Association between overweight or obesity and the risk for childhood asthma and wheeze: An updated meta-analysis on 18 articles and 73 252 children

Background: Overweight or obesity is increasingly recognized as a possible risk factor for childhood asthma. Objectives: We aimed to meta-analyse the association between overweight or obesity and the risk for childhood asthma and wheeze and meanwhile explore potential causes of between-study heterogeneity. Methods: Literature search, study selection, and data extraction were performed independently and in duplicate. Data were analysed by STATA software. Results: Eighteen articles and 73 252 children were analysed. In overall analyses, there was a significant association between overweight or obesity and the risk for childhood asthma (odds ratio [OR] = 1.30; 95% confidence interval [CI], 1.23-1.39; P < 0.001) and wheeze (OR = 1.90; 95% CI, 1.38-2.63; P < 0.001), with none/marginal publication bias as revealed by the Egger test (P = 0.938/0.038), respectively. Subgroup analyses showed that children with obesity (OR = 1.40; 95% CI, 1.29-1.52) were more likely to have asthma than children with overweight (OR = 1.22; 95% CI, 1.14-1.31), and in children with overweight or obesity, girls (OR = 1.34; 95% CI, 1.16-1.56) were more likely to have asthma than boys (OR = 1.27; 95% CI, 1.15-1.40). Conclusions: Our findings indicate that overweight or obesity is a significant risk factor for childhood asthma and wheeze and in children with overweight or obesity, the risk is more evident in girls than in boys.