321 children aged 5–17 years	Retrospective cohort study using electronic health records	Increased odds for multiple asthma exacerbation outcomes, including oral corticosteroid prescription: OR 1.21 (95% CI 1.13–1.29) for overweight; OR 1.28 (95% CI 1.21–1.36) for obese compared with normal weight children	Adjusted for demographics, parental education, asthma controller use and GERD
Kattan et al23	386 minority adolescents aged 12–20 years	Sub-study of placebo-controlled randomized clinical trial	Females with a BMI above the 85th percentile had increased risk for exacerbations: OR 2.49, 95% CI 1.25–5.14	1-year clinical trial during which asthma medications were managed by asthma specialist
Carroll et al29	884 ED visits for acute asthma, children aged 2–18 years	Retrospective chart review	Overweight children 1.76 times more likely to be admitted to hospital (95% CI 1.23–2.51)	Overweight defined as weight for age > 95th percentile, not BMI, because height measurements not routinely taken in ED
Ginde et al30	672 children aged 5–17 years, presenting to ED for acute asthma	Multicenter prospective cohort study	No relationship between BMI and exacerbation severity
Carroll et al32	2009 children aged 2–18 years admitted to an ICU for acute asthma	Retrospective medical record review	Obese children had longer ICU length of stay (116 ± 12 hours vs 69 ± 57 hours, P = 0.02) and hospital length of stay (9.8 ± 7.0 days vs 6.5 ± 3.4 days, P < 0.01)	Similar severity of exacerbation at time of admission

Abbreviations: BMI, body mass index; CI, confidence interval; ED, emergency department; GERD, gastroesophageal reflux disease; ICU, intensive care unit; OR, odds ratio.