Perinatal influences on the development of asthma and atopy in childhood

BackgroundIn most children with asthma and atopy, onset of disease occurs early in life, indicating a crucial role of in utero and early childhood environment. However, only a small part of this burden of disease established early in life has been explained.ObjectiveTo examine the effects of early environmental exposures on the development of asthma and atopy within the setting of an affluent urban population.MethodsThe authors followed 526 German children from birth to 5 years of age. Parental interviews in pregnancy and then yearly assessed the health of the child and environmental characteristics. Endotoxin and allergens in house dust were measured at 3 months. Atopic sensitization was assessed at 1 and 5 years.ResultsIn atopic mothers, acute atopic symptoms during pregnancy were associated with increased risk of early atopic dermatitis (adjusted odds ratio [aOR] 1.74, 95% confidence interval [CI] 1.00–3.02) and allergic rhinitis at 5 years (aOR 2.11, 95% CI 1.01–4.41). Further, maternal illnesses during pregnancy (ie, repeated common colds) increased the risk of asthma at 5 years (aOR 2.31, 95% CI 1.12–4.78). Endotoxin in the child's mattress was inversely associated with atopic sensitization (aOR 0.79, 95% CI 0.64–0.97) and asthma (aOR 0.71, 95% CI 0.55–0.93). A contrasting effect of early endotoxin and mite exposure was observed for mite sensitization: mite exposure increased the risk of mite sensitization at 5 years (aOR 1.30, 95% CI 1.11–1.53), whereas endotoxin exposure was inversely associated with mite sensitization (aOR 0.73, 95% CI 0.57–0.95).ConclusionFactors affecting the in utero environment, such as maternal atopy and infections, and bacterial exposure in pregnancy or early life may act as immunomodulators enhancing or inhibiting the development of asthma and atopy in childhood.     

Does the pill make a difference? Previous maternal use of contraceptive pills and allergic diseases among offspring

BACKGROUND: Maternal use of oral contraceptive pills (OCPs) might increase the prevalence of allergic diseases among offspring. The aim of the study was to clarify if there are differences between OCP types in this association. METHODS: Primary outcomes were asthma, allergic rhinitis and atopic eczema among 1182 children (618 asthmatic and 564 controls) aged 5-6 years. RESULTS: Maternal previous use of desogestrel, gestodene or cyproterone acetate before pregnancy, each combined with ethinyloestradiol (EO), increased the risk of allergic rhinitis among offspring compared with those children whose mothers had not used OCPs (OR 1.67, 95% CI 1.07-2.59, P < 0.024), and this risk was increased mainly in those children with parental allergy (OR 1.78, 95% CI 1.11-2.86, P < 0.018), especially in boys (OR 2.12, 95% CI 1.17-3.84, P < 0.014). No associations were observed between maternal use of OCPs before pregnancy and asthma or atopic eczema among offspring. The association between the previous use of OCPs and allergic rhinitis was not mediated through maternal sex steroid levels during early pregnancy, but women who had used more androgenic types of progestin formulas had higher serum levels of progesterone during early pregnancy. CONCLUSION: Maternal previous use of desogestrel, gestodene or cyproterone acetate before pregnancy, each combined with EO, increased the risk of allergic rhinitis among offspring compared with those children whose mothers had not used OCPs and this risk was detected mainly in boys and in children with parental allergy.     

Maternal vaginal microflora during pregnancy and the risk of asthma hospitalization and use of antiasthma medication in early childhood

BACKGROUND: Infants with wheezing and allergic diseases have a microflora that differs from that of healthy infants. The fetus acquires microorganisms during birth when exposed to the maternal vaginal microflora. It is therefore conceivable that the maternal vaginal microflora might influence the establishment of the infant flora and, as a consequence, the development of wheezing and allergic diseases. OBJECTIVE: We sought to study the associations between the composition of the maternal vaginal microflora and the development of wheezing and asthma in childhood. METHODS: We performed a population-based cohort study in Denmark. Vaginal samples for bacterial analysis were obtained during pregnancy. A total of 2927 women (80% of the invited women) completed the study and had 3003 live infants. Infant wheezing was assessed as one or more hospitalizations for asthma between 0 and 3 years of age. Asthma was assessed as use of 3 or more packages of antiasthma medication between 4 and 5 years of age. RESULTS: Maternal vaginal colonization with Ureaplasma urealyticum during pregnancy was associated with infant wheezing (odds ratio [OR], 2.0; 95% CI, 1.2-3.6), but not with asthma, during the fifth year of life. Maternal colonization with staphylococci (OR, 2.2; 95% CI, 1.4-3.4) and use of antibiotics in pregnancy (OR, 1.7; 95% CI, 1.1-2.6) were associated with asthma during the fifth year of life. CONCLUSION: The composition of the maternal vaginal micro-flora might be associated with wheezing and asthma in the offspring up to 5 years of age.     

Prenatal paracetamol exposure and risk of asthma and elevated immunoglobulin E in childhood

BACKGROUND: We recently found that paracetamol (acetaminophen) use in late pregnancy was associated with an increased risk of early wheezing in the offspring. OBJECTIVE: To see whether use of paracetamol in late pregnancy is associated with an increased risk of asthma, wheezing and other atopic outcomes in the child at school age. METHODS: In the population-based Avon Longitudinal Study of Parents and Children, we measured associations of paracetamol and aspirin use in late pregnancy (20-32 weeks) with asthma, hayfever, eczema (n = 8511) and wheezing (8381) in the offspring at 69-81 months, and with atopy (positive skin prick test to Dermatophagoides pteronyssinus, cat or grass, n = 6527) and blood total IgE (n = 5148) at 7 years. We used logistic and linear regression to analyse binary outcomes and log-transformed IgE, respectively, controlling for potential confounders. RESULTS: Use of paracetamol, but not aspirin, in late pregnancy was positively associated with asthma (odds ratios (ORs), comparing children whose mothers took paracetamol 'sometimes' and 'most days/daily' with those whose mothers never took it, 1.22 (95% confidence interval (CI): 1.06-1.41) and 1.62 (95% CI: 0.86-3.04), respectively; P trend = 0.0037), wheezing (ORs 1.20 (95% CI: 1.02-1.40) and 1.86 (95% CI: 0.98-3.55), respectively; P trend = 0.011), and total IgE (geometric mean ratios 1.14 (95% CI: 1.03-1.26) and 1.52 (95% CI: 0.98-2.38), respectively; P trend = 0.0034), but not hayfever, eczema or skin test positivity. The proportion of asthma attributable to paracetamol use in late pregnancy, assuming a causal relation, was 7%. CONCLUSION: Paracetamol exposure in late gestation may cause asthma, wheezing and elevated IgE in children of school age.     

Wheezing, asthma, hayfever, and atopic eczema in childhood following exposure to tobacco smoke in fetal life

BACKGROUND: Prenatal maternal smoking has been associated with adverse respiratory effects in childhood such as lung deficits and wheezing, but results concerning asthma, hayfever, and atopic eczema are inconsistent. OBJECTIVE: In the present study, we investigate the effects of maternal smoking in pregnancy on asthma, hayfever, atopic eczema, and wheezing in the offspring up to the age of 14-18. METHODS: The study was based on a cohort of mothers enrolled during midwife visits around the 36th week of gestation in Odense and Aalborg, Denmark, 1984-1987. Singleton, live born children (n = 11,144) were followed-up in 2002 to obtain a childhood history of atopic diseases, by means of questionnaires to the parents. Multivariate logistic regression analyses for medical diagnoses of asthma, hayfever, atopic eczema, and symptoms of wheezing before the age of 3, were carried out on 7844 children. RESULTS: After adjustment for confounders, late prenatal smoke exposure was associated with wheezing, with an odds ratio (OR) of 1.2, and a 95% confidence interval (CI) of 1.1-1.5. Furthermore, slightly reduced estimates for hayfever (OR 0.8, CI 0.7-1.0) and atopic eczema (OR 0.8, CI 0.7-0.9) were obtained for children exposed in late pregnancy compared with non-exposed. CONCLUSION: Late gestational smoke exposure was associated with wheezing but not with asthma, while null or even protective estimates were indicated for hayfever and atopic eczema. However, lack of control options for hereditary factors may have affected the results.     

Childhood allergy susceptibility: The role of the immune system development in the in-utero period

Expression of allergic diseases in very early childhood indicates that early life events play a significant role in childhood allergy development. The developmental origins of allergy hypothesis suggest events initiated in the in-utero period derived from the interaction between maternal, placental, and fetal factors may contribute to childhood allergy susceptibility. Environmental impacts on placental function and fetal programming are imperative in defining illness risk during pregnancy. Fetal programming, a process by which an injury delivered during a critical period of development, causes immediate adaptive responses with long-term consequences on an organism’s structure or function. During pregnancy, the maternal immune response is skewed towards Th2-related humoral responses, hence increasing the susceptibility of childhood allergy development. Maternal atopic phenotype markedly increases the probability of her offspring developing an allergic predisposition. Combination of in utero events – which include maternal asthma or infection, and exposures to maternal allergy which changes the placental function – can alter placental cytokine expression and could predispose offspring to an allergic phenotype. All these events may affect embryology and fetal immune system development. Interestingly, the mechanism and role of the in-utero events on the developmental origins of allergy are not clearly understood; this will be addressed in this review.(199 words)     

Women's status within the household as a determinant of maternal health care use in Nigeria

BackgroundAlthough gender inequality is often cited as a barrier to improving maternal health in sub-saharan Africa, there is lack of empirical data on how women''s socio-cultural characteristics may influence use of health services in Nigeria.ObjectiveTo describe how women''s position in the household affects receipt of maternity care services.MethodsSecondary data analysis of 10,052 and 4,590 currently married women aged 15 to 49 years from the 2008 Nigerian DHS who receive skilled antenatal and delivery care at least till pregnancy was done.ResultsReceipt of skilled delivery care was by 37.9% while, natal care was by 98.4%. Education, residence and wealth index all significantly influenced receipt of maternal health care. Women who were involved in decision making on their own health (aOR=1.97; 95%CI=1.88–2.06) and were employed throughout the year (aOR=1.11; 95%CI=1.01–1.23) were more likely to receive skilled antenatal care, while those who justified physical intimate partner violence were less likely to receive both skilled antenatal care (aOR=0.92; 95%CI=0.85–0.98) and delivery services (aOR 0.54; 95% CI 0.33–0.87).ConclusionInterventions aimed at improving maternal care should promote women empowerment (decision making, self worth, educational and economic) and should involve partners.     

Self-management support provided by trained asthma educators result in improved quality of life and asthma control compared to usual care: A systematic review and meta-analysis

ObjectivesWe sought to describe training activities on self-management support (SMS) for asthma educators and the effects of SMS provided by trained educators on asthma patient outcomes.MethodsWe conducted a systematic review of six medical databases and sought for trials assessing SMS provided for adults with asthma by trained educators. Two reviewers independently selected and extracted data on asthma educators’ training activities and patient outcomes. We performed meta-analyses for asthma-related quality of life (QoL) and asthma control.ResultsWe screened 3217 records and included 16 trials. Learning activities and assessments were reported in 8/16 and 4/16 trials, respectively. Compared to usual care, trained asthma educators provided SMS that resulted in clinically important improvements in QoL (pooled mean difference [MD] = 0.52; 95% confidence interval [95%CI]: 0.19 to 0.83) and asthma control (pooled MD= −0.68; 95%CI: −0.99 to −0.38).ConclusionAlthough asthma-specific SMS provided by trained educators had a beneficial effect over the current care, our results highlight the need to better describe training activities for asthma educators.Practice implicationsThis systematic review provides key elements of efficient training activities for asthma educators and reaffirms the importance of training educators to provide SMS in order to improve asthma patients’ QoL and asthma control.     

Caesarean delivery and risk of atopy and allergic disesase: meta-analyses

Background Studies of delivery by caesarean section (c‐section) and the offspring's risk of allergic diseases are of current interest due to concerns about the increased use of c‐section in many countries. However, previous studies have reported inconsistent findings. Objective We investigated whether delivery by c‐section is associated with an increased risk of atopy and allergic disease by reviewing the literature, performing a meta‐analysis, and assessing publication bias. Methods We used a systematic literature search of MEDLINE (1966 to May 2007). Six common allergic outcomes were included: food allergy/food atopy, inhalant atopy, eczema/atopic dermatitis, allergic rhinitis, asthma, and hospitalization for asthma. For each outcome a meta‐analysis was performed, where a summary odds ratio (OR) was calculated taking into account heterogeneity between the study‐specific relative risks. Publication bias was assessed using the funnel plot method. Results We identified 26 studies on delivery by c‐section and one or more of the six allergic outcomes. C‐section was associated with an increased summary OR of food allergy/food atopy (OR 1.32, 95% CI 1.12–1.55; six studies), allergic rhinitis (OR 1.23, 95% CI 1.12–1.35; seven studies), asthma (OR 1.18, 95% CI 1.05–1.32; 13 studies), and hospitalization for asthma (OR 1.21, 95% CI 1.12–1.31; seven studies), whereas there was no association with inhalant atopy (OR 1.06, 95% CI 0.82–1.38; four studies) and eczema/atopic dermatitis (OR 1.03, 95% CI 0.98–1.09; six studies). Funnel plots indicated that the association with food allergy/food atopy could be difficult to interpret due to publication bias. For each significant association with an allergic outcome, only 1–4% of cases were attributable to c‐section. Conclusion Delivery by c‐section is associated with a moderate risk increase for allergic rhinitis, asthma, hospitalization for asthma, and perhaps food allergy/food atopy, but not with inhalant atopy or atopic dermatitis. The increased use of c‐section during the last decades is unlikely to have contributed much to the allergy epidemic observed during the same period.     

Risk factors for wheezing in early adolescence: a prospective birth cohort study in Brazil.

BACKGROUND: Many asthma studies are available in the literature, but few investigated whether risk factors for asthma differ by sex. OBJECTIVE: To evaluate risk factors for wheezing in early adolescence, with emphasis on sex differences. METHODS: A prospective birth cohort study was initiated in 1993; 87.5% of the original cohort was traced at 11 years, totaling 4,452 adolescents. Current wheezing was defined as at least 1 crisis in the previous 12 months. The following independent variables were analyzed: maternal smoking during pregnancy, wheezing at 4 years, maternal wheezing, and adolescent body mass index. RESULTS: Current wheezing affected 13.5% (95% confidence interval [CI], 12.4%-14.5%) of the cohort. The prevalence of current wheezing was 15.3% (95% CI, 13.7%-16.8%) in boys and 11.7% (95% CI, 10.4%-13.1%) in girls (P < .001). Maternal smoking was related to an increased risk of wheezing for boys but not for girls. There was a significant tracking of wheezing from 4 to 11 years in both sexes, although the magnitude was stronger for boys. A dose-response association between maternal wheezing and adolescent wheezing was observed in boys but not in girls. Finally, obesity was associated with an increased risk of wheezing in boys but not in girls. CONCLUSIONS: The variables explored in this investigation had a stronger effect on adolescent wheezing in boys than in girls. Public health strategies aimed at minimizing the burden of wheezing should take these sex differences into account.     

Maternal vitamin D intake during pregnancy is inversely associated with asthma and allergic rhinitis in 5-year-old children

Background Vitamin D is known to have a number of immunological effects and it may play a role in preventing allergic diseases.
Objectives To study the effect of maternal intake of vitamin D during pregnancy on the emergence of asthma, allergic rhinitis (AR), and atopic eczema by the age of 5 years in children with HLA-DQB1-conferred susceptibility for type 1 diabetes.
Methods Children (1669) participating in the population-based birth cohort study were followed for asthma, AR, and atopic eczema assessed by validated questionnaire at 5 years. Maternal diet was assessed by a food-frequency questionnaire.
Results The mean maternal intake of vitamin D was 5.1 (SD 2.6) μg from food and 1.4 (2.6) μg from supplements. Only 32% of the women were taking vitamin D supplements. When adjusted for potential confounders, maternal intake of vitamin D from food was negatively related to risk of asthma [hazard ratio (HR) 0.80; 95% confidence interval (CI) 0.64–0.99] and AR [HR 0.85; 95% CI 0.75–0.97]. Vitamin D supplements alone were not associated with any outcome. Adjustment for maternal intake of other dietary factors did not change the results.
Conclusion Maternal vitamin D intake from foods during pregnancy may be negatively associated with risk of asthma and AR in childhood.     

Does maternal fermented dairy products consumption protect against cow's milk protein allergy in toddlers?

BackgroundCow's milk protein allergy (CMPA) is the most common immunoglobulin E-mediated food allergy in childhood.ObjectiveTo investigate the potential impact on the disease of the frequency, amount, and diversity of maternal consumption of fermented dairy products (FDP) during pregnancy and lactation in children with immunoglobulin E-mediated CMPA.MethodsOne hundred sixty toddlers (80 with physician-diagnosed CMPA and 80 healthy controls) and their mothers participated in this case-control study. The data were collected using a structured questionnaire and were compared between the 2 groups.ResultsThe most commonly consumed FDP were cheese, yogurt, and tarhana. The amounts of maternal yogurt, tarhana, and kefir consumed during pregnancy (P < .001, P < .001, and P = .04, respectively) in addition to yogurt and tarhana consumption during lactation (P < .001 and P = .001, respectively) were lower in toddlers with CMPA. The frequency of maternal consumption of yogurt, cheese, and tarhana during lactation (P = .001, P = .003, and P = .02, respectively) and the diversity of FDP were also lower in toddlers with CMPA (P = .001). At multivariate logistic regression analysis, maternal weight gain during pregnancy (odds ratio [OR], 1.11; 95% confidence interval [CI], 1.04-1.18; P = .001), maternal age (OR, 1.20; 95% CI, 1.09-1.31; P < .001), and gestational age at birth (OR, 1.23; 95% CI, 1.03-1.48; P = .02) increased the odds of the baby having CMPA. The diversity of FDP consumed during lactation was protective against CMPA (OR, 0.439; 95% CI, 0.272-0.711; P = .001).ConclusionWeekly maternal consumption of FDP was low during pregnancy and lactation in toddlers with CMPA. Although the diversity of FDP consumed during lactation may reduce the risk of CMPA, this effect was not observed during pregnancy.     

Temporal trends and racial/ethnic disparity in self-reported pediatric food allergy in the United States

BackgroundThe prevalence of food allergy is thought to be increasing, but data from the United States have not been systematically synthesized.ObjectiveTo summarize the data on prevalence of food allergy in the US pediatric population and to estimate the effects of time, race/ethnicity, and method of assessing food allergy on the estimated prevalence.MethodsEmbase, MEDLINE, bibliographies of identified reports, and data from publically available data sets were searched. Studies were limited to those in English with data from the general pediatric US population. Study synthesis was performed by meta-analysis and meta-regression to estimate the effect of study- and participant-level covariates. Meta-regression was limited to nationally representative surveys conducted by the Centers for Disease Control and Prevention.ResultsA total of 10,090 publications were identified, from which 27 different survey administrations, representing 452,237 children, were identified, covering the period of 1988 to 2011. Because of heterogeneity among surveys in the estimated food allergy prevalence, a summary estimate of food allergy prevalence was not possible. Meta-regression was performed using 20 of these surveys. Temporal trends were pronounced, with an estimated increased prevalence of self-reported food allergy of 1.2 percentage points per decade (95% confidence interval [CI], 0.7-1.6). The increase per decade varied by race/ethnicity: 2.1% among non-Hispanic blacks (95% CI, 1.5%-2.7%), 1.2% among Hispanics (95% CI, 0.7%-1.7%), and 1.0% among non-Hispanic whites (95% CI, 0.4%-1.6%).ConclusionSelf-report of food allergy among US children has sharply increased in the past 2 decades. The increase has been greatest among non-Hispanic black children, a disparity that needs to be investigated.     

Associations of urban greenness with asthma and respiratory symptoms in Mexican American children

Background

Evidence on the association between residential surrounding greenness (RSG) in urban areas with asthma and asthma symptoms is inconsistent.

Quality of life in food allergic children: Results from 174 quality-of-life patient questionnaires

BackgroundFood allergies are becoming a global concern and pose a significant burden on allergic children and their family, with reported physical and emotional effects.ObjectiveTo investigate the effect of food allergy on patients′ quality of life (QoL), to identify any characteristics associated with worse QoL, and to directly compare the effect of food allergies on the QoL of adolescents vs younger children.MethodsChildren 0 to 17 years old with a physician-confirmed food allergy diagnosis were invited to participate by completing the validated Food Allergy Quality of Life Questionnaire (FAQLQ). The FAQLQ form for children 10 to 12 years old was completed by the parent (proxy report), whereas the FAQLQ form for adolescents was completed by the adolescent (self-report). Scores were compared using the Wilcoxon rank sum test. Independent median regressions were used to test association between potential risk factors and QoL outcomes.ResultsIn our cohort, the median FAQLQ score was significantly higher (reflecting lower QoL) in adolescents compared with children (4.7 vs 3.5, P = .007). The median social and dietary limitations score (5.2 vs 4, P = .002) and the median emotional impact score (3.8 vs 3.1, P = .02) were also higher in adolescents. Limitations in family activities because of food allergy had a negative effect on QoL.ConclusionFood allergic adolescents are affected more than younger children (based on parental report) in terms of QoL, with a direct reflection on all areas of their daily life (emotional, dietary, and social). In addition, limitations in family activities because of the child′s food allergy significantly worsen the QoL and well being of all family members.     

Mediterranean diet is associated with reduced asthma and rhinitis in Mexican children

Background: Diet during pregnancy and childhood has been suggested to play an important role in children’s asthma risk. We assessed whether the adherence to a Mediterranean dietary pattern, for children in the last 12 months and their mothers during pregnancy, was associated with both childhood asthma and allergic rhinitis. Methods: A cross‐sectional study was conducted in 2004 using a random sample of 1476 children (6‐ to 7‐year old) from the Mexicali region, Mexico. Dietary data of children’s intake in the last 12 months and their mothers’ intake during pregnancy was collected, through a parental food frequency questionnaire. A Mediterranean diet score was computed [Trichopoulou et al., N Engl J Med 348 (2003), 2599]. Data on seven asthma and rhinitis‐related outcomes were obtained from the International Study of Asthma and Allergies in Childhood questionnaire. Results: Adherence to a Mediterranean dietary pattern was inversely associated with asthma ever (OR = 0.60, 95% CI = 0.40–0.91), wheezing ever (0.64, 0.47–0.87), rhinitis ever (0.41, 0.22–0.77), sneezing ever (0.79, 0.59–1.07), current sneezing (0.71, 0.52–0.96) and current itchy‐watery eyes (0.63, 0.42–0.95). No associations were found using the mothers’ pregnancy diet score, except for current sneezing (0.71, 0.53–0.97). Conclusions: Our findings suggest a protective effect of following a healthy dietary pattern on asthma and allergic rhinitis in Mexican children.     

Predicting Factors of Severe COVID-19 in Patients With Asthma: A Korean National Cohort Study

As there are limited data on the disease course of and factors predicting severe coronavirus disease 19 (COVID-19) in patients with asthma, this study aims to perform a detailed analysis of the clinical course of asthmatic patients with COVID-19 and evaluate factors related to severe infection. Of the 5,628 patients confirmed with COVID-19, 128 (2.3%) had asthma. Among the 128 asthmatic patients, 32 (25%) had severe COVID-19 and 96 (75%) had non-severe COVID-19. Among asthmatic patients, those with severe COVID-19 were significantly older and had more dyspnea and fever, more comorbidities, and lower lymphocyte and platelet counts than those with non-severe COVID-19. In multivariable logistic regression analysis, chronic obstructive pulmonary disease (adjusted odds ratio [aOR], 6.49; 95% confidence interval [CI], 1.18–41.81), low lymphocyte proportion (aOR, 0.91; 95% CI, 0.86–0.97), and low platelet count (aOR, 0.99; 95% CI, 0.98–0.99) were independently associated with severe COVID-19.     

Additive Effect of Obesity and Dyslipidemia on Wheezing in Korean Adults: A Nationwide Representative Survey Study

Besides obesity, there are limited studies regarding the relationship between the individual components of metabolic syndrome and wheezing. It is largely unknown whether the co-existence of other metabolic syndrome components has additive effects on wheezing in the adult population. The association between the individual components of metabolic syndrome and current wheezing was evaluated in adults using data from the Korea National Health and Nutrition Examination Survey from 2008 to 2012. Subjects with metabolic syndrome more frequently had wheezing during the past 12 months (current wheezing) (adjusted odds ratio [aOR] = 1.56; 95% confidence interval [CI] = 1.37–1.77) and wheezing during exercise in the past 12 months (aOR = 1.59; 95% CI = 1.37–1.84). Of the individual metabolic syndrome components, central obesity (aOR = 1.48; 95% CI = 1.31–1.66) and low high-density lipoprotein (HDL) cholesterol (aOR = 1.18; 95% CI = 1.05–1.34) were significantly associated with current wheezing. There were no significant associations between the other components of metabolic syndrome (high triglyceride level, blood pressure, and fasting plasma glucose level) and the presence of current wheezing. In addition, the association was much higher when both central obesity and low HDL cholesterol were present together compared to when either of the conditions was present alone (aOR = 1.67; 95% CI = 1.44–1.94). There is a significant association between metabolic syndrome and current wheezing in Korean adults. Of the components of metabolic syndrome, low HDL cholesterol and central obesity are independently and additively associated with the increased rate of current wheezing.