A Multifactorial Weight Reduction Programme for Children with Overweight and Asthma: A Randomized Controlled Trial

Background
There is increasing evidence that obesity is related to asthma development and severity. However, it is largely unknown whether weight reduction can influence asthma management, especially in children.
Objective
To determine the effects of a multifactorial weight reduction intervention on asthma management in overweight/obese children with (a high risk of developing) asthma.
Methods
An 18-month weight-reduction randomized controlled trial was conducted in 87 children with overweight/obesity and asthma. Every six months, measurements of anthropometry, lung function, lifestyle parameters and inflammatory markers were assessed. Analyses were performed with linear mixed models for longitudinal analyses.
Results
After 18 months, the body mass index-standard deviation score decreased by -0.14±0.29 points (p<0.01) in the intervention group and -0.12±0.34 points (p<0.01) in the control group. This change over time did not differ between groups (p>0.05). Asthma features (including asthma control and asthma-related quality of life) and lung function indices (static and dynamic) improved significantly over time in both groups. The FVC% predicted improved over time by 10.1 ± 8.7% in the intervention group (p<0.001), which was significantly greater than the 6.1 ± 8.4% in the control group (p<0.05).
Conclusions & clinical relevance
Clinically relevant improvements in body weight, lung function and asthma features were found in both the intervention and control group, although some effects were more pronounced in the intervention group (FVC, asthma control, and quality of life). This implies that a weight reduction intervention could be clinically beneficial for children with asthma.
Trial Registration
ClinicalTrials.gov NCT00998413

研究背景：越来越多的证据表明，肥胖与哮喘的发生及病情严重程度密切相关。然而，体重减轻是否会影响哮喘管理，尤其是在儿童群体中，目前尚未明确。
研究目的：明确多因素体重减轻干预对伴哮喘（或存在哮喘发病高风险）的超重/肥胖儿童的哮喘管理的影响。
研究方法：本研究纳入87例合并哮喘的超重/肥胖儿童，开展为期18个月的体重减轻随机对照试验（randomized controlled trial）。每6个月对受试者的人体测量学指标、肺功能、生活方式参数及炎症标志物进行检测评估。采用线性混合模型（linear mixed models）进行纵向数据分析。
研究结果：干预18个月后，干预组体质量指数标准差评分（body mass index-standard deviation score）较基线降低0.14±0.29分（p<0.01），对照组降低0.12±0.34分（p<0.01）；两组间随时间的变化幅度无显著差异（p>0.05）。两组的哮喘相关指标（包括哮喘控制情况及哮喘相关生活质量）与肺功能指标（静态及动态）均随时间显著改善。干预组的预测用力肺活量百分比（FVC% predicted）较基线提升10.1±8.7%（p<0.001），显著高于对照组的6.1±8.4%（p<0.05）。
结论与临床意义：尽管干预组的部分改善效果（如预测用力肺活量、哮喘控制情况及生活质量）更为显著，但两组受试者的体质量、肺功能及哮喘相关指标均出现了具有临床意义的改善。这表明体重减轻干预方案对哮喘儿童具有潜在的临床获益价值。
试验注册：ClinicalTrials.gov NCT00998413