Overweight and obesity are associated with poorer treatment response and impaired pulmonary function in children with bronchial asthma: a retrospective study.

OBJECTIVE: To investigate the effect of body mass index (BMI) on standardized treatment efficacy and pulmonary function in children with bronchial asthma. METHODS: Clinical data of 120 children with acute asthma attacks (January 2020-December 2023) were retrospectively analyzed. Children were divided into a normal-weight group (16th- < 85th percentile, n=62) and an overweight/obese group (≥ 85th percentile, n=58). Both received standardized treatment. Clinical efficacy, CACT scores, annual attack frequency, emergency visits, inflammatory markers, and pulmonary function were compared. RESULTS: The normal weight group showed significantly higher total effective rate (93.5% vs. 79.3%, P=0.022), better CACT scores post-treatment (23.5 ± 2.8 vs. 19.8 ± 3.2, P < 0.001), and fewer annual attacks (3.2 ± 1.5 vs. 5.6 ± 1.8, P < 0.001) and emergency visits (1.8 ± 1.0 vs. 3.4 ± 1.3, P < 0.001). Both groups improved in pulmonary function and inflammatory factors (all P < 0.05), but the improvement rates in FEV1 (23.5 ± 7.2% vs. 31.7 ± 8.5%), FEV1/FVC (13.1 ± 4.8% vs. 17.9 ± 5.6%), PEF (25.7 ± 7.5% vs. 35.7 ± 9.2%), and FEF50% (5.2 ± 4.5% vs. 27.9 ± 7.8%) were significantly lower in the overweight/obese group (all P < 0.05). CONCLUSION: Overweight and obesity are associated with poorer treatment response, less pulmonary function improvement, and worse disease control in asthmatic children. Weight management should be emphasized in this population to optimize therapeutic outcome.