Impaired glucose metabolism and bronchial hyperresponsiveness in obese prepubertal asthmatic children

Karampatakis, Nikolaos; Κarampatakis, Theodoros; Galli-Tsinopoulou, Assimina; Kotanidou, Eleni P; Tsergouli, Katerina; Eboriadou-Petikopoulou, Maria; Haidopoulou, Katerina

doi:10.1002/ppul.23516

Cited by 33 publications

(22 citation statements)

References 27 publications

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“…Different human studies analyzed the prevalence of insulin resistance (IR) among the asthmatic pediatric population, finding a negative correlation with lung function independently from BMI and obesity [ 4 , 5 , 17 , 18 , 79 ]. A possible explanation could be that IR promotes the development of a Th1 inflammatory background through the production of many cytokines, such as IL-6 and TNFα [ 4 ].…”

Section: Different Clinical Subtypes Of the Obese-asthmatic Phenotmentioning

confidence: 99%

Asthma and Obesity in Children

et al. 2020

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Asthma and obesity are two major chronic diseases in children and adolescents. Recent scientific evidence points out a causative role of obesity in asthma predisposition. However, studies assessing the real impact of excessive weight gain on lung function in children have shown heterogeneous results. In this review, the pathological mechanisms linking obesity and development of asthma in children are summarized and factors influencing this relationship are evaluated. Common disease modifying factors including age, sex, ethnicity, development of atopic conditions, and metabolic alterations significantly affect the onset and phenotypic characteristics of asthma. Given this, the impact of these several factors on the obesity–asthma link were considered, and from revision of the literature we suggest the possibility to define three main clinical subtypes on the basis of epidemiological data and physiological–molecular pathways: obese-asthmatic and atopy, obese-asthmatic and insulin-resistance, and obese-asthmatic and dyslipidemia. The hypothesis of the different clinical subtypes characterizing a unique phenotype might have an important impact for both future clinical management and research priorities. This might imply the necessity to study the obese asthmatic child with a “multidisciplinary approach”, evaluating the endocrinological and pneumological aspects simultaneously. This different approach might also make it possible to intervene earlier in a specific manner, possibly with a personalized and tailored treatment. Surely this hypothesis needs longitudinal and well-conducted future studies to be validated.

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Section: Different Clinical Subtypes Of the Obese-asthmatic Phenotmentioning

confidence: 99%

Asthma and Obesity in Children

et al. 2020

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“…More recently, obesity was shown to be associated with airway hyper-responsiveness (AHR) in children with asthma and coexisting insulin resistance 63 , but not in those with asthma but no insulin resistance. This could partly explain why some prior reports found no association between obesity and AHR.…”

Section: Insulin Resistance and The Metabolic Syndromementioning

confidence: 99%

The effect of obesity, weight gain, and weight loss on asthma inception and control

Forno

Celedón

2017

Current Opinion in Allergy &Amp; Clinical Immunology

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Purpose of the review There is ample and growing evidence that obesity increases the risk of asthma and morbidity from asthma. Here we review recent clinical evidence supporting a causal link between obesity and asthma, and the mechanisms that may lead to “obese asthma”. Recent findings While in some children obesity and asthma simply co-occur, those with “obese asthma” have increased asthma severity, lower quality of life, and reduced medication response. Underlying mechanistic pathways may include anatomical changes of the airways such as obstruction and dysanapsis; systemic inflammation; production of adipokines; impaired glucose-insulin metabolism; altered nutrient levels; genetic and epigenetic changes; and alterations in the airway and/or gut microbiome. A few small studies have shown that weight loss interventions may lead to improvements in asthma outcomes, but thus far research on therapeutic interventions for these children has been limited. Summary Obesity increases the risk of asthma –and worsens asthma severity or control– via multiple mechanisms. “Obese asthma” is a complex, multifactorial phenotype in children. Obesity and its complications must be managed as part of the treatment of asthma in obese children.

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“…Инсулинорезистентность и метаболический синдром были ассоциированы со снижением функциональных показателей легких у подростков с астмой или без, но ýффект был более выражен среди пациентов с астмой (ОФВ1 / ФЖЕЛ на 10% ниже, чем у здоровых подростков) [54]. Позднее было показано, что ожирение связано с гиперчувствительностью дыхательных путей у детей с астмой и инсулинорезистентностью, но не у пациентов с астмой и без инсулинорезистентности [55]. Потенциальные механизмы влияния резистентности к инсулину на развитие и течение астмы включают дисбаланс Th1-Th2 иммунного ответа, повышенную аллергическую сенсибилизацию, оксидативный стресс, дисфункцию гладких мышц дыхательных путей, пролиферацию фибробластов и повреждение ýпителия дыхательных путей [56][57][58][59][60].…”

Section: инсулинорезистентность и метаболический синдромunclassified

Asthma and obesity in children: what do we know?

et al. 2019

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The results of a large number of studies indicate the relationship of obesity and bronchial asthma in children. The review highlights the mechanisms of development of the so-called obese asthma: morphological changes in the respiratory tract, systemic inflammation, adipokine production, impaired glucose and insulin metabolism, genetic and epigenetic factors, changes in the microbiome of the respiratory tract and(or) intestines. The relationship of asthma and obesity can have both a genetic basis and can occur under the influence of a complex of pathogenic factors, and they can be especially important at the “early programming” stage. Obesity increases the risk of asthma development, and in patients with existing asthma due to a number of mechanisms it increases the severity or makes it difficult to achieve control of asthma. Studies showed that patients with obese asthma are distinguished by a more severe course of the disease, poor quality of life and a decreased response to therapy for asthma. Weight loss in children with asthma can lead to an improved well-being of patients, but data on the effectiveness of therapeutic interventions in these children is limited. Comorbidity of asthma and obesity is a complex multifactorial phenotype in children, which requires further study. Being overweight or obese needs to be taken into account as part of asthma treatment in this category of patients.

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Impaired glucose metabolism and bronchial hyperresponsiveness in obese prepubertal asthmatic children

Abstract: Our findings suggest that obesity per se does not correlate to airway hyperreactivity unless it is accompanied by glucose intolerance and insulin resistance. Pediatr Pulmonol. 2017;52:160-166. © 2016 Wiley Periodicals, Inc.

Cited by 33 publications

References 27 publications

Asthma and Obesity in Children

Asthma and Obesity in Children

The effect of obesity, weight gain, and weight loss on asthma inception and control

Asthma and obesity in children: what do we know?

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