Obesity and the risk of chronic rhinosinusitis, allergic rhinitis, and acute otitis media in school-age children

Objectives/hypothesis: To determine if obesity is a significant risk factor for acute otitis media (AOM), allergic rhinitis (AR), or chronic rhinosinusitis (CRS) in children and to understand the potential otolaryngological implications of childhood obesity.

Study design: Cross-Sectional Analysis.

Methods: The 2006 and 2008 the Medical Expenditure Panel Survey was utilized to identify school-aged children with AOM, AR, and/or CRS. Risk factors for the diagnoses extracted included standard demographics and the presence or absence of obesity. Multivariate analyses were conducted for associations between childhood obesity and AOM, AR, and CRS.

Results: 42.1 million (95% CI, 40.4-44.2) school-age children (unweighted N = 10623) were sampled in 2006 and 2008. There was a slight male predominance (51.0% [95% CI, 49.8-52.2]). Of these patients, 2.2 million (95% CI 1.9-2.4) received a diagnosis of AOM, 4.0 million (95% CI 3.6-4.4) received a diagnosis of AR, and 1.7 million (95% CI 1.4-1.9) received a diagnosis of CRS. Approximately 9.3 million (95% CI 8.7-10.0) children were obese, representing 22.2% (95% CI 21.0-23.3) of the U.S. population (age 6-17). Utilizing an adjusted multivariate model, childhood obesity was found to be associated with AOM (odds ratio, 1.44; [95% CI 1.08-1.93]; P = 0.033). Significant associations between obesity and AR (OR 1.14; [95% CI 0.88-1.47]; P = 0.60) or obesity and CRS (OR0.73; [95% CI 0.48-1.10]; P = 0.79) were not identified.

Conclusion: Childhood obesity appears to be associated with the development of AOM; however, an association between obesity and AR or CRS was not demonstrated. Given that in the United States nearly one-fourth of all children seeking health care are obese, these data may have important preventative care implications.

Level of evidence: 2C.