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Does adiposity mediate the relationship between socioeconomic position and non-allergic asthma in childhood?

ABSTRACT: BACKGROUND:Despite its high prevalence, early onset and chronic nature, the causes of asthma are not clearly established. The present study examined a plausible but untested relationship in the development of non-allergic asthma; an asthma phenotype closely linked to deprivation and other preventable risk factors. Our aim was to determine the mediating role of adiposity in the relationship between socioeconomic position in infancy and non-allergic asthma emergence in mid-childhood. METHODS:To estimate the causal indirect effect of adiposity we applied the parametric g-computational procedure to 6203 singleton children from the UK Millennium Cohort Study. Adiposity was measured at age 7 by body mass index, waist circumference and waist circumference-to-height ratio. Children who developed non-allergic asthma between the age of 7 and 14 were compared with children without allergies or allergic asthma at these ages. RESULTS:We found no evidence to suggest that adiposity is a mediator in the relationship between socioeconomic position and the development of non-allergic asthma in mid-childhood. After adjustment for risk factors, the direct effect of socioeconomic position remained; children in the lowest tertile of socioeconomic position had a 43% (OR 1.43, 95%?CI 1.38 to 1.49) greater odds of developing non-allergic asthma compared with the highest tertile. CONCLUSIONS:Adiposity at age 7 does not mediate the relationship between socioeconomic position and non-allergic asthma. The results suggest that improving socioeconomic conditions and promoting healthy weight are both important in reducing the development of non-allergic asthma in early to mid-childhood.

SUBMITTER: Lewis KM

PROVIDER: S-EPMC5909742 | biostudies-literature | 2018 May

REPOSITORIES: biostudies-literature

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Does adiposity mediate the relationship between socioeconomic position and non-allergic asthma in childhood?

Lewis Kate Marie KM Pikhart Hynek H Morrison Joana J

Journal of epidemiology and community health 20180124 5

<h4>Background</h4>Despite its high prevalence, early onset and chronic nature, the causes of asthma are not clearly established. The present study examined a plausible but untested relationship in the development of non-allergic asthma; an asthma phenotype closely linked to deprivation and other preventable risk factors. Our aim was to determine the mediating role of adiposity in the relationship between socioeconomic position in infancy and non-allergic asthma emergence in mid-childhood.<h4>Me ...[more]

PMID: 29367283

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Project description:Longitudinal studies drawn from high-income countries demonstrate long-term associations of early childhood socioeconomic deprivation with increased adiposity in adulthood. However, there are very few data from resource-poor countries where there are reasons to anticipate different gradients. Accordingly, we sought to characterise the nature of the socioeconomic status (SES)-adiposity association in Brazil.We use data from the Ribeirao Preto Cohort Study in Brazil in which 9067 newborns were recruited via their mothers in 1978/79 and one-in-three followed up in 2002/04 (23-25years). SES, based on family income (salaries, interest on savings, pensions and so on), was assessed at birth and early adulthood, and three different adiposity measures (body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR)) ascertained at follow-up. The association between childhood SES, adult SES and social mobility (defined as four permutations of SES in childhood and adulthood: low-low, low-high, high-low, high-high), and the adiposity measures was examined using linear regression.There was evidence that the association between SES and the three markers of adiposity was modified by gender in both adulthood (P<0.02 for all outcomes) and childhood SES (P<0.02 for WC and WHR). Thus, in an unadjusted model, linear regression analyses showed that higher childhood SES was associated with lower adiposity in women (coefficient (95% confidence intervals) BMI: -1.49 (-2.29,-0.69); WC: -3.85 (-5.73,-1.97); WHR: -0.03 (-0.04,-0.02)). However, in men, higher childhood SES was related to higher adiposity (BMI: 1.03 (0.28,-1.78); WC: 3.15 (1.20, 5.09); WHR: 0.009 (-0.001, 0.019)) although statistical significance was not seen in all analyses. There was a suggestion that adult SES (but not adult health behaviours or birthweight) accounted for these relationships in women only. Upward mobility was associated with protection against greater adiposity in women but not men.In the present study, in men there was some evidence that both higher childhood and adulthood SES was related to a higher adiposity risk, while the reverse gradient was apparent in women.

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Does adiposity mediate the relationship between socioeconomic position and non-allergic asthma in childhood?

Publications

Does adiposity mediate the relationship between socioeconomic position and non-allergic asthma in childhood?

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