Perbedaan arus puncak ekspirasi antara anak asma dengan obesitas dan anak asma tanpa obesitas

https://doi.org/10.22146/ijcn.18839

Nurul Hadi(1*), Madarina Julia(2), Roni Naning(3)

(1) Bagian Ilmu Kesehatan Anak, Fakultas Kedokteran Universitas Gadjah Mada Yogyakarta
(2) Bagian Ilmu Kesehatan Anak, Fakultas Kedokteran Universitas Gadjah Mada Yogyakarta
(3) Bagian Ilmu Kesehatan Anak, Fakultas Kedokteran Universitas Gadjah Mada Yogyakarta
(*) Corresponding Author

Abstract


Background: Obesity in children is associated with impairment of pulmonary function and increased risk of asthma. Obesity in asthmatic children may reduce lung function, that can be assessed by peak flow meter, a practical and an inexpensive tool.

Objectives: To compare the peak expiratory flow (PEF) between obese and non-obese asthmatic children.

Method: We conducted a cross sectional study in Yogyakarta during March 2010-September 2012. Fifty obese asthmatic patients and 50 non obese asthmatic control subjects participated in this study. Inclusion criteria were asthmatic patient, according to Pedoman Nasional Asma Anak (PNAA), and 6-18 years of age. Exclusion criteria were asthmatic attack, respiratory disease, heart disease and congenital chest malformation. Obesity is defined as body mass index (BMI) for age more than +3 SD WHO growth chart standards BMI for age 2007 z-score. Z-score is calculated with WHO AnthroPlus for Personal Computers. Data PEF is taken with electrical peak flow meter when the patient was not suffering from asthma attack. Normal PEF was defined as PEF ≥80% average (predicted) value for height.

Results: The mean of age of asthmatic children in this study was 9.38 years and 9.50 years for non obese and obese respectively. The PFR was not different between obese asthmatic children and non obese asthmatic children (p=0,83). Pearson correlation of PFR and z-score BMI for age was positive weak correlation (r=0.12). There was significant difference of PFR between z-score BMI for age <3,20 and z-score BMI for age ≥3.20 (p=0.03). Significant difference of PFR also appears in duration of illness (p<0.001).

Conclusion: There is no PFR difference between obese asthmatic children and non-obese asthmatic children. The difference of PFR emerges when statistic analysis performed using z-score BMI ≥3.20.


Keywords


peak flow rate; obesity; asthma; children

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References

Tantisira KG, Litonjua AA, Weiss ST, Fuhlbrigge AL. Association of body mass with pulmonary function in the Childhood Asthma Management Program (CAMP). Thorax 2003;58(12):1036-41.

Wulandari L, Edo MLU. Dampak obesitas terhadap fungsi paru. Majalah Farmacia 2007;68.

Schachter LM, Salome CM, Peat JK, Woolcock AJ. Obesity is a risk for asthma and wheeze but not airway hyperresponsiveness. Thorax 2001;56(1):4-8.

Eisenmann JC, Arnall DA, Kanuho V, Interpretter C, Coast JR. Obesity and pulmonary function in Navajo and Hopi children. Ethn Dis 2007;17(1):14-8.

Jeon YH, Yang HJ, Pyun BY. Lung function in Korean adolescent girls: in association with obesity and the menstrual cycle. J Korean Med Sci 2009;24(1):20-5.

Siregar FZ. Perbandingan arus puncak ekspirasi sebelum dan sesudah latihan fisik pada anak obesitas dan tidak obesitas [Tesis]. Sumatera: Perpustakaan USU; 2008.

Rubenstein I, Zamei N, Dubarry L, Hoffstein V. Airflow limitation in morbidly obese, nonsmoking men. Ann Intern Med 1990;112(11):828-32.

Biring MS, Lewis MI, Liu JT. Pulmonary physiological changes of morbid obesity. Am J Med Sci 1999;318(5):293-7.

Voter KZ, McBride JT. Back to basics: diagnostic tests of lung function. Pediatrics in Review 1996;17(2):53-63.

Wirjodiardjo M, Said M, Boediman HI. Perbandingan hasil pengukuran peak flow rate antara miniwright peak flow meter dan spirometer elektronik pada anak. Maj Kedok Indon 1992;42(10):575-85.

UKK Pulmonologi PP IDAI. Pedoman nasional asma anak. Jakarta: UKK Pulmonologi PP IDAI, Indonesian Pediatric Respiratory; 2003.

World Health Organization. WHO anthroplus for personal computers manual. [series online] 2009 [cited 2010 Jan]. Available from: URL: http://www.who.int/childgrowth/software/en/

Polgar G, Promedhat V. Pulmonary function testing in children: techniques and standards. Philadelphia: W.B. Saunders; 1971.

Consilvio NP, Di Pillo S, Verini M, de Giorgis M, Cingolani A, Chiavaroli V, Chiarelli F, Mohn A. The reciprocal influences of asthma and obesity on lung function testing, AHR and airway inflammation in prepubertal children. Pediatr Pulmonol 2010;45(11):1103-10.

Rastogi D, Canfield SM, Andrade A, Isasi CR, Hall CB, Rubinstein A, Arens R. Obesity-associated asthma in children: a distinct entity. Chest 2012;141(4):895-905.

Pakhale S, Doucette S, Vandemheen K, Boulet LP, McIvor RA, Fitzgerald JM, Hernandez P, Lemiere C, Sharma S, Field SK, Alvarez GG, Dales RE, Aaron SD. A comparison of obese and nonobese people with asthma: exploring an asthma-obesity interaction. Chest 2010;137(6):1316-23.

Zhang MX, Zhao XY, Li M, Cheng H, Hou DQ, Wen Y, Katherine C, Mi J. Abnormal adipokines associated with various types of obesity in Chinese children and adolescents. Biomed Environ Sci 2011;24(1):12-21.

Wang H, Wang J, Liu M, Wang D, Liu Y, Zhao Y, Huang M, Liu Y, Sun J, Dong H. Epidemiology of general obesity, abdominal obesity and related risk factors in urban adults from 33 communities of northeast china: the CHPSNE study. BMC Public Health 2012;12(967):1-10.

Canoy D, Pekkanen J, Elliott P, Pouta A, Laitinen J, Hartikainen AL, Zitting P, Patel S, Little MP, Järvelin MR. Early growth and adult respiratory function in men and women followed from the fetal period to adulthood. Thorax 2007;62(5):396-402.

Hellberg J. Factor associated with lung function impairment in children and adults with obstructive lung disease [Thesis]. Stockholm, Sweden: Karolinska Institutet; 2008.

Berhane K, McConnell R, Gilliland F, Islam T, Gauderman WJ, Avol E, London SJ, Rappaport E, Margolis HG, Peters JM. Sex-specific effects of asthma on pulmonary function in children. Am J Respir Crit Care Med 2000;162(5):1723-30.

Litof C. Asthma, poor respiratory function in children linked more firmly to parents lifestyles. J Respir Dis 2012;19.

Tantisira K, Weiss S. Complex interactions in complex traits: obesity and asthma. Thorax 2001;56(2):64-73.

Gundogdu Z, Eryilmaz N. Correlation between peak flow and body mass index in obese and non-obese children in Kocaeli, Turkey. Prim Care Respir J 2011;20(4):403-6.

Poulain M, Doucet M, Major GC, Drapeau V, Sériès F, Boulet LP, Tremblay A, Maltais F. The effect of obesity on chronic respiratory diseases: pathophysiology and therapeutic strategies. CMAJ 2006;174(9):1293-9.

Ülger Z, Demir E, Tanaç R, Göksen D, Gülen F, Darcan S, Can D, Coker M. The effect of childhood obesity on respiratory function tests and airway hyperresponsiveness. Turk J Pediatr 2006;48(1):43-50.

Belamarich PF, Luder E, Kattan M, Mitchell H, Islam S, Lynn H, Crain EF. Do obese inner-city children with asthma have more symptoms than nonobese children with asthma?. Pediatrics 2000;106(6):1436-41.

Lazarus R, Sparrow D, Weiss ST. Effect of obesity and fat distribution on ventilation function: the normative aging study. Chest 1997;111(4):891-8.

Luder E, Melnik TA, DiMaio M. Association of being overweight with greater asthma symptoms in inner city black and Hispanic children. J Pediatr 1998;132(4):699-703.



DOI: https://doi.org/10.22146/ijcn.18839

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