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Gastro-oesophageal reflux and worse asthma control in obese children: a case of symptom misattribution?

Publication ,  Journal Article
Lang, JE; Hossain, J; Holbrook, JT; Teague, WG; Gold, BD; Wise, RA; Lima, JJ
Published in: Thorax
March 2016

BACKGROUND: Obese children for unknown reasons report greater asthma symptoms. Asthma and obesity both independently associate with gastro-oesophageal reflux symptoms (GORS). Determining if obesity affects the link between GORS and asthma will help elucidate the obese-asthma phenotype. OBJECTIVE: Extend our previous work to determine the degree of associations between the GORS and asthma phenotype. METHODS: We conducted a cross-sectional study of lean (20%-65% body mass index, BMI) and obese (≥95% BMI) children aged 10-17 years old with persistent, early-onset asthma. Participants contributed demographics, GORS and asthma questionnaires and lung function data. We determined associations between weight status, GORS and asthma outcomes using multivariable linear and logistic regression. Findings were replicated in a second well-characterised cohort of asthmatic children. RESULTS: Obese children had seven times higher odds of reporting multiple GORS (OR=7.7, 95% CI 1.9 to 31.0, interaction p value=.004). Asthma symptoms were closely associated with GORS scores in obese patients (r=0.815, p<0.0001) but not in leans (r=0.291, p=0.200; interaction p value=0.003). Higher GORS scores associated with higher FEV1-per cent predicted (p=0.003), lower airway resistance (R10, p=0.025), improved airway reactance (X10, p=0.005) but significantly worse asthma control (Asthma Control Questionnaire, p=0.007). A significant but weaker association between GORS and asthma symptoms was seen in leans compared with obese in the replicate cohort. CONCLUSION: GORS are more likely to associate with asthma symptoms in obese children. Better lung function among children reporting gastro-oesophageal reflux and asthma symptoms suggests that misattribution of GORS to asthma may be a contributing mechanism to excess asthma symptoms in obese children.

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Published In

Thorax

DOI

EISSN

1468-3296

Publication Date

March 2016

Volume

71

Issue

3

Start / End Page

238 / 246

Location

England

Related Subject Headings

  • Surveys and Questionnaires
  • Severity of Illness Index
  • Retrospective Studies
  • Respiratory System
  • Respiratory Function Tests
  • Quality of Life
  • Prognosis
  • Obesity
  • Male
  • Humans
 

Citation

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Chicago
ICMJE
MLA
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Lang, J. E., Hossain, J., Holbrook, J. T., Teague, W. G., Gold, B. D., Wise, R. A., & Lima, J. J. (2016). Gastro-oesophageal reflux and worse asthma control in obese children: a case of symptom misattribution? Thorax, 71(3), 238–246. https://doi.org/10.1136/thoraxjnl-2015-207662
Lang, Jason E., Jobayer Hossain, Janet T. Holbrook, W Gerald Teague, Benjamin D. Gold, Robert A. Wise, and John J. Lima. “Gastro-oesophageal reflux and worse asthma control in obese children: a case of symptom misattribution?Thorax 71, no. 3 (March 2016): 238–46. https://doi.org/10.1136/thoraxjnl-2015-207662.
Lang JE, Hossain J, Holbrook JT, Teague WG, Gold BD, Wise RA, et al. Gastro-oesophageal reflux and worse asthma control in obese children: a case of symptom misattribution? Thorax. 2016 Mar;71(3):238–46.
Lang, Jason E., et al. “Gastro-oesophageal reflux and worse asthma control in obese children: a case of symptom misattribution?Thorax, vol. 71, no. 3, Mar. 2016, pp. 238–46. Pubmed, doi:10.1136/thoraxjnl-2015-207662.
Lang JE, Hossain J, Holbrook JT, Teague WG, Gold BD, Wise RA, Lima JJ. Gastro-oesophageal reflux and worse asthma control in obese children: a case of symptom misattribution? Thorax. 2016 Mar;71(3):238–246.

Published In

Thorax

DOI

EISSN

1468-3296

Publication Date

March 2016

Volume

71

Issue

3

Start / End Page

238 / 246

Location

England

Related Subject Headings

  • Surveys and Questionnaires
  • Severity of Illness Index
  • Retrospective Studies
  • Respiratory System
  • Respiratory Function Tests
  • Quality of Life
  • Prognosis
  • Obesity
  • Male
  • Humans