Overweight, obesity, adiposity measures, and asthma endotypes in Puerto Rican youth

To the Editor: Overweight and obesity are associated with asthma in Puerto Ricans, a group heavily affected by these conditions.1,2 Experimental and epidemiologic findings suggest that obesity-related asthma comprises endotypes other than Th2 (T2)–high asthma.3,4 Based on prior work,4-6 we hypothesized that overweight would be associated with T17-high and T2-low/T17-low asthma (collectively referred to as “T2-low asthma”) in Puerto Rican youth. The Epigenetic Variation and Childhood Asthma in Puerto Ricans study was described in detail.7 This was a case-control study of asthma in youth aged 9 to 20 years recruited from February 2014 to May 2017 in San Juan and Caguas (Puerto Rico). Of the 543 participants, 462 had complete data and were included in this analysis. Written parental consent and the participant’s assent were obtained for children younger than 18 years, and written consent was obtained for participants 18 years and older. The study was approved by the institutional review boards of the University of Pittsburgh and the University of Puerto Rico.