Do obese inner-city children with asthma have more symptoms than nonobese children with asthma?

Objective. To test whether obesity is associated with decreased peak expira tory flow rates (PEFR), increased asthma symptoms, and increased health ser vice use. Design/Methods. Secondary analysis of data from a cross-sectional convenien ce sample. Setting. Emergency departments (EDs) and primary care clinics in 8 inner-ci ty areas in 7 cities. Participants. One thousand three hundred twenty-two children aged 4 to 9 ye ars with asthma. Measures. Obesity was defined as a body mass index (BMI, weight/height(2)) >95th percentile. Nonobese children were those with a BMI between the 5th a nd 95th percentile. Underweight children with a BMI <5th percentile were el iminated from the study. Demographic and anthropometric data were obtained during a baseline interview with the primary caretaker and the child. Sympt oms, health service use data and measurements of PEFR were obtained by pare ntal report during the baseline interview and at 3-month intervals by telep hone interview over the following 9-month period. Results. Obese (n = 249) and nonobese (n = 1073) children did not differ in terms of age, gender, family income, passive smoke exposure, caretaker's m ental health, and skin test reactivity to indoor allergens. Obese children were more often Latino (28% vs 17%) and, in the 3 months before the baselin e interview, were more likely to have used oral steroids (30% vs 24%). Ther e were no differences between groups in terms of baseline PEFR scores. Duri ng the 9 months after baseline assessment, the obese group had a higher mea n number of days of wheeze per 2-week period (4.0 vs 3.4), and a greater pr oportion of obese individuals had unscheduled ED visits (39% vs 31%). There were no differences between the groups in terms of frequency of hospitaliz ation, or in nocturnal awakening. Conclusions. In our sample of inner-city children with asthma, obese childr en used more medicine, wheezed more, and a greater proportion had unschedul ed ED visits than the nonobese children.