Impact of weight loss on obese children and adolescents with asthma: a systematic review and meta-analysis

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OBJECTIVE: This systematic review and meta-analysis aims to evaluate the efficacy of weight management interventions on pulmonary function, asthma control, asthma-specific quality of life, and leptin levels in obese children and adolescents with asthma. METHODS: Randomized controlled trials (RCTs) and single-group pretest-posttest designs (SGPPDs) involving obese children and adolescents with asthma receiving weight management interventions were identified through systematic searches of six databases (PubMed, Cochrane Library, Web of Science, Embase, CNKI, Wanfang Data) and three trial registries from inception to September 26, 2024. Risk of bias was assessed using the Cochrane Risk of Bias 2.0 (ROB 2.0) tool for RCTs and the Joanna Briggs Institute (JBI) critical appraisal tool for SGPPDs. RESULTS: Nine studies met the inclusion criteria. Meta-analysis of RCTs revealed significant improvements in FEV₁% (MD=4.53, 95% CI: 3.51-5.55) and FVC% (MD=4.91, 95% CI: 4.15-5.67) following weight management interventions. Asthma Control Test (ACT) and Pediatric Asthma-specific Quality of Life Questionnaire (PAQLQ) scores increased by 1.41 (95% CI: 1.11-1.71) and 0.46 (95% CI: 0.07-0.85), respectively. Leptin levels showed a decreasing trend but lacked statistical significance. SGPPD results were similar to RCT findings but with higher heterogeneity. Peter's regression indicated no publication bias (P>0.05), and sensitivity analysis supported the stability of effect sizes. CONCLUSIONS: Weight management positively impacts pulmonary function, asthma control, and asthma-specific quality of life in obese pediatric asthma patients, while its effect on leptin levels requires further exploration. This study provides critical evidence for weight management strategies.

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