Adiposity and Asthma in a Nationwide Study of Children and Adults in the United States

Ann Am Thorac Soc. 2018 Mar;15(3):322-330. doi: 10.1513/AnnalsATS.201709-723OC.


Rationale: Although obesity has been associated with asthma, body mass index is suboptimal to fully characterize adiposity.

Objectives: We examined the relation between adiposity and asthma in a large sample of the U.S. population, using indices defined by dual-energy X-ray absorptiometry.

Methods: We analyzed data from 8,886 children (aged 8-19 yr) and 12,795 adults (aged 20-69 yr) from the 2001 to 2006 National Health and Nutrition Examination Survey. In addition to body mass index, percent body fat, waist circumference, and waist-to-height ratio, dual-energy X-ray absorptiometry was used to calculate whole-body and local adiposity indices: fat mass index; total, trunk, and legs percent fat; and trunk-to-total fat mass ratio, legs-to-total fat mass ratio, and trunk-to-legs fat mass ratios. Logistic regression was used for the analysis of adiposity measures and asthma.

Results: Among children, general adiposity was significantly associated with asthma, with no major differences by sex. Results were driven by nonatopic children, in whom trunk-predominant (central) adiposity (assessed by waist circumference, waist-to-height ratio, trunk-to-total fat mass ratio, and trunk-to-legs fat mass ratio) was also associated with asthma. There were no significant associations among atopic children. Among adults, all adiposity indices were associated with asthma, with central adiposity significant only among women. The results in adults were driven by atopy, especially in women.

Conclusions: Adiposity measured by dual-energy X-ray absorptiometry provides similar information to that obtained by using anthropometric indices among children of both sexes and among adult men. However, dual-energy X-ray absorptiometry provides additional information in adult women, in whom dual-energy X-ray absorptiometry-measured central adiposity is significantly associated with asthma, particularly atopic asthma.

Keywords: adiposity; asthma; dual-energy X-ray absorptiometry; obesity.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Absorptiometry, Photon
  • Adiposity*
  • Adolescent
  • Adult
  • Aged
  • Asthma / epidemiology*
  • Body Mass Index
  • Child
  • Female
  • Humans
  • Logistic Models
  • Male
  • Middle Aged
  • Nutrition Surveys
  • Obesity / diagnosis
  • United States / epidemiology
  • Waist Circumference
  • Waist-Height Ratio
  • Young Adult