Adult but not childhood onset asthma is associated with the metabolic syndrome, independent from body mass index

Abstract

Adult-onset asthma (AOA) is usually more severe compared to childhood onset asthma (CoA). Given the increasing evidence that AoA is associated with obesity, we investigated the relationship of other related metabolic comorbid conditions with AoA compared to CoA. Study design and methods: This cross-sectional study compared the metabolic syndrome and lipid derived inflammatory markers in patients with AoA, CoA and age-and sex-matched control subjects without asthma. Participants were asthma patients visiting the outpatient clinic of two teaching hospitals in Rotterdam, The Netherlands. All participants underwent lung function tests, blood tests and physical activity tracking. AoA was defined as asthma age of onset after the age of 18 years. Metabolic syndrome was defined according to the international joint interim statement criteria.Results: Eighty-one participants were included (27 AoA, 25 CoA, 29 controls). AoA was associated with the metabolic syndrome (Odds Ratio = 3.64 95% ) p = 0.03, Nagelkerke R 2 = 0.26), adjusted for age, sex, body mass index and smoking habits. AoA patients had higher median serum IL-6 and leptin-adiponectin (LA) ratio compared to controls (IL-6 (pg/mL): 3.10 [1.11-4.30] vs. 1.13 [0.72-1.58], p = 0.002 and LA ratio (pg/mL): 6.21 [2.45-14.11] vs. 2.24 [0.67-4.71], p = 0.0390). This was not observed in CoA and controls. Conclusion: AoA was associated with the metabolic syndrome and its related pro-inflammatory endocrine and cytokine status. This may suggest adipose tissue derived inflammatory markers play a role in the pathophysiology of AoA.

An Elevated METS-IR Index Is Associated With Higher Asthma Morbidity and Earlier Age of First Asthma in US Adults: Results Based on a Cross-Sectional Study

“…We showed significant positive correlations in age, gender, race, hypertension, diabetes and presence of blood relatives with asthma subgroups, which also indicates the prevalence of METS-IR index use for asthma population. Furthermore, we observed that increasing age, females, hypertensive, and diabetic populations have higher prevalences, which is in accordance with previous findings ( 12 , 22 – 25 )…”

“…We showed significant positive correlations in age, gender, race, hypertension, diabetes and presence of blood relatives with asthma subgroups, which also indicates the prevalence of METS-IR index use for asthma population. Furthermore, we observed that increasing age, females, hypertensive, and diabetic populations have higher prevalences, which is in accordance with previous findings (12,(22)(23)(24)(25) According to epidemiological studies, asthma is a heterogeneous disease, and there are several clinical subgroups depending on age of onset, duration of disease, and clinical features (26). Literature indicates that the longer a person suffers from asthma, the more likely they are to decline in respiratory function and their prognosis will be adverse (27).…”

The “Asthma-Polycystic Ovary Overlap Syndrome” and the Therapeutic Role of Myo-Inositol

“…The prevalence of metabolic syndrome is elevated in asthma patients [ 53 ]. Although the correlation between asthma and metabolic syndrome needs to be cleared, it may be influenced by various factors, including high BMI, increased resistin levels, dyslipidemia, and mitochondrial dysfunction [ 54 , 55 , 56 ].…”

Hidden Comorbidities in Asthma: A Perspective for a Personalized Approach

“…The prevalence of metabolic syndrome among patients with asthma is estimated to be 25% [ 91 ]. A recent study has shown that metabolic syndrome is more prevalent in asthma patients compared to controls, and that the onset of asthma in adulthood is associated with metabolic syndrome, even when adjusted for age, sex, body mass index and smoking history [ 92 ]. Among the components of metabolic syndrome, two are mainly associated with an increased risk of incident asthma in adults: high waist circumference and elevated glucose or diabetes.…”