Estudo da associação entre asma e obesidade na infância: padrões inflamatórios, clínicos e funcionais

Abstract

Asthma associated with obesity has been related to phenotype T helper (Th) 1 in contrast to the classic Th2 pattern of atopic asthma in childhood and may negatively influence the severity and control of the disease. Our aim was to compare inflammatory, clinical and spirometric patterns between obese and non-obese asthmatic children. Between 2013 and 2015, 79 children were selected, 5-10 years, of both sexes, divided into four groups: obese asthmatics, nonobese asthmatics, obese nonasthmatics and nonasthmatics nonobese. In addition to collecting clinical data, socio-demographic and anthropometric, all children underwent spirometry and skin prick test for inhalants allergens. It was also collected blood sample for measurement of cytokines and adipokines. The prick test were positive in 81.8% and 80% of nonobese asthmatics and obese asthmatics, respectively. Obese asthmatics had significantly worse control of asthma than nonobese asthmatics (OR = 4.9, 95% CI 1.08 to 22.14; p = 0.043), regardless of sex, physical activity and atopy. No differences in spirometry and Th1 and Th2 cytokines and adipokines levels were observed among the four groups. The leptin levels were significantly higher in obese patients as compared to healthy irrespective of the presence of asthma. The presence of atopy was high in both asthmatic groups, however there were no differences in inflammatory and functional patterns between nonobese asthmatics and obese asthmatics. The degree of control of the disease was significantly lower in the latter. Larger and prospective studies should be conducted to confirm our findings.