The Impact of Childhood Obesity on Asthma Severity: A Cross-Sectional Study at Sabratha Teaching Hospital

Abstract

There is strong experimental and epidemiological support for the "obesity-related asthma" phenotype. Children who are obese are more likely to develop asthma, and those who already have the condition have worse symptoms, more frequent attacks, and a lower overall quality of life. Data on the relationship between childhood obesity and asthma severity remain scarce in Libya. This study aimed to assess the relationship between body mass index (BMI) and asthma severity among children attending Sabratha Teaching Hospital in western Libya, and to identify the lifestyle, environmental, and clinical factors most strongly associated with disease severity and exacerbation frequency. A cross-sectional descriptive analytical study was conducted among 99 children (aged 2–18 years) with a confirmed diagnosis of asthma. Data were collected via a structured interviewer-administered questionnaire and standardised anthropometric measurements. BMI was classified according to age- and sex specific reference standards. Asthma severity, attack frequency, and hospital admission were assessed as primary outcomes. Pearson correlation, chi-square tests, and a multivariate general linear model (GLM) were applied to identify associations and independent predictors. The study population had a mean age of 9.87 ± 3.84 years, with a male predominance (66.7%). Abnormal BMI was prevalent in 74.7% of participants, comprising 60.6% underweight and 12.1% obese. BMI category was significantly and positively correlated with asthma severity (r = 0.306, p = 0.002) and hospital admission (r = 0.352, p < 0.001). In the multivariate GLM, regular exercise emerged as the strongest independent predictor of asthma severity (F = 12.604, p = 0.001, partial η² = 0.118), followed by BMI category (F = 9.504, p = 0.003, partial η² = 0.092) and passive smoking exposure (F = 4.965, p = 0.028, partial η² = 0.050). Across the cohort, pharmacological treatment alone did not significantly differentiate controlled from uncontrolled asthma status. Our findings suggest that abnormal BMI, particularly obesity, is significantly correlated with asthma severity and hospitalisation among children, as well as physical inactivity and passive smoking exposure being the most clinically significant risk factors identified. Integrating nutritional assessment, regular exercise, and tobacco-exposure counselling into routine pediatric asthma management is highly recommended in systematic inclusion.