Phenotypic characterization of treatment-naïve childhood asthma with obesity: features of lung function, inflammation, and lipid profiles

• At asthma diagnosis, treatment-naïve children with obesity present a distinct phenotype characterized by 1) early airflow obstruction, 2) a frequent T2-low inflammatory signature (with elevated neutrophils), and 3) a high prevalence of dyslipidemia-despite a high background of clinical atopy. Obesity itself is a primary, independent determinant of this early lung impairment. These findings establish a critical baseline profile, underscoring the need for multidimensional assessment to stratify risk and guide clinical decision-making in this population.