Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology · 2019
Pubertal BMI change and adult-onset asthma in men: Population-based cohort study in Sweden.
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Nwaru Bright I, Ohlsson Claes, Bygdell Maria, Martikainen Jari, Kindblom Jenny M
Аннотация
BACKGROUND: The role of pubertal BMI change in adult-onset concomitant asthma and allergic rhinitis is unknown.
OBJECTIVE: We investigated the association of childhood and young adult BMI, and pubertal BMI changes with adult-onset asthma, allergic rhinitis, and concomitant asthma and rhinitis in Swedish men.
METHODS: The BMI Epidemiology Study in Gothenburg, Sweden, comprised of height and weight measures taken from school health records (6.5-9.5 years) and during military conscription (17.5-22 years) for all men born 1945-1961 (n = 37 652). Age-adjusted childhood BMI centred at 8 years and young adult BMI at 20 years were linked to high quality data on asthma and allergic rhinitis diagnoses from the Swedish National Patient Register.
FINDINGS: High BMI (4th quartile vs the two median quartiles) at 8 years was associated with increased risk of concomitant asthma and allergic rhinitis (HR 1.45; 95% CI 1.00-2.11). Overweight (HR 1.45; 95% CI 1.12-1.89) and obesity (HR 1.95; 95% CI 1.08-3.54) at 20 years were associated with increased risk of asthma without concomitant allergic rhinitis as main or auxiliary diagnosis. Pubertal BMI change showed a non-linear association, so that both low (1st quartile vs the two median quartiles) and high pubertal BMI changes were associated with increased risk of asthma (low: HR 1.36; 95% CI 1.11-1.68; high: HR 1.32; 95% CI 1.07-1.63) and asthma without concomitant allergic rhinitis (low: HR 1.33; 95% CI 1.04-1.69; high: HR 1.36; 95% CI 1.07-1.74) as a main diagnosis.
CONCLUSIONS AND CLINICAL RELEVANCE: Both low and high pubertal BMI changes are predictors of adult-onset asthma in men, particularly asthma without concomitant allergic rhinitis. Primary prevention of adult-onset asthma requires monitoring of changes in BMI during puberty.
OBJECTIVE: We investigated the association of childhood and young adult BMI, and pubertal BMI changes with adult-onset asthma, allergic rhinitis, and concomitant asthma and rhinitis in Swedish men.
METHODS: The BMI Epidemiology Study in Gothenburg, Sweden, comprised of height and weight measures taken from school health records (6.5-9.5 years) and during military conscription (17.5-22 years) for all men born 1945-1961 (n = 37 652). Age-adjusted childhood BMI centred at 8 years and young adult BMI at 20 years were linked to high quality data on asthma and allergic rhinitis diagnoses from the Swedish National Patient Register.
FINDINGS: High BMI (4th quartile vs the two median quartiles) at 8 years was associated with increased risk of concomitant asthma and allergic rhinitis (HR 1.45; 95% CI 1.00-2.11). Overweight (HR 1.45; 95% CI 1.12-1.89) and obesity (HR 1.95; 95% CI 1.08-3.54) at 20 years were associated with increased risk of asthma without concomitant allergic rhinitis as main or auxiliary diagnosis. Pubertal BMI change showed a non-linear association, so that both low (1st quartile vs the two median quartiles) and high pubertal BMI changes were associated with increased risk of asthma (low: HR 1.36; 95% CI 1.11-1.68; high: HR 1.32; 95% CI 1.07-1.63) and asthma without concomitant allergic rhinitis (low: HR 1.33; 95% CI 1.04-1.69; high: HR 1.36; 95% CI 1.07-1.74) as a main diagnosis.
CONCLUSIONS AND CLINICAL RELEVANCE: Both low and high pubertal BMI changes are predictors of adult-onset asthma in men, particularly asthma without concomitant allergic rhinitis. Primary prevention of adult-onset asthma requires monitoring of changes in BMI during puberty.