Overweight, Obesity, and Asthma Independently Increase Expression of Inflammatory Biomarkers
The results of this study show that the concurrent presence of asthma and obesity did not synergistically amplify inflammation in children with both asthma and overweight/obesity.
Asthma and overweight/obesity were independently associated with an increased expression of proinflammatory cytokines and decreased expression of anti-inflammatory cytokines in pediatric patients, according to results of a study published in Frontiers in Allergy. Previously, researchers thought that obesity enhanced inflammation for patients with asthma, but the results of this study show that the concurrent presence of asthma and obesity did not synergistically amplify inflammation in the patient population.1
The investigators of the current study said that the impact of obesity on inflammation and asthma has not been studied extensively in pediatric patients, despite rising obesity numbers. | Image Credit: MarekPhotoDesign.com | stock.adobe.com
“The obesity epidemic is a risk factor for increased asthma incidence in children, as demonstrated by various case-control and cross-sectional studies,” the study authors said. However, they added that some studies have shown varying results indicating whether obesity affects airway inflammation. In 2023, 23 US states showed that more than 1 in 3 adults had obesity, and before 2013, there were no states that had an obesity prevalence at or above 35%, according to the CDC. There is an estimated 1 in 5 adults in each US state that is living with obesity based on the 2023 data.1,2
For pediatric patients, the prevalence of obesity was 19.7% for children and adolescents from 2017 to 2020, according to the CDC. However, the investigators of the current study said that the impact of obesity on inflammation and asthma has not been studied extensively in pediatric patients, despite rising obesity numbers.1,3
In the study, the investigators aimed to determine if children with both asthma and either obesity or overweight would have synergistically elevated proinflammatory cytokine profiles compared with patients who only had 1 condition. Further, they aimed to determine if the interaction between obesity and asthma reduced lung function in children.1
Patients included in the study were recruited from outpatient clinics at Sidra Medicine, Qatar, and were classified into groups based on asthma status and weight, including normal weight and asthma, overweight/obesity and asthma, normal weight and no asthma, and overweight/obesity and no asthma. The mean age for patients with obesity or overweight and asthma was higher compared to the control group for patients without obesity or overweight and asthma. There were no differences between sexes in both groups; however, in the non-asthma groups, there was a higher number of females. Patients in the overweight and obesity group had higher blood neutrophil counts than those in the normal weight groups, regardless of asthma status.1
For inflammatory markers, investigators found that IL-33, IL-17A, leptin, IL-5, and TNF-α were consistently increased in both asthma groups and the overweight/obesity group, even without asthma, compared with the normal weight group. Additionally, the results showed that the levels of IL-2 and IL-22 were significantly increased in only the asthma groups compared with the normal weight group. Investigators also found that children with asthma had higher levels of IL-2, IL-5, IL-13, IL-17A, IL-22, IL-33, and TNF-α and lower levels of IL-19 and leptin compared with patients without asthma.
For obesity and overweight, investigators found that patients had higher levels of IL-5, IL-17A, IL-22, IL-33, TNF-α, leptin, and lower levels of IL-10 compared with children of normal weight, supporting that obesity/overweight affects these levels regardless of asthma. Although investigators found that both asthma and obesity had effects on overlapping inflammatory markers, the effects were not synergistic or additive.1
For lung function, children with asthma had reduced forced expiratory volume in 1 second (FEV1), FEV1/forced vital capacity (FVC) ratio, and forced expiratory flow midexpiratory phase compared to children without asthma. For those with overweight or obesity, children had an increased risk for FVC compared to those with normal weight, but there were no obesity-asthma-related interactions.1
We observed that the interaction between asthma and obesity does not appear to have a synergistic or additive effect on the inflammatory response, but rather a moderating influence,” the authors noted.1 “These interactions challenge the previously held view that obesity amplifies the inflammatory response in asthma.”
REFERENCES
1. Shailesh H, Noor S, Hayati L, et al. Asthma and obesity increase inflammatory markers in children. Front Allergy. 2025;5:1536168. Published 2025 Jan 20. doi:10.3389/falgy.2024.1536168
2. New CDC data show adult obesity prevalence remains high. News release. CDC. September 12, 2024. Accessed February 25, 2025. https://www.cdc.gov/media/releases/2024/p0912-adult-obesity.html
3. CDC. Childhood Obesity Facts. April 2, 2024. Accessed February 25, 2025. https://www.cdc.gov/obesity/childhood-obesity-facts/childhood-obesity-facts.html
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