PT  - JOURNAL ARTICLE
AU  - An-Hsuan Chih
AU  - Yang-Ching Chen
AU  - Yu-Kang Tu
AU  - Kuo-Chin Huang
AU  - Tai-Yuan Chiu
AU  - Yungling Leo Lee
TI  - Mediating pathways from central obesity to childhood asthma: a population-based longitudinal study
AID  - 10.1183/13993003.00226-2016
DP  - 2016 Sep 01
TA  - European Respiratory Journal
PG  - 748--757
VI  - 48
IP  - 3
4099  - http://erj.ersjournals.com/content/48/3/748.short
4100  - http://erj.ersjournals.com/content/48/3/748.full
SO  - Eur Respir J2016 Sep 01; 48
AB  - 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