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The Relationship Between Asthma, Sleep Apnea, and Other Respiratory Disorders and Childhood Metabolic Syndrome

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Pediatric Metabolic Syndrome

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Abstract

Introduction: Obesity and the metabolic syndrome are associated with increased morbidity from chronic respiratory diseases such as asthma and sleep-disordered breathing, as well as increased risk of perioperative respiratory complications.

Asthma: Asthma is the most common chronic disease of childhood, and its prevalence has risen significantly in the last few decades, in parallel with the increase in childhood obesity and metabolic syndrome. There is ever-growing evidence of an association between both, and while our understanding of this relationship far from complete, several mechanisms have been proposed. These include mechanical changes on the airways and the lungs due to excess weight, alterations in the function of airway smooth muscle, a generalized inflammatory state that induces airway inflammation and hyperreactivity, several metabolic abnormalities such as decreased vitamin D or increased oxidative stress, alterations in insulin metabolism that promotes airway remodeling, hormonal differences, and shared genetic determinants between both illnesses.

Sleep-disordered breathing: This term encompasses upper airway resistance syndrome, obstructive sleep apnea (OSA), and obesity hypoventilation syndrome, all of which have been associated with obesity. Proposed mechanisms are in part similar to those mentioned for asthma, including mechanical effects of added weight in the upper airways, a systemic proinflammatory milieu, hormonal changes, and oxidative stress. As a result, these patients are also at higher risk of cardiovascular and other complications from both their obesity/metabolic syndrome and their sleep-disordered breathing.

Other conditions: Patients with obesity/metabolic syndrome are also at higher risk of perioperative respiratory complications, and patients should be carefully assessed and monitored to minimize morbidity. While studies in children are lacking, obese adults are also at increased risk for acute lung injury and acute respiratory distress syndrome (ARDS), with increased length of stay and increased mortality.

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References

  1. Taussig L, Landau LI. Pediatric respiratory medicine. 2nd ed. Philadelphia: Elsevier Health Sciences; 2008.

    Google Scholar 

  2. Akinbami LJ. The state of childhood asthma, United States, 1980–2005. National Center for Health Statistics, Hyatsville; 2006. Report no.: 24.

    Google Scholar 

  3. CDC. Vital signs: asthma prevalence, disease characteristics, and self-management education - United States, 2001–2009. MMWR Morb Mortal Wkly Rep. 2011;60(17):547–52.

    Google Scholar 

  4. Moorman JE, Rudd RA, Johnson CA, King M, Minor P, Bailey C, et al. National surveillance for asthma – United States, 1980–2004. Morb Mortal Wkly Rep Surveill Summ. 2007;56(8):18–54.

    Google Scholar 

  5. Ramsey F, Ussery-Hall A, Garcia D, McDonald GJ, Easton A, Kambon M, et al. Prevalence of selected risk behaviors and chronic diseases – behavioral risk factor surveillance system (BRFSS), 39 steps communities, United States, 2005. MMWR Morb Mortal Wkly Rep [Internet] 2008 [cited 8/4/2010]; 57(SS11):8/04/2010.

    Google Scholar 

  6. Dilley JA, Pizacani BP, Macdonald SM, Bardin J. The burden of asthma in Washington state. Washington State Department of Health, Olympia; 2005. Report no.: DOH Pub No. 345-201.

    Google Scholar 

  7. Garcia-Marcos L, Valverde-Molina J, Ortega ML, Sanchez-Solis M, Martinez-Torres AE, Castro-Rodriguez JA. Percent body fat, skinfold thickness or body mass index for defining obesity or overweight, as a risk factor for asthma in schoolchildren: Which one to use in epidemiological studies? Matern Child Nutr. 2008;4(4):304–10.

    PubMed  Google Scholar 

  8. Taveras EM, Rifas-Shiman S, Camargo Jr CA, Gold DR, Litonjua AA, Oken E, et al. Higher adiposity in infancy associated with recurrent wheeze in a prospective cohort of children. J Allergy Clin Immunol. 2008;121(5):1161–6.

    PubMed  Google Scholar 

  9. Michelson PH, Williams LW, Benjamin DK, Barnato AE. Obesity, inflammation, and asthma severity in childhood: data from the national health and nutrition examination survey 2001–2004. Ann Allergy Asthma Immunol. 2009;103(5):381–5.

    PubMed  Google Scholar 

  10. Reichman NE, Nepomnyaschy L. Maternal pre-pregnancy obesity and diagnosis of asthma in offspring at age 3 years. Matern Child Health J. 2008;12(6):725–33.

    PubMed  Google Scholar 

  11. Ronmark E, Andersson C, Nystrom L, Forsberg B, Jarvholm B, Lundback B. Obesity increases the risk of incident asthma among adults. Eur Respir J. 2005;25(2):282–8.

    PubMed  CAS  Google Scholar 

  12. Ma J, Xiao L, Knowles SB. Obesity, insulin resistance and the prevalence of atopy and asthma in US adults. Allergy. 2010;65(11):1455–63. doi:10.1111/j.1398-9995.2010.02402.x.

    PubMed  CAS  Google Scholar 

  13. Flaherman V, Rutherford GW. A meta-analysis of the effect of high weight on asthma. Arch Dis Child. 2006;91(4):334–9.

    PubMed  CAS  Google Scholar 

  14. Guerra S, Wright AL, Morgan WJ, Sherrill DL, Holberg CJ, Martinez FD. Persistence of asthma symptoms during adolescence: role of obesity and age at the onset of puberty. Am J Respir Crit Care Med. 2004;170(1):78–85.

    PubMed  Google Scholar 

  15. Mannino DM, Mott J, Ferdinands JM, Camargo CA, Friedman M, Greves HM, et al. Boys with high body masses have an increased risk of developing asthma: findings from the national longitudinal survey of youth (NLSY). Int J Obes (Lond). 2006;30(1):6–13.

    CAS  Google Scholar 

  16. Gold DR, Damokosh AI, Dockery DW, Berkey CS. Body-mass index as a predictor of incident asthma in a prospective cohort of children. Pediatr Pulmonol. 2003;36(6):514–21.

    PubMed  Google Scholar 

  17. Collins LC, Hoberty PD, Walker JF, Fletcher EC, Peiris AN. The effect of body fat distribution on pulmonary function tests. Chest. 1995;107(5):1298–302.

    PubMed  CAS  Google Scholar 

  18. Al Dabal L, Bahammam AS. Obesity hypoventilation syndrome. Ann Thorac Med. 2009;4(2):41–9.

    PubMed  Google Scholar 

  19. Tantisira KG, Litonjua AA, Weiss ST, Fuhlbrigge AL, Childhood Asthma Management Program Research Group. Association of body mass with pulmonary function in the childhood asthma management program (CAMP). Thorax. 2003;58(12):1036–41.

    PubMed  CAS  Google Scholar 

  20. Fredberg JJ, Inouye D, Miller B, Nathan M, Jafari S, Raboudi SH, et al. Airway smooth muscle, tidal stretches, and dynamically determined contractile states. Am J Respir Crit Care Med. 1997;156(6):1752–9.

    PubMed  CAS  Google Scholar 

  21. Boulet LP, Turcotte H, Boulet G, Simard B, Robichaud P. Deep inspiration avoidance and airway response to methacholine: influence of body mass index. Can Respir J. 2005;12(7):371–6.

    PubMed  Google Scholar 

  22. Canoz M, Erdenen F, Uzun H, Muderrisoglu C, Aydin S. The relationship of inflammatory cytokines with asthma and obesity. Clin Invest Med. 2008;31(6):E373–9.

    PubMed  CAS  Google Scholar 

  23. Matricardi PM, Gruber C, Wahn U, Lau S. The asthma-obesity link in childhood: open questions, complex evidence, a few answers only. Clin Exp Allergy. 2007;37(4):476–84.

    PubMed  CAS  Google Scholar 

  24. Alessi MC, Bastelica D, Morange P, Berthet B, Leduc I, Verdier M, et al. Plasminogen activator inhibitor 1, transforming growth factor-beta1, and BMI are closely associated in human adipose tissue during morbid obesity. Diabetes. 2000;49(8):1374–80.

    PubMed  CAS  Google Scholar 

  25. Sharma S, Raby BA, Hunninghake GM, Soto-Quiros M, Avila L, Murphy AJ, et al. Variants in TGFB1, dust mite exposure, and disease severity in children with asthma. Am J Respir Crit Care Med. 2009;179(5):356–62.

    PubMed  CAS  Google Scholar 

  26. Weiss ST. Obesity: insight into the origins of asthma. Nat Immunol. 2005;6(6):537–9.

    PubMed  CAS  Google Scholar 

  27. Johnston RA, Zhu M, Rivera-Sanchez YM, Lu FL, Theman TA, Flynt L, et al. Allergic airway responses in obese mice. Am J Respir Crit Care Med. 2007;176(7):650–8.

    PubMed  CAS  Google Scholar 

  28. Shore SA. Obesity and asthma: lessons from animal models. J Appl Physiol. 2007;102(2):516–28.

    PubMed  CAS  Google Scholar 

  29. Shore SA, Terry RD, Flynt L, Xu A, Hug C. Adiponectin attenuates allergen-induced airway inflammation and hyperresponsiveness in mice. J Allergy Clin Immunol. 2006;118(2):389–95.

    PubMed  CAS  Google Scholar 

  30. Kattan M, Kumar R, Bloomberg GR, Mitchell HE, Calatroni A, Gergen PJ, et al. Asthma control, adiposity, and adipokines among inner-city adolescents. J Allergy Clin Immunol. 2010;125(3):584–92.

    PubMed  Google Scholar 

  31. Thuesen BH, Husemoen LL, Hersoug LG, Pisinger C, Linneberg A. Insulin resistance as a predictor of incident asthma-like symptoms in adults. Clin Exp Allergy. 2009;39(5):700–7.

    PubMed  CAS  Google Scholar 

  32. Dekkers BG, Schaafsma D, Tran T, Zaagsma J, Meurs H. Insulin-induced laminin expression promotes a hypercontractile airway smooth muscle phenotype. Am J Respir Cell Mol Biol. 2009;41(4):494–504.

    PubMed  CAS  Google Scholar 

  33. Agrawal A, Mabalirajan U, Ahmad T, Ghosh B. Emerging interface between metabolic syndrome and asthma. Am J Respir Cell Mol Biol. 2011;44(3):270–5.

    PubMed  CAS  Google Scholar 

  34. Murphy A, Tantisira KG, Soto-Quiros ME, Avila L, Klanderman BJ, Lake S, et al. PRKCA: a positional candidate gene for body mass index and asthma. Am J Hum Genet. 2009;85(1):87–96.

    PubMed  CAS  Google Scholar 

  35. Szczepankiewicz A, Breborowicz A, Sobkowiak P, Popiel A. Are genes associated with energy metabolism important in asthma and BMI? J Asthma. 2009;46(1):53.

    PubMed  CAS  Google Scholar 

  36. Castro-Giner F, Kogevinas M, Imboden M, de Cid R, Jarvis D, Machler M, et al. Joint effect of obesity and TNFA variability on asthma: two international cohort studies. Eur Respir J. 2009;33(5):1003–9.

    PubMed  CAS  Google Scholar 

  37. Choi IW, Sun-Kim KYS, Ko HM, Im SY, Kim JH, et al. TNF-alpha induces the late-phase airway hyperresponsiveness and airway inflammation through cytosolic phospholipase A(2) activation. J Allergy Clin Immunol. 2005;116(3):537–43.

    PubMed  CAS  Google Scholar 

  38. Tremblay K, Lemire M, Provost V, Pastinen T, Renaud Y, Sandford AJ, et al. Association study between the CX3CR1 gene and asthma. Genes Immun. 2006;7(8):632–9.

    PubMed  CAS  Google Scholar 

  39. Sirois-Gagnon D, Chamberland A, Perron S, Brisson D, Gaudet D, Laprise C. Association of common polymorphisms in the fractalkine receptor (CX3CR1) with obesity. Obesity (Silver Spring). 2011;19(1):222–7. Epub 2010 Jun 3.

    CAS  Google Scholar 

  40. Pashankar DS, Corbin Z, Shah SK, Caprio S. Increased prevalence of gastroesophageal reflux symptoms in obese children evaluated in an academic medical center. J Clin Gastroenterol. 2009;43(5):410–3.

    PubMed  Google Scholar 

  41. Hancox RJ, Poulton R, Taylor DR, Greene JM, McLachlan CR, Cowan JO, et al. Associations between respiratory symptoms, lung function and gastro-oesophageal reflux symptoms in a population-based birth cohort. Respir Res. 2006;7:142.

    PubMed  Google Scholar 

  42. Sulit LG, Storfer-Isser A, Rosen CL, Kirchner HL, Redline S. Associations of obesity, sleep-disordered breathing, and wheezing in children. Am J Respir Crit Care Med. 2005;171(6):659–64.

    PubMed  Google Scholar 

  43. Verhulst SL, Aerts L, Jacobs S, Schrauwen N, Haentjens D, Claes R, et al. Sleep-disordered breathing, obesity, and airway inflammation in children and adolescents. Chest. 2008;134(6):1169–75.

    PubMed  Google Scholar 

  44. Strine TW, Mokdad AH, Balluz LS, Gonzalez O, Crider R, Berry JT, et al. Depression and anxiety in the United States: findings from the 2006 behavioral risk factor surveillance system. Psychiatr Serv. 2008;59(12):1383–90.

    PubMed  Google Scholar 

  45. Brehm JM, Celedón JC, Soto-Quiros ME, Avila L, Hunninghake GM, Forno E, et al. Serum vitamin D levels and markers of severity of childhood asthma in Costa Rica. Am J Respir Crit Care Med. 2009;179(9):765–71.

    PubMed  CAS  Google Scholar 

  46. Alemzadeh R, Kichler J, Babar G, Calhoun M. Hypovitaminosis D in obese children and adolescents: relationship with adiposity, insulin sensitivity, ethnicity, and season. Metabolism. 2008;57(2):183–91.

    PubMed  CAS  Google Scholar 

  47. Forno E, Lescher R, Strunk R, Weiss S, Fuhlbrigge A, Celedón JC. Decreased response to inhaled steroids in overweight and obese asthmatic children. J Allergy Clin Immunol. 2011;127(3):741–9.

    PubMed  CAS  Google Scholar 

  48. Litonjua AA. Childhood asthma may be a consequence of vitamin D deficiency. Curr Opin Allergy Clin Immunol. 2009;9(3):202–7.

    PubMed  CAS  Google Scholar 

  49. Wells SM, Buford MC, Migliaccio CT, Holian A. Elevated asymmetric dimethylarginine alters lung function and induces collagen deposition in mice. Am J Respir Cell Mol Biol. 2009;40(2):179–88.

    PubMed  CAS  Google Scholar 

  50. Breton CV, Byun HM, Wang X, Salam MT, Siegmund K, Gilliland FD. DNA methylation in the arginase-nitric oxide synthase pathway is associated with exhaled nitric oxide in children with asthma. Am J Respir Crit Care Med. 2011;184(2):191–7.

    PubMed  CAS  Google Scholar 

  51. Sordillo JE, Lange NE, Tarantini L, Bollati V, Zanobetti A, Sparrow D, et al. Global DNA methylation, BMI, wheeze, and allergic sensitization in older men. Am J Respir Crit Care Med. 2011;183:A5679.

    Google Scholar 

  52. Troisi RJ, Speizer FE, Willett WC, Trichopoulos D, Rosner B. Menopause, postmenopausal estrogen preparations, and the risk of adult-onset asthma. A prospective cohort study. Am J Respir Crit Care Med. 1995;152(4 Pt 1):1183–8.

    PubMed  CAS  Google Scholar 

  53. Hamano N, Terada N, Maesako K, Numata T, Konno A. Effect of sex hormones on eosinophilic inflammation in nasal mucosa. Allergy Asthma Proc. 1998;19(5):263–9.

    PubMed  CAS  Google Scholar 

  54. Peters-Golden M, Swern A, Bird SS, Hustad CM, Grant E, Edelman JM. Influence of body mass index on the response to asthma controller agents. Eur Respir J. 2006;27(3):495–503.

    PubMed  CAS  Google Scholar 

  55. Sousa AR, Lane SJ, Cidlowski JA, Staynov DZ, Lee TH. Glucocorticoid resistance in asthma is associated with elevated in vivo expression of the glucocorticoid receptor beta-isoform. J Allergy Clin Immunol. 2000;105(5):943–50.

    PubMed  CAS  Google Scholar 

  56. Webster JC, Oakley RH, Jewell CM, Cidlowski JA. Proinflammatory cytokines regulate human glucocorticoid receptor gene expression and lead to the accumulation of the dominant negative beta isoform: a mechanism for the generation of glucocorticoid resistance. Proc Natl Acad Sci USA. 2001;98(12):6865–70.

    PubMed  CAS  Google Scholar 

  57. Eneli IU, Skybo T, Camargo Jr CA. Weight loss and asthma: a systematic review. Thorax. 2008;63(8):671–6.

    PubMed  CAS  Google Scholar 

  58. Beck LA, Leung DYM. Allergen sensitization through the skin induces systemic allergic responses. J Allergy Clin Immunol. 2000;106(5, Part 2):258–63.

    Google Scholar 

  59. Kalliomaki M, Kirjavainen P, Eerola E, Kero P, Salminen S, Isolauri E. Distinct patterns of neonatal gut microflora in infants in whom atopy was and was not developing. J Allergy Clin Immunol. 2001;107(1):129–34.

    PubMed  CAS  Google Scholar 

  60. Bottcher MF, Nordin EK, Sandin A, Midtvedt T, Bjorksten B. Microflora-associated characteristics in faeces from allergic and nonallergic infants. Clin Exp Allergy. 2000;30(11):1590–6.

    PubMed  CAS  Google Scholar 

  61. Bjorksten B, Naaber P, Sepp E, Mikelsaar M. The intestinal microflora in allergic Estonian and Swedish 2-year-old children. Clin Exp Allergy. 1999;29(3):342–6.

    PubMed  CAS  Google Scholar 

  62. Sepp E, Julge K, Vasar M, Naaber P, Bjorksten B, Mikelsaar M. Intestinal microflora of Estonian and Swedish infants. Acta Paediatr. 1997;86(9):956–61.

    PubMed  CAS  Google Scholar 

  63. Gronlund MM, Lehtonen OP, Eerola E, Kero P. Fecal microflora in healthy infants born by different methods of delivery: permanent changes in intestinal flora after cesarean delivery. J Pediatr Gastroenterol Nutr. 1999;28(1):19–25.

    PubMed  CAS  Google Scholar 

  64. Weiner HL. Current issues in the treatment of human diseases by mucosal tolerance. Ann N Y Acad Sci. 2004;1029:211–24.

    PubMed  CAS  Google Scholar 

  65. Umetsu DT, Akbari O, Dekruyff RH. Regulatory T cells control the development of allergic disease and asthma. J Allergy Clin Immunol. 2003;112(3):480–7.

    PubMed  CAS  Google Scholar 

  66. Strauch UG, Obermeier F, Grunwald N, Guerster S, Dunger N, Schultz M, et al. Influence of intestinal bacteria on induction of regulatory T-cells: lessons from a transfer model of colitis. Gut. 2005;54(11):1546–52. Epub 2005 Jun 29.

    PubMed  CAS  Google Scholar 

  67. Cooper PJ, Chico ME, Rodrigues LC, Strachan DP, Anderson HR, Rodriguez EA, et al. Risk factors for atopy among school children in a rural area of Latin America. Clin Exp Allergy. 2004;34(6):845–52.

    PubMed  CAS  Google Scholar 

  68. Robinson DS, Larche M, Durham SR. Tregs and allergic disease. J Clin Invest. 2004;114(10):1389–97.

    PubMed  CAS  Google Scholar 

  69. Guarner F, Malagelada JR. Gut flora in health and disease. Lancet. 2003;361(9356):512–9.

    PubMed  Google Scholar 

  70. Sudo N, Sawamura S, Tanaka K, Aiba Y, Kubo C, Koga Y. The requirement of intestinal bacterial flora for the development of an IgE production system fully susceptible to oral tolerance induction. J Immunol. 1997;159(4):1739–45.

    PubMed  CAS  Google Scholar 

  71. Moreau MC, Corthier G. Effect of the gastrointestinal microflora on induction and maintenance of oral tolerance to ovalbumin in C3H/HeJ mice. Infect Immun. 1988;56(10):2766–8.

    PubMed  CAS  Google Scholar 

  72. Moreau MC, Gaboriau-Routhiau V. The absence of gut flora, the doses of antigen ingested and aging affect the long-term peripheral tolerance induced by ovalbumin feeding in mice. Respir Immunol. 1996;147:49–59.

    CAS  Google Scholar 

  73. Rask C, Evertsson S, Telemo E, Wold AE. A full flora, but not monocolonization by Escherichia coli or lactobacilli, supports tolerogenic processing of a fed antigen. Scand J Immunol. 2005;61(6):529–35.

    PubMed  CAS  Google Scholar 

  74. Mah KW, Bjorksten B, Lee BW, van Bever HP, Shek LP, Tan TN, et al. Distinct pattern of commensal gut microbiota in toddlers with eczema. Int Arch Allergy Immunol. 2006;140(2):157–63.

    PubMed  CAS  Google Scholar 

  75. Romagnani S. Immunologic influences on allergy and the TH1/TH2 balance. J Allergy Clin Immunol. 2004;113(3):395–400.

    PubMed  CAS  Google Scholar 

  76. Dransfield MT, Garver RI, Weill D. Standardized guidelines for surveillance bronchoscopy reduce complications in lung transplant recipients. J Heart Lung Transplant. 2004;23(1):110–4.

    PubMed  Google Scholar 

  77. Janson C, Asbjornsdottir H, Birgisdottir A, Sigurjonsdottir RB, Gunnbjornsdottir M, Gislason D, et al. The effect of infectious burden on the prevalence of atopy and respiratory allergies in Iceland, Estonia, and Sweden. J Allergy Clin Immunol. 2007;120(3):673–9.

    PubMed  CAS  Google Scholar 

  78. Benden C, Ranasinghe AS, Harpur-Sinclair O, Aurora P. 20: the role of surveillance bronchoscopy in pediatric lung transplant recipients. J Heart Lung Transpl. 2006;25((2, Suppl 1)):50–1.

    Google Scholar 

  79. Kalliomaki M, Salminen S, Poussa T, Arvilommi H, Isolauri E. Probiotics and prevention of atopic disease: 4-year follow-up of a randomised placebo-controlled trial. Lancet. 2003;361(9372):1869–71.

    PubMed  Google Scholar 

  80. Li Y, Saxena D, Barnes VM, Trivedi HM, Ge Y, Xu T. Polymerase chain reaction-based denaturing gradient gel electrophoresis in the evaluation of oral microbiota. Oral Microbiol Immunol. 2006;21(5):333–9.

    PubMed  CAS  Google Scholar 

  81. Fujimoto C, Maeda H, Kokeguchi S, Takashiba S, Nishimura F, Arai H, et al. Application of denaturing gradient gel electrophoresis (DGGE) to the analysis of microbial communities of subgingival plaque. J Periodontal Res. 2003;38(4):440–5.

    PubMed  CAS  Google Scholar 

  82. Osman M, Hansell AL, Simpson CR, Hollowell J, Helms PJ. Gender-specific presentations for asthma, allergic rhinitis and eczema in primary care. Prim Care Respir J. 2007;16(2):28–35.

    PubMed  Google Scholar 

  83. Ramsey CD, Celedón JC. The hygiene hypothesis and asthma. Curr Opin Pulm Med. 2005;11(1):14–20.

    PubMed  Google Scholar 

  84. Thomsen SF, Ulrik CS, Kyvik KO, JvB H, Skadhauge LR, Steffensen I, et al. Importance of genetic factors in the etiology of atopic dermatitis: a twin study. Allergy Asthma Proc. 2007;28:535–9.

    PubMed  Google Scholar 

  85. Mannino DM, Homa DM, Akinbami LJ, Moorman JE, Gwynn C, Redd SC. Surveillance for asthma – United States, 1980–1999. Morb Mortal Wkly Rep Surveill Summ. 2002;51(1):1–13.

    Google Scholar 

  86. Coca AF, Cooke RA. On the classification of the phenomena of hypersensitiveness. J Immunol. 1922;8:163–82.

    Google Scholar 

  87. Penders J, Thijs C, van den Brandt PA, Kummeling I, Snijders B, Stelma F, et al. Gut microbiota composition and development of atopic manifestations in infancy: the KOALA birth cohort study. Gut. 2007;56(5):661–7.

    PubMed  CAS  Google Scholar 

  88. Bjorksten B. The intrauterine and postnatal environments. J Allergy Clin Immunol. 1999;104(6):1119–27.

    PubMed  CAS  Google Scholar 

  89. CDC. Asthma – United States, 1982–1992. MMWR. 1995;43:952–5.

    Google Scholar 

  90. Harris JM, Williams HC, White C, Moffat S, Mills P, Newman Taylor AJ, et al. Early allergen exposure and atopic eczema. Br J Dermatol. 2007;156(4):698–704.

    PubMed  CAS  Google Scholar 

  91. Schabereiter-Gurtner C, Maca S, Rolleke S, Nigl K, Lukas J, Hirschl A, et al. 16S rDNA-based identification of bacteria from conjunctival swabs by PCR and DGGE fingerprinting. Invest Ophthalmol Vis Sci. 2001;42(6):1164–71.

    PubMed  CAS  Google Scholar 

  92. Kalliomaki M, Salminen S, Arvilommi H, Kero P, Koskinen P, Isolauri E. Probiotics in primary prevention of atopic disease: a randomised placebo-controlled trial. Lancet. 2001;357(9262):1076–9.

    PubMed  CAS  Google Scholar 

  93. Pearce N, Pekkanen J, Beasley R. How much asthma is really attributable to atopy. Thorax. 1999;54(3):268–72.

    PubMed  CAS  Google Scholar 

  94. Sheffer A. In: A global initiative for asthma. NHLBI/WHO workshop report: National heart, lung, and blood institute publication #96–3659A; Bethesda; 1995.

    Google Scholar 

  95. Ninan TK, Russell G. Respiratory symptoms and atopy in Aberdeen schoolchildren: evidence from two surveys 25 years apart. BMJ. 1992;304:873–5.

    PubMed  CAS  Google Scholar 

  96. Robertson CF, Heycock E, Bishop J, Nolan T, Olinsky A, Phelan PD. Prevalence of asthma in Melbourne schoolchildren: changes over 26 years. BMJ. 1991;302(6785):1116–8.

    PubMed  CAS  Google Scholar 

  97. Eckburg PB, Bik EM, Bernstein CN, Purdom E, Dethlefsen L, Sargent M, et al. Diversity of the human intestinal microbial flora. Science. 2005;308(5728):1635–8.

    PubMed  Google Scholar 

  98. Miyake Y, Ohya Y, Tanaka K, Yokoyama T, Sasaki S, Fukushima W, et al. Home environment and suspected atopic eczema in Japanese infants: the Osaka maternal and child health study. Pediatr Allergy Immunol. 2007;18(5):425–32.

    PubMed  Google Scholar 

  99. Weston S, Halbert AR, Richmond P, Prescott SL. Effects of probiotics on atopic dermatitis: a randomised controlled trial. Arch Dis Child. 2005;90(9):892–7. Epub 2005 Apr 29.

    PubMed  CAS  Google Scholar 

  100. Peat JK, Haby M, Spijker J, Berry G, Woolcock AJ. Prevalence of asthma in adults in Busselton, Western Australia. BMJ. 1992;305(6865):1326–9.

    PubMed  CAS  Google Scholar 

  101. Hopper JL, Jenkins MA, Carlin JB, Giles GG. Increase in the self-reported prevalence of asthma and hay fever in adults over the last generation: a matched parent-offspring study. Aust J Public Health. 1995;19(2):120–4.

    PubMed  CAS  Google Scholar 

  102. Gillespie KM, Bain SC, Barnett AH, Bingley PJ, Christie MR, Gill GV, et al. The rising incidence of childhood type 1 diabetes and reduced contribution of high-risk HLA haplotypes. Lancet. 2004;364(9446):1645–7.

    Google Scholar 

  103. Strachan DP. Family size, infection and atopy: the first decade of the “hygiene hypothesis”. Thorax. 2000;55 Suppl 1:S2–10.

    PubMed  Google Scholar 

  104. Wegmann TG, Lin H, Guilbert L, Mosmann TR. Bidirectional cytokine interactions in the maternal-fetal relationship: Is successful pregnancy a TH2 phenomenon? Immunol Today. 1993;14(7):353–6.

    PubMed  CAS  Google Scholar 

  105. Prescott SL, Macaubas C, Holt BJ, Smallacombe TB, Loh R, Sly PD, et al. Transplacental priming of the human immune system to environmental allergens: universal skewing of initial T cell responses toward the Th2 cytokine profile. J Immunol. 1998;160(10):4730–7.

    PubMed  CAS  Google Scholar 

  106. Lotz M, Gutle D, Walther S, Menard S, Bogdan C, Hornef MW. Postnatal acquisition of endotoxin tolerance in intestinal epithelial cells. J Exp Med. 2006;203(4):973–84.

    PubMed  CAS  Google Scholar 

  107. Romagnani S. The increased prevalence of allergy and the hygiene hypothesis: missing immune deviation, reduced immune suppression, or both? Immunology. 2004;112(3):352–63.

    PubMed  CAS  Google Scholar 

  108. Cooper PJ, Chico ME, Rodrigues LC, Ordonez M, Strachan D, Griffin GE, et al. Reduced risk of atopy among school-age children infected with geohelminth parasites in a rural area of the tropics. J Allergy Clin Immunol. 2003;111(5):995–1000.

    PubMed  Google Scholar 

  109. Mohrenschlager M, Schafer T, Huss-Marp J, Eberlein-Konig B, Weidinger S, Ring J, et al. The course of eczema in children aged 5–7 years and its relation to atopy: differences between boys and girls. Br J Dermatol. 2006;154(3):505–13.

    PubMed  CAS  Google Scholar 

  110. Asher MI, Montefort S, Bjorksten B, Lai CK, Strachan DP, Weiland SK, et al. Worldwide time trends in the prevalence of symptoms of asthma, allergic rhinoconjunctivitis, and eczema in childhood: ISAAC phases one and three repeat multicountry cross-sectional surveys. Lancet. 2006;368(9537):733–43.

    PubMed  Google Scholar 

  111. Pearce N, Ait-Khaled N, Beasley R, Mallol J, Keil U, Mitchell E, et al. Worldwide trends in the prevalence of asthma symptoms: phase III of the international study of asthma and allergies in childhood (ISAAC). Thorax. 2007;62(9):757–65.

    Google Scholar 

  112. Tantisira KG, Weiss ST. Complex interactions in complex traits: obesity and asthma. Thorax. 2001;56 Suppl 2:ii64–73.

    PubMed  Google Scholar 

  113. Sporik R, Platts-Mills TA. Allergen exposure and the development of asthma. Thorax. 2001;56 Suppl 2:ii58–63.

    PubMed  Google Scholar 

  114. Diaz-Sanchez D, Proietti L, Polosa R. Diesel fumes and the rising prevalence of atopy: An urban legend? Curr Allergy Asthma Rep. 2003;3(2):146–52.

    PubMed  Google Scholar 

  115. Ball TM, Castro-Rodriguez JA, Griffith KA, Holberg CJ, Martinez FD, Wright AL. Siblings, day-care attendance, and the risk of asthma and wheezing during childhood. N Engl J Med. 2000;343(8):538–43.

    PubMed  CAS  Google Scholar 

  116. McKeever TM, Britton J. Pulmonary perspective: diet and asthma. Am J Respir Crit Care Med. 2004;15(170):725–9.

    Google Scholar 

  117. Karmaus W, Botezan C. Does a higher number of siblings protect against the development of allergy and asthma? A review. J Epidemiol Community Health. 2002;56(3):209–17.

    PubMed  CAS  Google Scholar 

  118. Celedón JC, Wright RJ, Litonjua AA, Sredl D, Ryan L, Weiss ST, et al. Day care attendance in early life, maternal history of asthma, and asthma at age 6 years. Am J Respir Crit Care Med. 2003;167(9):1239–43.

    PubMed  Google Scholar 

  119. McKeever TM, Lewis SA, Smith C, Hubbard R. Vaccination and allergic disease: a birth cohort study. Am J Public Health. 2004;94(6):985–9.

    PubMed  Google Scholar 

  120. Matricardi PM, Yazdanbakhsh M. Mycobacteria and atopy, 6 years later: a fascinating, still unfinished, business. Clin Exp Allergy. 2003;33(6):717–20.

    PubMed  CAS  Google Scholar 

  121. Maitra A, Sherriff A, Griffiths M, Henderson J. Pertussis vaccination in infancy and asthma or allergy in later childhood: birth cohort study. BMJ. 2004;328(7445):925–6.

    PubMed  Google Scholar 

  122. Krause TG, Hviid A, Koch A, Friborg J, Hjuler T, Wohlfahrt J, et al. BCG vaccination and risk of atopy. JAMA. 2003;289(8):1012–5.

    PubMed  Google Scholar 

  123. Bager P, Rostgaard K, Nielsen NM, Melbye M, Westergaard T. Age at bacille calmette-guerin vaccination and risk of allergy and asthma. Clin Exp Allergy. 2003;33(11):1512–7.

    PubMed  CAS  Google Scholar 

  124. Ota MO, van der Sande MA, Walraven GE, Jeffries D, Nyan OA, Marchant A, et al. Absence of association between delayed type hypersensitivity to tuberculin and atopy in children in the Gambia. Clin Exp Allergy. 2003;33(6):731–6.

    PubMed  CAS  Google Scholar 

  125. Illi S, von Mutius E, Lau S, Bergmann R, Niggemann B, Sommerfeld C, et al. Early childhood infectious diseases and the development of asthma up to school age: a birth cohort study. BMJ. 2001;322(7283):390–5.

    PubMed  CAS  Google Scholar 

  126. Matricardi PM, Rosmini F, Riondino S, Fortini M, Ferrigno L, Rapicetta M, et al. Exposure to foodborne and orofecal microbes versus airborne viruses in relation to atopy and allergic asthma: epidemiological study. BMJ. 2000;320(7232):412–7.

    PubMed  CAS  Google Scholar 

  127. Matricardi PM, Rosmini F, Panetta V, Ferrigno L, Bonini S. Hay fever and asthma in relation to markers of infection in the United States. J Allergy Clin Immunol. 2002;110(3):381–7.

    PubMed  Google Scholar 

  128. Ponsonby AL, Couper D, Dwyer T, Carmichael A, Kemp A. Relationship between early life respiratory illness, family size over time, and the development of asthma and hay fever: a seven year follow up study [in process citation]. Thorax. 1999;54(8):664–9.

    PubMed  CAS  Google Scholar 

  129. Cullinan P, Harris JM, Newman Taylor AJ, Jones M, Taylor P, Dave JR, et al. Can early infection explain the sibling effect in adult atopy? Eur Respir J. 2003;22(6):956–61.

    PubMed  CAS  Google Scholar 

  130. Uter W, Stock C, Pfahlberg A, Guillen-Grima F, Aguinaga-Ontoso I, Brun-Sandiumenge C, et al. Association between infections and signs and symptoms of ‘atopic’ hypersensitivity–results of a cross-sectional survey among first-year university students in Germany and Spain. Allergy. 2003;58(7):580–4.

    PubMed  CAS  Google Scholar 

  131. Yunginger JW, Reed CE, O’Connell EJ, Melton 3rd LJ, O’Fallon WM, Silverstein MD. A community-based study of the epidemiology of asthma, incidence rates, 1964–1983. Am Rev Respir Dis. 1992;146(4):888–94.

    PubMed  CAS  Google Scholar 

  132. Vargas PA, Simpson PM, Gary Wheeler J, Goel R, Feild CR, Tilford JM, et al. Characteristics of children with asthma who are enrolled in a head start program. J Allergy Clin Immunol. 2004;114(3):499–504.

    PubMed  Google Scholar 

  133. Linneberg A, Ostergaard C, Tvede M, Andersen LP, Nielsen NH, Madsen F, et al. IgG antibodies against microorganisms and atopic disease in Danish adults: the Copenhagen allergy study. J Allergy Clin Immunol. 2003;111(4):847–53.

    PubMed  CAS  Google Scholar 

  134. Lara M, Rosenbaum S, Rachelefsky G, Nicholas W, Morton SC, Emont S, et al. Improving childhood asthma outcomes in the United States: a blueprint for policy action. Pediatrics. 2002;109(5):919–30.

    PubMed  Google Scholar 

  135. Morgan WJ, Crain EF, Gruchalla RS, O’Connor GT, Kattan M, Evans 3rd R, et al. Results of a home-based environmental intervention among urban children with asthma. N Engl J Med. 2004;351(11):1068–80.

    PubMed  CAS  Google Scholar 

  136. Burrows B, Martinez FD, Halonen M, Barbee RA, Cline MG. Association of asthma with serum IgE levels and skin-test reactivity to allergens. N Engl J Med. 1989;320(5):271–7.

    PubMed  CAS  Google Scholar 

  137. Sunyer J, Anto JM, Tobias A, Burney P. Generational increase of self-reported first attack of asthma in fifteen industrialized countries. European Community Respiratory Health Study (ECRHS). Eur Respir J. 1999;14(4):885–91.

    PubMed  CAS  Google Scholar 

  138. Schernhammer ES, Vutuc C, Waldhor T, Haidinger G. Time trends of the prevalence of asthma and allergic disease in Austrian children. Pediatr Allergy Immunol. 2007;19(2):125–31.

    PubMed  Google Scholar 

  139. Ramsey CD, Gold DR, Litonjua AA, Sredl DL, Ryan L, Celedón JC. Respiratory illnesses in early life and asthma and atopy in childhood. J Allergy Clin Immunol. 2007;119(1):150–6.

    PubMed  Google Scholar 

  140. Braun-Fahrlander C, Gassner M, Grize L, Takken-Sahli K, Neu U, Stricker T, et al. No further increase in asthma, hay fever and atopic sensitisation in adolescents living in Switzerland. Eur Respir J. 2004;23(3):407–13.

    PubMed  CAS  Google Scholar 

  141. Beasley R, Crane J, Lai CK, Pearce N. Prevalence and etiology of asthma. J Allergy Clin Immunol. 2000;105(2 Pt 2):S466–72.

    PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Division of Pediatric Pulmonology, University of Miami, 1580 NW 10th Avenue #123, Miami, FL, 33130, USA

    Erick Forno M.D., MPH & Annabelle Quizon M.D.

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  1. Erick Forno M.D., MPH
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  2. Annabelle Quizon M.D.
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Correspondence to Erick Forno M.D., MPH .

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  1. , Pediatrics, Miller School of Medicine, D820, Miami, 33101-6820, Florida, USA

    Steven E. Lipshultz

  2. , Pediatrics, Miller School of Medicine, 1580 NW 10th Avenue, Miami, 33130, USA

    Sarah E. Messiah

  3. , Pediatrics, Miller School of Medicine, 1580 NW 10th Avenue #123, Miami, 33101, USA

    Tracie L. Miller

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Forno, E., Quizon, A. (2012). The Relationship Between Asthma, Sleep Apnea, and Other Respiratory Disorders and Childhood Metabolic Syndrome. In: Lipshultz, S., Messiah, S., Miller, T. (eds) Pediatric Metabolic Syndrome. Springer, London. https://doi.org/10.1007/978-1-4471-2366-8_8

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