TY - JOUR T1 - Mediating pathways from central obesity to childhood asthma: a population-based longitudinal study JF - European Respiratory Journal JO - Eur Respir J DO - 10.1183/13993003.00226-2016 SP - ERJ-00226-2016 AU - An-Hsuan Chih AU - Yang-Ching Chen AU - Yu-Kang Tu AU - Kuo-Chin Huang AU - Tai-Yuan Chiu AU - Yungling Leo Lee Y1 - 2016/05/12 UR - http://erj.ersjournals.com/content/early/2016/05/12/13993003.00226-2016.abstract N2 - The mediating pathways linking obesity and asthma are largely unknown. We aimed to investigate the mediating pathways and to search for the most prominent pathological mechanism between central obesity and childhood asthma.In the Taiwan Children Health Study, we collected data on an open cohort of children aged 9–13 years. Children's respiratory outcomes, atopic conditions, obesity measures and pulmonary function were surveyed annually between 2010 and 2012. Exhaled nitric oxide fraction concentrations were recorded in 2012. Generalised estimating equations and general linear models were used to examine the associations between central obesity, possible mediators and asthma. Structural equation models were applied to investigate the pathways that mediate the link between central obesity and asthma.Central obesity (waist-to-hip ratio) most accurately predicted childhood asthma. In the active asthma model, the percentage of mediation was 28.6% for pulmonary function, 18.1% for atopy and 5.7% for airway inflammation. The percentage of mediation for pulmonary function was 40.2% in the lifetime wheeze model. Pulmonary function was responsible for the greatest percentage of mediation among the three mediators in both models.Decline in pulmonary function is the most important pathway in central obesity related asthma. Pulmonary function screening should be applied to obese children for asthma risk prediction.Decline in pulmonary function is the most prominent pathological pathway from central obesity to childhood asthma http://ow.ly/4mJomZ ER -