Quantifying the interaction between adiposity and hyperglycemia on incident asthma among youth

This study aimed to investigate the association between overweight and diabetes with childhood asthma and to assess potential synergistic effects among these conditions. This cross - sectional study analyzed 14,281 US children aged 2–17 years (NHANES 1999–2023). Active asthma was defined as the outcome. Overweight and diabetes were the exposure variables. Multivariable logistic regression models were used to assess the association between overweight, diabetes, and asthma risk. The models were adjusted for demographics, HDL, hypertension, poverty - income ratio, and physical activity. Both overweight and diabetes were associated with increased asthma risk in children, with an interaction effect between the two conditions. After adjusting for confounders, children with both overweight and diabetes had a significantly increased asthma risk (OR 3.861, 95% CI 1.02–14.63). Subgroup analysis demonstrated that the positive association between overweight/diabetes and asthma risk remained consistent across most demographic and clinical strata, with no significant interactions observed, confirming the robustness of the findings across diverse populations. Adiposity and hyperglycaemia synergistically amplify childhood asthma risk, especially in adolescents and inactive youth, underscoring integrated metabolic–respiratory prevention strategies.