A cross-sectional study assessing the relationship between BMI, asthma, atopy, and eNO among schoolchildren

Ann Allergy Asthma Immunol. 2011 Oct;107(4):330-6. doi: 10.1016/j.anai.2011.08.001.


Background: Increased body weight may influence airway inflammatory mechanisms.

Objective: To assess whether overweight-obesity (OW-O), evaluated as increased body mass index, is associated either with exhaled nitric oxide (eNO), a marker of airway inflammation, or with allergic sensitization in a large sample of children and adolescents.

Methods: A cross-sectional, epidemiological study was performed on a population sample of schoolchildren evaluating 708 subjects (age 10-16 years; BMI 13-39 kg/m(2)) by respiratory health questionnaire, skin prick tests, spirometry, and eNO measure.

Results: Prevalence rates were: OW-O 16.4%, asthma ever (A) 11.9%, and rhinoconjunctivitis (RC) 14.8%. Asthma ever and allergic sensitization were significantly more frequent among OW-O (21.0 and 51.6%) than in non-OW-O (10.2 and 37.0%, respectively). The forced expiratory volume in 1 second (FEV(1))/forced vital capacity (FVC) ratio was not significantly different between OW-O and non-OW-O. Exhaled NO (median and interquartile range) was 15.3 (11.2-23.1) ppb in the overall sample, 20.3 (12.9-35.8) ppb among allergic subjects, and 13.9 (10.6-18.3) ppb among nonallergic subjects (P<.0001). No significant difference between OW-O and non OW-O subjects was found in eNO levels. Similarly, OW-O subjects with A or RC did not show significantly higher eNO levels than non-OW-O. In a logistic regression model, presence of allergic sensitization, A, and RC, and not OW-O, were significant predictors of increased eNO.

Conclusions: In children, OW-O was not associated with increased eNO levels, but it was an independent risk factor for asthma and allergic sensitization.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Asthma / complications
  • Asthma / epidemiology*
  • Asthma / metabolism
  • Body Mass Index
  • Child
  • Cross-Sectional Studies
  • Female
  • Forced Expiratory Volume
  • Humans
  • Logistic Models
  • Male
  • Nitric Oxide / metabolism*
  • Obesity / complications
  • Obesity / epidemiology*
  • Obesity / metabolism
  • Prevalence
  • Rhinitis, Allergic, Perennial / complications
  • Rhinitis, Allergic, Perennial / epidemiology*
  • Rhinitis, Allergic, Perennial / metabolism
  • Sicily / epidemiology
  • Vital Capacity


  • Nitric Oxide