Association Between Prediabetes/Diabetes and Asthma Exacerbations in a Claims-Based Obese Asthma Cohort

Abstract

Background: Metabolic dysfunction may contribute to worsened asthma in obesity. The relationship between pre-diabetes and diabetes, metabolic conditions more common in obesity, with asthma outcomes is not well-characterized. Objective: We sought to determine the association between pre-diabetes/diabetes and asthma exacerbations in an obese asthma cohort. Methods: A retrospective cohort of US adults with obese asthma, age 18-64, was created from a claims-based health services database spanning 2010-2015. Individuals with a hemoglobin A1c (HbA1c) measurement were identified, categorized as within normal (<5.6%), pre-diabetes (5.7-6.4%), and diabetes (≥6.5%) ranges. Exacerbations, defined as asthma-related hospitalization, emergency department visit, or corticosteroid prescription ±14 days of an asthma-related outpatient visit, were ascertained. Associations were fit with zero-inflated negative binomial models, adjusted for age, sex, region, smoking, medication use, and comorbidities. Results: 5,722 individuals were identified. Higher HgbA1c was associated with higher asthma exacerbation rates. In the fully-adjusted model, compared to individuals with normal HbA1c, those

Novel Comprehensive Bioinformatics Approaches to Determine the Molecular Genetic Susceptibility Profile of Moderate and Severe Asthma

“…INSR has a potential role in mediating insulin-like growth factor 2 (IGF2) signaling and therefore regulates cell proliferation, growth, migration, differentiation, and survival. It was reported that, INSR has a high correlation with asthma and diabetes [32,33]. Similarly, I have found that discoidin domain receptor 1 (DDR1/PTK3) is strongly linked to chronic obstructive pulmonary disease (COPD), a type of obstructive pulmonary disease typified by having long-term respiratory problems and a weak airflow [34].…”

Physiological Network From Anthropometric and Blood Test Biomarkers

“…For example, it has become clear that the simultaneous occurrence of diseases in the same individual (comorbidity) occurs more often than would be expected from the individual prevalence of each disease by chance alone ( Alberti et al, 2009 ). Additionally, when a comorbid state is present, the clinical expression of each individual disease is usually more difficult to treat and associated with worsened outcomes ( Wu et al, 2019 ). Although these observations are common in medical practice, relatively few health conditions are regarded with an extensive perspective.…”

“…Although these observations are common in medical practice, relatively few health conditions are regarded with an extensive perspective. Some of the most common examples are the metabolic syndrome ( Alberti et al, 2009 ), and the asthma-obesity-diabetes triad ( Wu et al, 2019 ). Mainstream methodology in disease diagnosis and disease treatment employs a reductionist approach to physiology, where at most two variables are studied simultaneously.…”

Data_Sheet_1.PDF

“…For example, it has become clear that the simultaneous occurrence of diseases in the same individual (comorbidity) occurs more often than would be expected from the individual prevalence of each disease by chance alone (Alberti et al, 2009). Additionally, when a comorbid state is present, the clinical expression of each individual disease is usually more difficult to treat and associated with worsened outcomes (Wu et al, 2019). Although these observations are common in medical practice, relatively few health conditions are regarded with an extensive perspective.…”

“…Although these observations are common in medical practice, relatively few health conditions are regarded with an extensive perspective. Some of the most common examples are the metabolic syndrome (Alberti et al, 2009), and the asthma-obesity-diabetes triad (Wu et al, 2019). Mainstream methodology in disease diagnosis and disease treatment employs a reductionist approach to physiology, where at most two variables are studied simultaneously.…”