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Lotfata A, Moosazadeh M, Helbich M, Hoseini B. Socioeconomic and environmental determinants of asthma prevalence: a cross-sectional study at the U.S. County level using geographically weighted random forests. Int J Health Geogr 2023; 22:18. [PMID: 37563691 PMCID: PMC10413687 DOI: 10.1186/s12942-023-00343-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Accepted: 08/04/2023] [Indexed: 08/12/2023] Open
Abstract
BACKGROUND Some studies have established associations between the prevalence of new-onset asthma and asthma exacerbation and socioeconomic and environmental determinants. However, research remains limited concerning the shape of these associations, the importance of the risk factors, and how these factors vary geographically. OBJECTIVE We aimed (1) to examine ecological associations between asthma prevalence and multiple socio-physical determinants in the United States; and (2) to assess geographic variations in their relative importance. METHODS Our study design is cross sectional based on county-level data for 2020 across the United States. We obtained self-reported asthma prevalence data of adults aged 18 years or older for each county. We applied conventional and geographically weighted random forest (GWRF) to investigate the associations between asthma prevalence and socioeconomic (e.g., poverty) and environmental determinants (e.g., air pollution and green space). To enhance the interpretability of the GWRF, we (1) assessed the shape of the associations through partial dependence plots, (2) ranked the determinants according to their global importance scores, and (3) mapped the local variable importance spatially. RESULTS Of the 3059 counties, the average asthma prevalence was 9.9 (standard deviation ± 0.99). The GWRF outperformed the conventional random forest. We found an indication, for example, that temperature was inversely associated with asthma prevalence, while poverty showed positive associations. The partial dependence plots showed that these associations had a non-linear shape. Ranking the socio-physical environmental factors concerning their global importance showed that smoking prevalence and depression prevalence were most relevant, while green space and limited language were of minor relevance. The local variable importance measures showed striking geographical differences. CONCLUSION Our findings strengthen the evidence that socio-physical environments play a role in explaining asthma prevalence, but their relevance seems to vary geographically. The results are vital for implementing future asthma prevention programs that should be tailor-made for specific areas.
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Affiliation(s)
- Aynaz Lotfata
- Department of Pathology, Microbiology, and Immunology, School of Veterinary Medicine, University of California, Davis, CA, USA
| | - Mohammad Moosazadeh
- Integrated Engineering, Department of Environmental Science and Engineering, College of Engineering, KyungHee University, Yongin, 446-701, Republic of Korea
| | - Marco Helbich
- Department of Human Geography and Spatial Planning, Faculty of Geosciences, University Utrecht, Utrecht, The Netherlands
| | - Benyamin Hoseini
- Pharmaceutical Research Center, Pharmaceutical Technology Institute, Mashhad University of Medical Sciences, Mashhad, Iran.
- Department of Medical Informatics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
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Khalil M, Shanmugam H, Abdallah H, John Britto JS, Galerati I, Gómez-Ambrosi J, Frühbeck G, Portincasa P. The Potential of the Mediterranean Diet to Improve Mitochondrial Function in Experimental Models of Obesity and Metabolic Syndrome. Nutrients 2022; 14:3112. [PMID: 35956289 PMCID: PMC9370259 DOI: 10.3390/nu14153112] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2022] [Revised: 07/24/2022] [Accepted: 07/25/2022] [Indexed: 01/27/2023] Open
Abstract
The abnormal expansion of body fat paves the way for several metabolic abnormalities including overweight, obesity, and diabetes, which ultimately cluster under the umbrella of metabolic syndrome (MetS). Patients with MetS are at an increased risk of cardiovascular disease, morbidity, and mortality. The coexistence of distinct metabolic abnormalities is associated with the release of pro-inflammatory adipocytokines, as components of low-to-medium grade systemic inflammation and increased oxidative stress. Adopting healthy lifestyles, by using appropriate dietary regimens, contributes to the prevention and treatment of MetS. Metabolic abnormalities can influence the function and energetic capacity of mitochondria, as observed in many obesity-related cardio-metabolic disorders. There are preclinical studies both in cellular and animal models, as well as clinical studies, dealing with distinct nutrients of the Mediterranean diet (MD) and dysfunctional mitochondria in obesity and MetS. The term "Mitochondria nutrients" has been adopted in recent years, and it depicts the adequate nutrients to keep proper mitochondrial function. Different experimental models show that components of the MD, including polyphenols, plant-derived compounds, and polyunsaturated fatty acids, can improve mitochondrial metabolism, biogenesis, and antioxidant capacity. Such effects are valuable to counteract the mitochondrial dysfunction associated with obesity-related abnormalities and can represent the beneficial feature of polyphenols-enriched olive oil, vegetables, nuts, fish, and plant-based foods, as the main components of the MD. Thus, developing mitochondria-targeting nutrients and natural agents for MetS treatment and/or prevention is a logical strategy to decrease the burden of disease and medications at a later stage. In this comprehensive review, we discuss the effects of the MD and its bioactive components on improving mitochondrial structure and activity.
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Affiliation(s)
- Mohamad Khalil
- Clinica Medica “A. Murri”, Department of Biomedical Sciences & Human Oncology, University of Bari Medical School, Piazza Giulio Cesare 11, 70124 Bari, Italy; (M.K.); (H.S.); (H.A.); (J.S.J.B.); (I.G.)
- Department of Soil, Plant and Food Sciences, University of Bari Aldo Moro, Via Amendola 165/a, 70126 Bari, Italy
| | - Harshitha Shanmugam
- Clinica Medica “A. Murri”, Department of Biomedical Sciences & Human Oncology, University of Bari Medical School, Piazza Giulio Cesare 11, 70124 Bari, Italy; (M.K.); (H.S.); (H.A.); (J.S.J.B.); (I.G.)
| | - Hala Abdallah
- Clinica Medica “A. Murri”, Department of Biomedical Sciences & Human Oncology, University of Bari Medical School, Piazza Giulio Cesare 11, 70124 Bari, Italy; (M.K.); (H.S.); (H.A.); (J.S.J.B.); (I.G.)
| | - Jerlin Stephy John Britto
- Clinica Medica “A. Murri”, Department of Biomedical Sciences & Human Oncology, University of Bari Medical School, Piazza Giulio Cesare 11, 70124 Bari, Italy; (M.K.); (H.S.); (H.A.); (J.S.J.B.); (I.G.)
| | - Ilaria Galerati
- Clinica Medica “A. Murri”, Department of Biomedical Sciences & Human Oncology, University of Bari Medical School, Piazza Giulio Cesare 11, 70124 Bari, Italy; (M.K.); (H.S.); (H.A.); (J.S.J.B.); (I.G.)
| | - Javier Gómez-Ambrosi
- Metabolic Research Laboratory, Clínica Universidad de Navarra, 31008 Pamplona, Spain; (J.G.-A.); (G.F.)
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), ISCIII, 28029 Pamplona, Spain
- Obesity and Adipobiology Group, Instituto de Investigación Sanitaria de Navarra (IdiSNA), 31008 Pamplona, Spain
| | - Gema Frühbeck
- Metabolic Research Laboratory, Clínica Universidad de Navarra, 31008 Pamplona, Spain; (J.G.-A.); (G.F.)
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), ISCIII, 28029 Pamplona, Spain
- Obesity and Adipobiology Group, Instituto de Investigación Sanitaria de Navarra (IdiSNA), 31008 Pamplona, Spain
- Department of Endocrinology & Nutrition, Clínica Universidad de Navarra, 31008 Pamplona, Spain
| | - Piero Portincasa
- Clinica Medica “A. Murri”, Department of Biomedical Sciences & Human Oncology, University of Bari Medical School, Piazza Giulio Cesare 11, 70124 Bari, Italy; (M.K.); (H.S.); (H.A.); (J.S.J.B.); (I.G.)
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Cao S, Wen D, Li S, Guo Q, Duan X, Gong J, Xu X, Meng X, Qin N, Wang B, Zhang JJ. Changes in children's lung function over two decades in relation to socioeconomic, parental and household factors in Wuhan, China. J Thorac Dis 2021; 13:4601-4613. [PMID: 34422385 PMCID: PMC8339758 DOI: 10.21037/jtd-21-158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 06/03/2021] [Indexed: 11/06/2022]
Abstract
Background It is important to identify risk and beneficial factors for children's lung function. This study aims to ascertain potential changes in children's lung function in relation to changes in socioeconomic, parental and household factors, based on a comparison between two periods spanning 25 years in Wuhan, the largest metropolis in central China. Methods In two cross-sectional studies, lung function measurements and questionnaire surveys were conducted on school-age children in 1993-1996 (Period I) and in 2018 (Period II). Children of 6-12 years old from elementary schools were selected by a multistage sampling method. Demographic information, socioeconomic status, feeding methods, parental illness and behavior patterns, as well as household characteristics, were collected through a questionnaire survey. Spirometric lung function was measured, including forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), forced expiratory flow at 25% and 75% of the pulmonary volume (FEF25-75), and peak expiratory flow (PEF). Wilcoxon analysis of variances was used to assess the differences in lung function indexes between Period I and Period II. Multiple linear regression models were used to estimate the association of lung function with regard to socioeconomic, parental and household factors, respectively. Results Significant prevalence reductions were observed for household coal use, paternal smoking and maternal asthma, while the prevalence increased significantly for children sleeping in their own rooms or own beds and breastfeeding, ventilation use during cooking, and parental education level from Period I to Period II. When adjusted for age, height, weight, sex and other factors assessed in the study, children had significant lower values of FVC, FEV1, and PEF in Period II than in Period I. Enclosed kitchen was significantly associated with lower lung function in children in Period I. Urban living condition and higher maternal education level were each associated with a higher FVC, while father having no fixed income was associated with a lower FVC and a lower FEV1, respectively, in Period II. In comparison with Period I, the beneficial impact of urban living and that of breastfeeding were enhanced and the detrimental effect of poor household condition was weakened in Period II. Conclusions Lung function was lower in 2018 than in 1993-1996 in school-age children living in Wuhan. Although improvements in urban living and household environmental conditions as well as increased breastfeeding in Period II could have contributed to increased lung function, other unmeasured risk factors may have played a more dominant role in leading to a net decrease in lung function from Period I to Period II. Future studies are needed to identify these risk factors.
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Affiliation(s)
- Suzhen Cao
- Beijing Key Laboratory of Resource-oriented Treatment of Industrial Pollutants, School of Energy and Environmental Engineering, University of Science and Technology Beijing, Beijing, China
| | - Dongsen Wen
- Beijing Key Laboratory of Resource-oriented Treatment of Industrial Pollutants, School of Energy and Environmental Engineering, University of Science and Technology Beijing, Beijing, China
| | - Sai Li
- Beijing Key Laboratory of Resource-oriented Treatment of Industrial Pollutants, School of Energy and Environmental Engineering, University of Science and Technology Beijing, Beijing, China
| | - Qian Guo
- Beijing Key Laboratory of Resource-oriented Treatment of Industrial Pollutants, School of Energy and Environmental Engineering, University of Science and Technology Beijing, Beijing, China
| | - Xiaoli Duan
- Beijing Key Laboratory of Resource-oriented Treatment of Industrial Pollutants, School of Energy and Environmental Engineering, University of Science and Technology Beijing, Beijing, China
| | - Jicheng Gong
- Beijing Innovation Center for Engineering Science and Advanced Technology, State Key Joint Laboratory for Environmental Simulation and Pollution Control, College of Environmental Sciences and Engineering, And Center for Environment and Health, Peking University, Beijing, China
| | - Xiangyu Xu
- Beijing Key Laboratory of Resource-oriented Treatment of Industrial Pollutants, School of Energy and Environmental Engineering, University of Science and Technology Beijing, Beijing, China
| | - Xin Meng
- Beijing Innovation Center for Engineering Science and Advanced Technology, State Key Joint Laboratory for Environmental Simulation and Pollution Control, College of Environmental Sciences and Engineering, And Center for Environment and Health, Peking University, Beijing, China
| | - Ning Qin
- Beijing Key Laboratory of Resource-oriented Treatment of Industrial Pollutants, School of Energy and Environmental Engineering, University of Science and Technology Beijing, Beijing, China
| | - Beibei Wang
- Beijing Key Laboratory of Resource-oriented Treatment of Industrial Pollutants, School of Energy and Environmental Engineering, University of Science and Technology Beijing, Beijing, China
| | - Junfeng Jim Zhang
- Nicholas School of the Environment and Duke Global Health Institute, Duke University, Durham, USA.,Global Health Research Center, Duke Kunshan University, Kunshan, China.,Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
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Gu C, Upchurch K, Mamaril-Davis J, Wiest M, Lanier B, Millard M, Turner J, Joo H, Oh S. Obesity influences the outcomes of anti-IgE (omalizumab) therapy of asthma. Clin Exp Allergy 2020; 50:1196-1199. [PMID: 32585057 DOI: 10.1111/cea.13696] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 06/12/2020] [Accepted: 06/17/2020] [Indexed: 01/10/2023]
Affiliation(s)
- Chao Gu
- Department of Immunology, Mayo Clinic, Scottsdale, Arizona, USA
| | | | | | - Matthew Wiest
- Department of Immunology, Mayo Clinic, Scottsdale, Arizona, USA.,Institute for Biomedical Studies, Baylor University, Waco, Texas, USA
| | - Bobby Lanier
- North Texas Institute for Clinical Trials, Ft Worth, Texas, USA
| | - Mark Millard
- Martha Foster Lung Care Center, Baylor University Medical Center, Dallas, Texas, USA
| | - Jacob Turner
- Department of Mathematics and Statistics, Stephen F. Austin State University, Nacogdoches, Texas, USA
| | - HyeMee Joo
- Department of Immunology, Mayo Clinic, Scottsdale, Arizona, USA.,Institute for Biomedical Studies, Baylor University, Waco, Texas, USA
| | - SangKon Oh
- Department of Immunology, Mayo Clinic, Scottsdale, Arizona, USA.,Institute for Biomedical Studies, Baylor University, Waco, Texas, USA
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Mikalsen IB, Byberg K, Forman MR, Øymar K. Adipokines in adolescence; the associations with lung function and atopy - A cross-sectional study. Respir Med 2020; 170:106063. [PMID: 32705985 DOI: 10.1016/j.rmed.2020.106063] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 06/07/2020] [Accepted: 06/08/2020] [Indexed: 12/31/2022]
Abstract
Both inflammatory and mechanical effects have been proposed to explain the increased risk of asthma and reduced lung function observed in obese children and adults. The evidence regarding the potential role of obesity in the aetiology of atopy and allergy is more conflicting. The adipokines leptin and adiponectin are inflammatory markers of fat metabolism which may be involved in explaining the increased risk of asthma and reduced lung function in obese children and adults. In this cross-sectional study, we aimed to study how adiponectin and leptin were associated with lung function and atopic sensitisation in adolescents. The study included 384 children at mean age 12.9 years with measurements of adiponectin, leptin, lung function and atopic sensitisation. Adiponectin and leptin levels were measured in serum, lung function was measured by spirometry and atopic sensitisation was measured by serum specific Immunoglobulin E. In linear regression models, leptin was negatively associated with forced vital capacity (FVC) (Beta: -4.13; 95% Confidence Interval: -5.83, -2.44, P < 0.001) and forced expiratory volume in the first second (FEV1) (-3.74; -5.39, -2.09, P < 0.001) after adjusting for body mass index (BMI) and other covariates. No associations were observed between adiponectin and lung function or between leptin or adiponectin and atopic sensitisation. In this cross-sectional analysis of adolescents in all weight classes, leptin was negatively associated with FEV1 and FVC independent of BMI, but no associations were found between adiponectin and lung function. The results suggest that leptin may have a functional role in the airways of healthy children.
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Affiliation(s)
- Ingvild Bruun Mikalsen
- Department of Pediatrics, Stavanger University Hospital, Stavanger, Norway; Department of Clinical Science, University of Bergen, Norway.
| | - Kristine Byberg
- Department of Pediatrics, Stavanger University Hospital, Stavanger, Norway
| | - Michele R Forman
- Department of Nutritional Sciences, Purdue University, West Lafayette, IN, USA
| | - Knut Øymar
- Department of Pediatrics, Stavanger University Hospital, Stavanger, Norway; Department of Clinical Science, University of Bergen, Norway
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Mhamed SC, Saad AB, Migaou A, Fahem N, Rouatbi N, Joobeur S. [Asthma and obesity: relationship and therapeutic implications in patients with asthma at the Department of Pneumology in Monastir, Tunisia]. Pan Afr Med J 2020; 36:49. [PMID: 32774625 PMCID: PMC7388602 DOI: 10.11604/pamj.2020.36.49.21098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Accepted: 03/15/2020] [Indexed: 11/11/2022] Open
Abstract
Introduction L’obésité et l’asthme sont deux maladies chroniques touchant des millions d’individus à travers le monde. La présence d’un lien de causalité est suggérée. L'objectif de notre travail est d'étudier le profil de l’asthmatique obèse et de déterminer la relation entre les différents paramètres de sévérité de l’asthme avec les grades de l’obésité. Méthodes Il s'agit d'une étude rétrospective, monocentrique, analytique menée au Service de Pneumologie et d’Allergologie au CHU Fattouma Bourguiba de Monastir portant sur 450 asthmatiques, ayant un indice de masse corporelle (IMC) ≥ 30 kg/m2 avec un recul d’au moins 6 mois. Résultats L’âge moyen au moment du diagnostic était de 45±12.8 ans. L’IMC moyen était de 34,8±4,2 kg/m2. L’asthme était bien contrôlé chez 55,3% des patients. Des critères de sévérité étaient notés dans 37.4% des cas. Selon GINA 2016, 24,2% sont traités par le palier 4. Deux phénotypes de l’asthme associé à l’obésité étaient notés. Le premier phénotype (52,4%) était caractérisé par un asthme à début précoce, associé à une fréquence plus élevée d’allergie, et des manifestations d'atopie. Le deuxième (47,6 %) était caractérisé par un asthme à début tardif, fréquemment associé au sexe féminin et un taux plus élevé de comorbidités et d’hospitalisations. Les obèses de grade II et III avaient un déficit ventilatoire important (CVF: p = 0,002 et VEMS: p = 0,007). Conclusion L’obésité est l’un des facteurs clefs impliqués dans le mauvais contrôle de l’asthme. Sa prise en charge, qui n'est pas encore codifiée, doit être multidisciplinaire.
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Affiliation(s)
- Saousen Cheikh Mhamed
- Service de Pneumologie et d'Allergologie, Hôpital Universitaire Fattouma Bourguiba, Rue 1 juin, 5000 Monastir, Tunisie
| | - Ahmed Ben Saad
- Service de Pneumologie et d'Allergologie, Hôpital Universitaire Fattouma Bourguiba, Rue 1 juin, 5000 Monastir, Tunisie
| | - Asma Migaou
- Service de Pneumologie et d'Allergologie, Hôpital Universitaire Fattouma Bourguiba, Rue 1 juin, 5000 Monastir, Tunisie
| | - Nesrine Fahem
- Service de Pneumologie et d'Allergologie, Hôpital Universitaire Fattouma Bourguiba, Rue 1 juin, 5000 Monastir, Tunisie
| | - Naceur Rouatbi
- Service de Pneumologie et d'Allergologie, Hôpital Universitaire Fattouma Bourguiba, Rue 1 juin, 5000 Monastir, Tunisie
| | - Samah Joobeur
- Service de Pneumologie et d'Allergologie, Hôpital Universitaire Fattouma Bourguiba, Rue 1 juin, 5000 Monastir, Tunisie
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Hu Z, Song X, Hu K, Ruan Y, Zeng F. Association between sleep duration and asthma in different weight statuses (CHNS 2009-2015). Sleep Breath 2020; 25:493-502. [PMID: 32335852 DOI: 10.1007/s11325-020-02081-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 03/28/2020] [Accepted: 04/04/2020] [Indexed: 11/26/2022]
Abstract
PURPOSE Inadequate sleep duration affects asthma and weight. The associations among sleep duration, asthma, and different weight statuses in the Chinese population need to be further determined. METHODS The study included 32,776 Chinese adults from the China Health and Nutrition Survey during 2009-2015. Self-reported sleep duration was classified into three groups: ≤ 6 h (short), 7 to 8 h (optimal), and ≥ 9 h (long). Age, sex, smoking, drinking alcohol, and residence location were adjusted as potential confounding factors in a generalized estimating equations model. RESULTS The prevalence of asthma in the Chinese population was approximately 1.17% (383/32,776). Asthmatics were associated with shorter sleep duration and higher indices of central obesity (mean waist circumference, waist to height ratio, and conicity index) than the population without asthma. After adjusting for potential confounding factors, odds ratios (ORs) indicated positive associations between sleep duration and asthma (short vs optimal, adjusted OR = 1.74, 95%CI 1.33, 2.26; and long vs optimal, adjusted OR = 1.51, 95%CI 1.18, 1.93). When stratified by weight status, the participants with central obesity showed highest prevalence of asthma among the three sleep duration groups. With the adjustment of confounding factors, underweight and obesity grouped by waist to height ratio and conicity index remained associated with higher risk of asthma among short and long sleepers than in optimal sleepers. CONCLUSIONS Short and long sleepers with central obesity and underweight status were associated with significantly higher prevalence of asthma than optimal sleepers in Chinese adults.
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Affiliation(s)
- Zhigang Hu
- Department of Respiratory and Critical Care Medicine, Renmin Hospital of Wuhan University, Zhangzhidong Road No. 99, Wuhan, 430060, China
- Department of Respiratory and Critical Care Medicine, The first College of Clinical Medicine science, China Three Gorges University, No. 183 Yiling Road, Yichang, 443003, People's Republic of China
- Department of Respiratory and Critical Care Medicine, Yichang Central People's Hospital, Yichang, China
| | - Xinyu Song
- Department of Respiratory and Critical Care Medicine, The first College of Clinical Medicine science, China Three Gorges University, No. 183 Yiling Road, Yichang, 443003, People's Republic of China
- Department of Respiratory and Critical Care Medicine, Yichang Central People's Hospital, Yichang, China
| | - Ke Hu
- Department of Respiratory and Critical Care Medicine, Renmin Hospital of Wuhan University, Zhangzhidong Road No. 99, Wuhan, 430060, China.
| | - Yushu Ruan
- Department of Respiratory and Critical Care Medicine, The first College of Clinical Medicine science, China Three Gorges University, No. 183 Yiling Road, Yichang, 443003, People's Republic of China
- Department of Respiratory and Critical Care Medicine, Yichang Central People's Hospital, Yichang, China
| | - Fanjun Zeng
- Department of Respiratory and Critical Care Medicine, The first College of Clinical Medicine science, China Three Gorges University, No. 183 Yiling Road, Yichang, 443003, People's Republic of China
- Department of Respiratory and Critical Care Medicine, Yichang Central People's Hospital, Yichang, China
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Differences in respiratory consultations in primary care between underweight, normal-weight, and overweight children. NPJ Prim Care Respir Med 2019; 29:15. [PMID: 31053706 PMCID: PMC6499776 DOI: 10.1038/s41533-019-0131-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Accepted: 04/16/2019] [Indexed: 11/08/2022] Open
Abstract
This prospective cohort study investigates whether the suggested association between weight status and respiratory complaints in open populations is also reflected in the frequency of consultations for respiratory complaints at the general practice. Children aged 2–18 years presenting at one of the participating general practices in the Netherlands could be included. Electronic medical files were used to extract data on consultations. Logistic regression analyses and negative binomial regression analyses were used to assess the associations between weight status and the presence, and frequency of respiratory consultations, respectively, during 2-year follow-up. Subgroup analyses were performed in children aged 2–6, 6–12, and 12–18 years old. Of the 617 children, 115 (18.6%) were underweight, 391 (63.4%) were normal-weight, and 111 (18%) were overweight. Respiratory consultations were not more prevalent in underweight children compared to normal-weight children (odds ratio (OR) 0.87, 95% confidence inteval (CI) 0.64–1.10), and in overweight children compared to normal-weight children (OR 1.33, 95% CI 0.99–1.77). Overweight children aged 12–18 years had more respiratory consultations (OR 2.14, 95% CI 1.14–4.01), more asthma-like consultations (OR 3.94, 95%CI 1.20–12.88), and more respiratory allergy-related consultations (OR 3.14, 95% CI 1.25–7.86) than normal-weight children. General practitioners should pay attention to weight loss as part of the treatment of respiratory complaints in overweight and obese children.
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Talaminos Barroso A, Márquez Martín E, Roa Romero LM, Ortega Ruiz F. Factors Affecting Lung Function: A Review of the Literature. ACTA ACUST UNITED AC 2018. [DOI: 10.1016/j.arbr.2018.04.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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10
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Talaminos Barroso A, Márquez Martín E, Roa Romero LM, Ortega Ruiz F. Factors Affecting Lung Function: A Review of the Literature. Arch Bronconeumol 2018; 54:327-332. [PMID: 29496283 DOI: 10.1016/j.arbres.2018.01.030] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Revised: 01/26/2018] [Accepted: 01/30/2018] [Indexed: 11/30/2022]
Abstract
Lung function reference values are traditionally based on anthropometric factors, such as weight, height, sex, and age. FVC and FEV1 decline with age, while volumes and capacities, such as RV and FRC, increase. TLC, VC, RV, FVC and FEV1 are affected by height, since they are proportional to body size. This means that a tall individual will experience greater decrease in lung volumes as they get older. Some variables, such as FRC and ERV, decline exponentially with an increase in weight, to the extent that tidal volume in morbidly obese patients can be close to that of RV. Men have longer airways than women, causing greater specific resistance in the respiratory tract. The increased work of breathing to increase ventilation among women means that their consumption of oxygen is higher than men under similar conditions of physical intensity. Lung volumes are higher when the subject is standing than in other positions. DLCO is significantly higher in supine positions than in sitting or standing positions, but the difference between sitting and standing positions is not significant. Anthropometric characteristics are insufficient to explain differences in lung function between different ethnic groups, underlining the importance of considering other factors in addition to the conventional anthropometric measurements.
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Affiliation(s)
| | - Eduardo Márquez Martín
- Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío, Sevilla, España
| | - Laura María Roa Romero
- Departamento de Ingeniería Biomédica, Universidad de Sevilla, Sevilla, España; Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina, España
| | - Francisco Ortega Ruiz
- Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío, Sevilla, España; Centro de Investigación Biomédica en Red de Enfermedades Respiratorias CIBERES, España.
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Chong L, Zhang W, Yu G, Zhang H, Zhu L, Li H, Shao Y, Li C. High-fat-diet induces airway hyperresponsiveness partly through activating CD38 signaling pathway. Int Immunopharmacol 2018; 56:197-204. [PMID: 29414651 DOI: 10.1016/j.intimp.2018.01.033] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Revised: 01/19/2018] [Accepted: 01/22/2018] [Indexed: 01/05/2023]
Abstract
CD38 is a plasma membrane bound multifunctional enzyme. It can be activated by inflammatory cytokines such as tumor necrosis factor (TNF)-α, interleukin (IL)-13, inducing calcium responses to agonist in airway smooth muscle cells (ASMC). Previous studies have found that high-fat-diet (HFD) induced obesity exhibited innate airway hyperresponsiveness (AHR). This study aimed to detect the effect of CD38 signaling pathway on the AHR of overweight/obese mice. The HFD-fed mice exhibited a significantly higher baseline airway resistance (Rn), and the increasing rates of Rn responded to increasing doses of methacholine compared with the LFD-fed mice. High-fat-diet increased CD38 expressions both in lung tissues and primary cultured ASMCs. Besides, preincubation with TNF-α led to a higher expression of CD38 protein and increased intracellular calcium in ASMC of the HFD-fed mice. Furthermore, CD38 gene knockdown through transfection of CD38 siRNA decreased the concentration of intracellular calcium. Additionally, the upregulations of CD38 protein and CD38 mRNA were also found in the lung tissues of HFD-fed mice challenged by ovalbumin (OVA). Collectively, our findings demonstrated a role of CD38 signaling pathway on the AHR of obesity and might be a potential therapeutic target for treating difficult-to-control obese asthma phenotype.
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Affiliation(s)
- Lei Chong
- Institute of Pediatrics, National Key Clinical Specialty of Pediatric Respiratory Medicine, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Weixi Zhang
- Discipline of Pediatric Respiratory Medicine, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Gang Yu
- Discipline of Pediatric Respiratory Medicine, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Hailin Zhang
- Discipline of Pediatric Respiratory Medicine, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Lili Zhu
- Discipline of Pediatric Respiratory Medicine, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Haiyan Li
- Discipline of Pediatric Respiratory Medicine, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Youyou Shao
- Discipline of Pediatric Respiratory Medicine, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Changchong Li
- Discipline of Pediatric Respiratory Medicine, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.
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12
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Xu XW, Huang Y, Wang J, Zhang XL, Liang FM, Luo R. [Effect of obesity on pulmonary function in asthmatic children of different age groups]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2017; 19:519-523. [PMID: 28506341 PMCID: PMC7389131 DOI: 10.7499/j.issn.1008-8830.2017.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Accepted: 02/01/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE To study the effect of obesity on pulmonary function in newly diagnosed asthmatic children of different age groups. METHODS Two hundred and ninety-four children with newly diagnosed asthma were classified into preschool-age (<6 years) and school-age (6 to 12.5 years) groups. They were then classified into obese, overweight, and normal-weight subgroups based on their body mass index (BMI). All the children underwent pulmonary function tests, including large airway function tests [forced vital capacity (FVC%) and forced expiratory volume in one second (FEV1%)] and small airway function tests [maximal expiratory flow at 25% of vital capacity (MEF25%), maximal expiratory flow at 50% of vital capacity (MEF50%), and maximal expiratory flow at 75% of vital capacity (MEF75%)]. RESULTS The school-age group showed lower FEV1%, MEF25%, and MEF50% than the preschool-age group (P<0.05) after adjustment for sex and BMI. The normal-weight children in the school-age group had lower FEV1%, MEF25%, and MEF50% compared with their counterparts in the preschool-age group (P<0.05). The overweight children in the school-age group showed lower FVC% and MEF50% than those in the preschool-age group. However, all the pulmonary function parameters showed no significant differences between the obese children in the preschool-age and school-age groups. In the preschool-age group, FVC%, FEV1%, and MEF75% of the obese children were lower than those of the normal-weight children. In the school-age group, only FVC% and FEV1% showed differences between the obese and normal-weight children (P<0.05). CONCLUSIONS The effect of obesity on the pulmonary function varies with age in children with asthma, and the effect is more obvious in those of preschool age.
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Affiliation(s)
- Xiao-Wen Xu
- Respiratory Center, Children's Hospital of Chongqing Medical University/ Ministry of Education Key Laboratory of Child Development and Disorders/Chongqing Key Laboratory of Pediatrics/China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing 400014, China.
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13
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Lee EJ, Kim JH, Lee KH, Hong SC, Lee HS, Kang JW. New Allergen Sensitization Might be Associated with Increased Body Mass Index in Children. Am J Rhinol Allergy 2016; 30:124-7. [DOI: 10.2500/ajra.2016.30.4339] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Background Results of previous studies have shown a relationship between obesity and allergic diseases. However, concrete evidence about the association between obesity and allergies has been lacking. Objective The present study aimed to evaluate the potential association between body mass index (BMI) and the change in sensitization on skin-prick tests in children over a 2-year follow-up period. Methods Children in first and second grade from six elementary schools were recruited in 2010. The same participants, now in third and fourth grade, were recruited again in 2012. The enrolled children underwent skin-prick tests and physical examinations in 2010 and again in 2012. Results Four hundred fourteen children (boys to girls, 208 to 206) were included. Among 414 participants, 73 children showed new sensitization and 24 children showed negative conversion of allergic sensitization after 2 years. One hundred sixty-one children showed positive results on both tests, and 156 children showed negative results on both tests. The mean (standard deviation) change in BMI (1.09 ± 1.81 kg/m2) over a 2-year follow-up in newly sensitized children was significantly greater than that of other groups (p = 0.008). Conclusion Children who became newly sensitized to allergens tended to exhibit significant increases in BMI. Therefore, further evaluation of the relationship between obesity and allergy is needed.
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Affiliation(s)
- Eun Jung Lee
- Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, Korea
| | - Jeong Hong Kim
- The Environmental Health Center (Atopic Dermatitis and Allergic Rhinitis), Jeju National University School of Medicine, Jeju, South Korea
- Department of Otorhinolaryngology, Jeju National University Hospital, Jeju, South Korea
| | - Keun-Hwa Lee
- The Environmental Health Center (Atopic Dermatitis and Allergic Rhinitis), Jeju National University School of Medicine, Jeju, South Korea
| | - Seong-Chul Hong
- The Environmental Health Center (Atopic Dermatitis and Allergic Rhinitis), Jeju National University School of Medicine, Jeju, South Korea
| | - Hye-Sook Lee
- The Environmental Health Center (Atopic Dermatitis and Allergic Rhinitis), Jeju National University School of Medicine, Jeju, South Korea
| | - Ju Wan Kang
- Department of Otorhinolaryngology, Jeju National University Hospital, Jeju, South Korea
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14
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Singh S, Bodas M, Bhatraju NK, Pattnaik B, Gheware A, Parameswaran PK, Thompson M, Freeman M, Mabalirajan U, Gosens R, Ghosh B, Pabelick C, Linneberg A, Prakash YS, Agrawal A. Hyperinsulinemia adversely affects lung structure and function. Am J Physiol Lung Cell Mol Physiol 2016; 310:L837-45. [PMID: 26919895 DOI: 10.1152/ajplung.00091.2015] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2015] [Accepted: 02/12/2016] [Indexed: 12/13/2022] Open
Abstract
There is limited knowledge regarding the consequences of hyperinsulinemia on the lung. Given the increasing prevalence of obesity, insulin resistance, and epidemiological associations with asthma, this is a critical lacuna, more so with inhaled insulin on the horizon. Here, we demonstrate that insulin can adversely affect respiratory health. Insulin treatment (1 μg/ml) significantly (P < 0.05) increased the proliferation of primary human airway smooth muscle (ASM) cells and induced collagen release. Additionally, ASM cells showed a significant increase in calcium response and mitochondrial respiration upon insulin exposure. Mice administered intranasal insulin showed increased collagen deposition in the lungs as well as a significant increase in airway hyperresponsiveness. PI3K/Akt mediated activation of β-catenin, a positive regulator of epithelial-mesenchymal transition and fibrosis, was observed in the lungs of insulin-treated mice and lung cells. Our data suggests that hyperinsulinemia may have adverse effects on airway structure and function. Insulin-induced activation of β-catenin in lung tissue and the contractile effects on ASM cells may be causally related to the development of asthma-like phenotype.
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Affiliation(s)
- Suchita Singh
- Center of Excellence for Translational Research in Asthma and Lung Disease, CSIR-Institute of Genomics and Integrative Biology, New Delhi, India
| | - Manish Bodas
- Center of Excellence for Translational Research in Asthma and Lung Disease, CSIR-Institute of Genomics and Integrative Biology, New Delhi, India
| | - Naveen K Bhatraju
- Center of Excellence for Translational Research in Asthma and Lung Disease, CSIR-Institute of Genomics and Integrative Biology, New Delhi, India
| | - Bijay Pattnaik
- Center of Excellence for Translational Research in Asthma and Lung Disease, CSIR-Institute of Genomics and Integrative Biology, New Delhi, India
| | - Atish Gheware
- Center of Excellence for Translational Research in Asthma and Lung Disease, CSIR-Institute of Genomics and Integrative Biology, New Delhi, India
| | | | - Michael Thompson
- Departments of Anesthesiology and Physiology and Biomedical Engineering, Mayo Clinic, Rochester, Minnesota; and
| | - Michelle Freeman
- Departments of Anesthesiology and Physiology and Biomedical Engineering, Mayo Clinic, Rochester, Minnesota; and
| | - Ulaganathan Mabalirajan
- Center of Excellence for Translational Research in Asthma and Lung Disease, CSIR-Institute of Genomics and Integrative Biology, New Delhi, India
| | - Reinoud Gosens
- Department of Molecular Pharmacology, Groningen Research Institute for Asthma and COPD (GRIAC), University of Groningen, Groningen, Netherlands
| | - Balaram Ghosh
- Center of Excellence for Translational Research in Asthma and Lung Disease, CSIR-Institute of Genomics and Integrative Biology, New Delhi, India
| | - Christina Pabelick
- Departments of Anesthesiology and Physiology and Biomedical Engineering, Mayo Clinic, Rochester, Minnesota; and
| | - Allan Linneberg
- Research Centre for Prevention and Health, the Capital Region of Denmark, Copenhagen, Denmark; Department of Clinical Experimental Research, Glostrup University Hospital, Glostrup, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Y S Prakash
- Departments of Anesthesiology and Physiology and Biomedical Engineering, Mayo Clinic, Rochester, Minnesota; and
| | - Anurag Agrawal
- Center of Excellence for Translational Research in Asthma and Lung Disease, CSIR-Institute of Genomics and Integrative Biology, New Delhi, India;
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15
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Diaz J, Warren L, Helfner L, Xue X, Chatterjee PK, Gupta M, Solanki MH, Esposito M, Bonagura V, Metz CN. Obesity shifts house dust mite-induced airway cellular infiltration from eosinophils to macrophages: effects of glucocorticoid treatment. Immunol Res 2015; 63:197-208. [PMID: 26476732 PMCID: PMC6035857 DOI: 10.1007/s12026-015-8717-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Although classically characterized by chronic airway inflammation with eosinophil infiltration, asthma is a complex and multifactorial condition with numerous clinical phenotypes. Epidemiological studies strongly support the link between obesity and asthma and suggest that obesity precedes and promotes asthma development, increases asthma severity, and reduces steroid responsivity. Using a house dust mite (HDM) model of airway hyperresponsiveness in C57BL/6 mice, we examined the effects of diet-induced obesity on allergic airway inflammation and its treatment with dexamethasone. When compared to lean mice treated with HDM, obese-HDM mice had reduced plasma adiponectin, an anti-inflammatory adipokine, lower eosinophil and higher macrophage infiltration into the lungs and bronchoalveolar lavage (BAL) fluid, increased expression of total, M1, and M2 macrophage markers in the lungs, and enhanced Th2 and non-Th2 cytokine expression in the lungs. While Th2-associated responses in obese-HDM mice were suppressed by systemic dexamethasone, several Th2-independent responses, including total and M1 macrophage markers in the lungs, and lung CXC-motif ligand 1 (CXCL1) levels, were not improved following dexamethasone treatment. Thus, HDM combined with obesity promotes mixed localized inflammatory responses (e.g., M1, M2, Th1, and Th2) and shifts the cellular infiltration from eosinophils to macrophages, which are less sensitive to dexamethasone regulation. Because obese asthmatics exhibit more severe symptoms, lack a predominance of Th2 biomarkers, and are predicted to experience more steroid resistance when compared to lean asthmatics, this model could be used to study blunted steroid responses in obese-HDM mice and to define the macrophages found in the lungs.
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Affiliation(s)
- J Diaz
- Division of Allergy and Immunology, Department of Pediatrics, Hofstra North Shore-LIJ School of Medicine, Hempstead, NY, USA
- The Center for Immunology and Inflammation, The Feinstein Institute for Medical Research, Manhasset, NY, USA
| | - L Warren
- Department of Molecular Medicine, Hofstra North Shore-LIJ School of Medicine, Hempstead, NY, USA
| | - L Helfner
- Division of Allergy and Immunology, Department of Pediatrics, Hofstra North Shore-LIJ School of Medicine, Hempstead, NY, USA
- The Center for Immunology and Inflammation, The Feinstein Institute for Medical Research, Manhasset, NY, USA
| | - X Xue
- The Center for Immunology and Inflammation, The Feinstein Institute for Medical Research, Manhasset, NY, USA
| | - P K Chatterjee
- The Center for Immunology and Inflammation, The Feinstein Institute for Medical Research, Manhasset, NY, USA
| | - M Gupta
- The Center for Immunology and Inflammation, The Feinstein Institute for Medical Research, Manhasset, NY, USA
- Elmezzi Graduate School of Molecular Medicine, Manhasset, NY, USA
| | - M H Solanki
- The Center for Immunology and Inflammation, The Feinstein Institute for Medical Research, Manhasset, NY, USA
- Department of Pathology, Hofstra North Shore-LIJ School of Medicine, Hempstead, NY, USA
- Elmezzi Graduate School of Molecular Medicine, Manhasset, NY, USA
| | - M Esposito
- Department of Pathology, Hofstra North Shore-LIJ School of Medicine, Hempstead, NY, USA
| | - V Bonagura
- Division of Allergy and Immunology, Department of Pediatrics, Hofstra North Shore-LIJ School of Medicine, Hempstead, NY, USA
- The Center for Immunology and Inflammation, The Feinstein Institute for Medical Research, Manhasset, NY, USA
- Elmezzi Graduate School of Molecular Medicine, Manhasset, NY, USA
| | - C N Metz
- The Center for Immunology and Inflammation, The Feinstein Institute for Medical Research, Manhasset, NY, USA.
- Department of Molecular Medicine, Hofstra North Shore-LIJ School of Medicine, Hempstead, NY, USA.
- Elmezzi Graduate School of Molecular Medicine, Manhasset, NY, USA.
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16
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de Korte-de Boer D, Mommers M, Thijs C, Jaminon M, Jansen M, Mujakovic S, Feron FJM, van Schayck OCP. Early life growth and the development of preschool wheeze, independent from overweight: the LucKi Birth Cohort Study. J Pediatr 2015; 166:343-9.e1. [PMID: 25282065 DOI: 10.1016/j.jpeds.2014.08.064] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2014] [Revised: 07/24/2014] [Accepted: 08/27/2014] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To investigate whether birth weight and postnatal growth rates are independently related to the development of overweight and wheeze up to age 3 years. STUDY DESIGN Children from the LucKi Birth Cohort Study with complete follow-up for repeated questionnaires (at age 0, 7, and 14 months and 3 years) and informed consent to use height and weight data (measured by trained personnel at age 0, 7, and 14 months and 2 and 3 years) were included (n = 566). Wheeze (parental-reported) and overweight (body mass index [BMI] >85th percentile) were regressed with generalized estimating equations on birth weight and relative growth rates (difference SDS for weight, height, and BMI). RESULTS Higher birth weight and higher weight and BMI growth rates were associated with increased risk of overweight, but not of wheeze, up to age 3 years. Higher height growth rate was associated with lower risk of wheeze up to 3 years, independent of overweight (aOR, 0.65; 95% CI, 0.53-0.79). In time-lag models, wheeze was associated with subsequently reduced height growth up to age 14 months, but not vice versa. CONCLUSION Only height growth rate, and not weight and BMI growth rate, is associated with preschool wheeze, independent of overweight. Children who wheeze demonstrate a subsequent reduction in height growth up to age 14 months, but not vice versa. Because height growth rate is not associated with overweight, preschool wheeze and overweight are not associated throughout early life growth.
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Affiliation(s)
- Dianne de Korte-de Boer
- Department of Epidemiology, School of Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands.
| | - Monique Mommers
- Department of Epidemiology, School of Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands
| | - Carel Thijs
- Department of Epidemiology, School of Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands
| | - Marielle Jaminon
- Orbis Child and Youth Health Care, Orbis Medical Concern, Sittard, The Netherlands
| | - Maria Jansen
- Department of Health Services Research, School of Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands
| | - Suhreta Mujakovic
- Department of Research and Development, South Limburg Public Health Service, Geleen, The Netherlands
| | - Frans J M Feron
- Department of Social Medicine, School of Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands
| | - Onno C P van Schayck
- Department of General Practice, School of Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands
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17
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Guilbert TW, Mauger DT, Lemanske RF. Childhood asthma-predictive phenotype. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2014; 2:664-70. [PMID: 25439355 DOI: 10.1016/j.jaip.2014.09.010] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 08/08/2014] [Revised: 09/11/2014] [Accepted: 09/12/2014] [Indexed: 12/31/2022]
Abstract
Wheezing is a fairly common symptom in early childhood, but only some of these toddlers will experience continued wheezing symptoms in later childhood. The definition of the asthma-predictive phenotype is in children with frequent, recurrent wheezing in early life who have risk factors associated with the continuation of asthma symptoms in later life. Several asthma-predictive phenotypes were developed retrospectively based on large, longitudinal cohort studies; however, it can be difficult to differentiate these phenotypes clinically as the expression of symptoms, and risk factors can change with time. Genetic, environmental, developmental, and host factors and their interactions may contribute to the development, severity, and persistence of the asthma phenotype over time. Key characteristics that distinguish the childhood asthma-predictive phenotype include the following: male sex; a history of wheezing, with lower respiratory tract infections; history of parental asthma; history of atopic dermatitis; eosinophilia; early sensitization to food or aeroallergens; or lower lung function in early life.
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Affiliation(s)
- Theresa W Guilbert
- Pulmonary Medicine Division, Department of Pediatrics, Cincinnati Children's Hospital, Cincinnati, Ohio.
| | - David T Mauger
- Department of Health Evaluation Sciences, Pennsylvania State University, Hershey, Pa
| | - Robert F Lemanske
- Allergy Division, Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, Wis
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18
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Agrawal A, Prakash YS. Obesity, metabolic syndrome, and airway disease: a bioenergetic problem? Immunol Allergy Clin North Am 2014; 34:785-96. [PMID: 25282291 DOI: 10.1016/j.iac.2014.07.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Multiple studies have determined that obesity increases asthma risk or severity. Metabolic changes of obesity, such as diabetes or insulin resistance, are associated with asthma and poorer lung function. Insulin resistance is also found to increase asthma risk independent of body mass. Conversely, asthma is associated with abnormal glucose and lipid metabolism, insulin resistance, and obesity. Here we review our current understanding of how dietary and lifestyle factors lead to changes in mitochondrial metabolism and cellular bioenergetics, inducing various components of the cardiometabolic syndrome and airway disease.
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Affiliation(s)
- Anurag Agrawal
- Molecular Immunogenetics Laboratory and Centre of Excellence for Translational Research in Asthma & Lung Disease, CSIR-Institute of Genomics and Integrative Biology, Mall Road, Delhi 110007, India.
| | - Y S Prakash
- Department of Anesthesiology, Mayo Clinic, Rochester, MN 55905, USA; Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN 55905, USA.
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19
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Agrawal A. Urban, obese, allergic, and breathless: the shape of things to come? Immunol Allergy Clin North Am 2014; 34:xiii-xviii. [PMID: 25282297 DOI: 10.1016/j.iac.2014.07.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Anurag Agrawal
- Centre of Excellence for Translational Researchin Asthma and Lung Disease, CSIR-Institute of Genomics andIntegrative Biology, Mall Road, Delhi 110007, India.
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20
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Goutaki M, Pescatore AM, Singh P, Beardsmore CS, Kuehni CE. Increased prevalence of pre-school wheeze is not explained by time trends in body mass index. Eur Respir J 2014; 44:1078-82. [PMID: 24969649 DOI: 10.1183/09031936.00011514] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- Myrofora Goutaki
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Anina M Pescatore
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Parvinder Singh
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Caroline S Beardsmore
- Dept of Infection, Immunity and Inflammation, University of Leicester, Leicester, UK
| | - Claudia E Kuehni
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
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21
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González JR, Cáceres A, Esko T, Cuscó I, Puig M, Esnaola M, Reina J, Siroux V, Bouzigon E, Nadif R, Reinmaa E, Milani L, Bustamante M, Jarvis D, Antó JM, Sunyer J, Demenais F, Kogevinas M, Metspalu A, Cáceres M, Pérez-Jurado LA. A common 16p11.2 inversion underlies the joint susceptibility to asthma and obesity. Am J Hum Genet 2014; 94:361-72. [PMID: 24560518 PMCID: PMC3951940 DOI: 10.1016/j.ajhg.2014.01.015] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2013] [Accepted: 01/28/2014] [Indexed: 12/21/2022] Open
Abstract
The prevalence of asthma and obesity is increasing worldwide, and obesity is a well-documented risk factor for asthma. The mechanisms underlying this association and parallel time trends remain largely unknown but genetic factors may be involved. Here, we report on a common ~0.45 Mb genomic inversion at 16p11.2 that can be accurately genotyped via SNP array data. We show that the inversion allele protects against the joint occurrence of asthma and obesity in five large independent studies (combined sample size of 317 cases and 543 controls drawn from a total of 5,809 samples; combined OR = 0.48, p = 5.5 × 10(-6)). Allele frequencies show remarkable worldwide population stratification, ranging from 10% in East Africa to 49% in Northern Europe, consistent with discordant and extreme genetic drifts or adaptive selections after human migration out of Africa. Inversion alleles strongly correlate with expression levels of neighboring genes, especially TUFM (p = 3.0 × 10(-40)) that encodes a mitochondrial protein regulator of energy balance and inhibitor of type 1 interferon, and other candidates for asthma (IL27) and obesity (APOB48R and SH2B1). Therefore, by affecting gene expression, the ~0.45 Mb 16p11.2 inversion provides a genetic basis for the joint susceptibility to asthma and obesity, with a population attributable risk of 39.7%. Differential mitochondrial function and basal energy balance of inversion alleles might also underlie the potential selection signature that led to their uneven distribution in world populations.
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Affiliation(s)
- Juan R González
- Center for Research in Environmental Epidemiology (CREAL), Barcelona 08003, Spain; Hospital del Mar Research Institute (IMIM), Barcelona 08003, Spain; Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública (CIBERESP), Barcelona 08003, Spain; Department of Mathematics, Universitat Autònoma de Barcelona, Bellaterra (Barcelona) 08193, Spain.
| | - Alejandro Cáceres
- Center for Research in Environmental Epidemiology (CREAL), Barcelona 08003, Spain; Hospital del Mar Research Institute (IMIM), Barcelona 08003, Spain
| | - Tonu Esko
- Estonian Genome Center, University of Tartu, Tartu 50090, Estonia; Institute of Molecular and Cell Biology, University of Tartu, Tartu 50090, Estonia
| | - Ivon Cuscó
- Hospital del Mar Research Institute (IMIM), Barcelona 08003, Spain; Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona 08003, Spain; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Barcelona 08003, Spain
| | - Marta Puig
- Institut de Biotecnologia i de Biomedicina, Universitat Autònoma de Barcelona, Bellaterra (Barcelona) 08193, Spain
| | - Mikel Esnaola
- Center for Research in Environmental Epidemiology (CREAL), Barcelona 08003, Spain; Hospital del Mar Research Institute (IMIM), Barcelona 08003, Spain; Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública (CIBERESP), Barcelona 08003, Spain
| | - Judith Reina
- Hospital del Mar Research Institute (IMIM), Barcelona 08003, Spain; Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona 08003, Spain; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Barcelona 08003, Spain
| | - Valerie Siroux
- INSERM-UJF, U823, Institut Albert Bonniot, 38042 Grenoble, France; Université Joseph Fourier - BP 53, 38041 Grenoble, France
| | - Emmanuelle Bouzigon
- INSERM, UMRS-946, Genetic Variation of Human Diseases Unit, 75010 Paris, France; Université Paris Diderot, Sorbonne Paris Cité, Institut Universitaire d'Hématologie, 75010 Paris, France
| | - Rachel Nadif
- INSERM, U1018, CESP Centre for Research in Epidemiology and Population Health, Respiratory and Environmental Epidemiology Team, 94807 Villejuif, France; Université Paris-Sud 11, UMRS 1018, 94807 Villejuif, France
| | - Eva Reinmaa
- Estonian Genome Center, University of Tartu, Tartu 50090, Estonia
| | - Lili Milani
- Estonian Genome Center, University of Tartu, Tartu 50090, Estonia
| | - Mariona Bustamante
- Center for Research in Environmental Epidemiology (CREAL), Barcelona 08003, Spain; Hospital del Mar Research Institute (IMIM), Barcelona 08003, Spain; Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública (CIBERESP), Barcelona 08003, Spain; Genes and Disease Group, Centre for Genomic Regulation (CRG), Barcelona 08003, Spain
| | - Deborah Jarvis
- National Heart and Lung Institute, Imperial College, London SW7 2AZ, UK
| | - Josep M Antó
- Center for Research in Environmental Epidemiology (CREAL), Barcelona 08003, Spain; Hospital del Mar Research Institute (IMIM), Barcelona 08003, Spain; Department of Mathematics, Universitat Autònoma de Barcelona, Bellaterra (Barcelona) 08193, Spain; Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona 08003, Spain
| | - Jordi Sunyer
- Center for Research in Environmental Epidemiology (CREAL), Barcelona 08003, Spain; Hospital del Mar Research Institute (IMIM), Barcelona 08003, Spain; Department of Mathematics, Universitat Autònoma de Barcelona, Bellaterra (Barcelona) 08193, Spain; Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona 08003, Spain
| | - Florence Demenais
- INSERM, UMRS-946, Genetic Variation of Human Diseases Unit, 75010 Paris, France; Université Paris Diderot, Sorbonne Paris Cité, Institut Universitaire d'Hématologie, 75010 Paris, France
| | - Manolis Kogevinas
- Center for Research in Environmental Epidemiology (CREAL), Barcelona 08003, Spain; Hospital del Mar Research Institute (IMIM), Barcelona 08003, Spain; Centro de Investigación Biomédica en Red en Epidemiología y Salud Pública (CIBERESP), Barcelona 08003, Spain; National School of Public Health, Athens 115 21, Greece
| | - Andres Metspalu
- Estonian Genome Center, University of Tartu, Tartu 50090, Estonia; Institute of Molecular and Cell Biology, University of Tartu, Tartu 50090, Estonia
| | - Mario Cáceres
- Institut de Biotecnologia i de Biomedicina, Universitat Autònoma de Barcelona, Bellaterra (Barcelona) 08193, Spain; Institució Catalana de Recerca i Estudis Avancats (ICREA), Barcelona 08010, Spain
| | - Luis A Pérez-Jurado
- Hospital del Mar Research Institute (IMIM), Barcelona 08003, Spain; Department of Experimental and Health Sciences, Universitat Pompeu Fabra, Barcelona 08003, Spain; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Barcelona 08003, Spain.
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Lean mass, not fat mass, is associated with lung function in male and female children with asthma. Pediatr Res 2014; 75:93-8. [PMID: 24129552 DOI: 10.1038/pr.2013.181] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2013] [Accepted: 06/11/2013] [Indexed: 01/09/2023]
Abstract
BACKGROUND Whether body composition is associated with lung function in asthmatic children has not been investigated. This study aimed to primarily investigate whether BMI z-score and body composition were associated with respiratory function in asthmatic children. METHODS In a cross-sectional study, male (n = 27; mean age: 11.9 y (SD: 2.3)) and female (n = 21; mean age: 13.6 y (SD: 2.2)) asthmatic children underwent clinical assessment. RESULTS BMI z-score was associated with forced expiratory volume in 1 s (FEV1; r = 0.458), forced vital capacity (FVC; r = 0.477), and total lung capacity (TLC; r = 0.451) in males only (P < 0.05). Total lean mass was associated with FEV1 (r = 0.655), FVC (r = 0.562), and TLC (r = 0.635) in males, as was thoracic lean mass (FEV1 (r = 0.573), FVC (r = 0.526), and TLC (r = 0.497); P < 0.05). TLC was associated with total (r = 0.522) and thoracic (r = 0.532) lean mass in females (P < 0.05). Fat mass was not associated with lung function in this group. CONCLUSION Lean mass, not fat mass, is associated with lung function in children with asthma. The positive association between BMI z-score and respiratory function in male children is driven by lean mass. Although body weight can be easily monitored in the clinical setting, body composition can provide important information. Future research exploring lean mass and lung function associations could inform future interventions.
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Brumpton BM, Leivseth L, Romundstad PR, Langhammer A, Chen Y, Camargo CA, Mai XM. The joint association of anxiety, depression and obesity with incident asthma in adults: the HUNT study. Int J Epidemiol 2013; 42:1455-63. [PMID: 24008330 DOI: 10.1093/ije/dyt151] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Anxiety or depression symptoms may increase the risk of developing asthma, and their interaction with obesity is not known. We aimed to assess the association of anxiety or depression symptoms and the joint association of these symptoms and obesity with incident asthma. METHODS We conducted a prospective cohort study of 23 599 adults who were 19-55 years old and free from asthma at baseline in the Norwegian Nord-Trøndelag Health Study. The Hospital Anxiety and Depression Scale was used to measure anxiety or depression symptoms. Obesity was defined as a body mass index≥30.0 kg/m2. Incident asthma was self-reported new cases of asthma during the 11-year follow-up. RESULTS Having anxiety or depression symptoms was associated with incident asthma [odds ratio (OR) 1.39, 95% confidence interval (CI) 1.09-1.78). Obese participants with anxiety or depression symptoms had a substantially higher risk of incident asthma (OR 2.93, 95% CI 2.20-3.91) than any other group (non-obese participants without anxiety or depression symptoms [reference], non-obese participants with anxiety or depression symptoms (OR 1.20, 95% CI 1.00-1.45) and obese participants without anxiety or depression symptoms (OR 1.47, 95% CI 1.19-1.82)]. The relative excess risk for incident asthma due to interaction between anxiety or depression symptoms and obesity was 1.26 (95% CI 0.39-2.12). CONCLUSIONS This study suggests that having anxiety or depression symptoms contributes to the development of asthma in adults. The risk of asthma may be further increased by the interaction between anxiety or depression symptoms and obesity.
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Affiliation(s)
- Ben Michael Brumpton
- Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway, Department of Epidemiology and Community Medicine, Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada and Department of Emergency Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
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24
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Lowe AJ, Ekeus C, Bråbäck L, Rajaleid K, Forsberg B, Hjern A. Impact of maternal obesity on inhaled corticosteroid use in childhood: a registry based analysis of first born children and a sibling pair analysis. PLoS One 2013; 8:e67368. [PMID: 23840681 PMCID: PMC3696102 DOI: 10.1371/journal.pone.0067368] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2012] [Accepted: 05/17/2013] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND It has been proposed that maternal obesity during pregnancy may increase the risk that the child develops allergic disease and asthma, although the mechanisms underpinning this relationship are currently unclear. We sought to assess if this association may be due to confounding by genetic or environmental risk factors that are common to maternal obesity and childhood asthma, using a sibling pair analysis. METHODS The study population comprised a Swedish national cohort of term children born between 1992 and 2008 to native Swedish parents. Maternal body mass index (BMI) was measured at 8-10 weeks gestation. Unconditional logistic regression models were used to determine if maternal obesity was associated with increased risk of inhaled corticosteroid (ICS) in 431,718 first-born children, while adjusting for potential confounders. An age-matched discordant sib-pair analysis was performed, taking into account shared genetic and environmental risk factors. RESULTS Maternal over-weight and obesity were associated with increased risk that the child would require ICS (for BMI≥35 kg/m(2), aOR = 1.30, 95%CI = 1.10-1.52 compared with normal weight mothers) in children aged 6-12 years. Similar effects were seen in younger children, but in children aged 13-16 years, maternal obesity (BMI≥30) was related to increased risk of ICS use in girls (aOR = 1.28, 95%CI = 1.07-1.53) but not boys (OR = 1.05, 95%CI = 0.87-1.26). The sib-pair analysis, which included 2,034 sib-pairs older than six years who were discordant for both ICS use and maternal BMI category, failed to find any evidence that increasing maternal weight was related to increased risk of ICS use. CONCLUSION Maternal obesity is associated with increased risk of childhood ICS use up to approximately 12 years of age, but only in girls after this age. These effects could not be confirmed in a sib pair analysis, suggesting either limited statistical power, or the effects of maternal BMI may be due to shared genetic or environmental risk factors.
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Affiliation(s)
- Adrian J Lowe
- Occupational and Environmental Medicine, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden.
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Mabalirajan U, Ghosh B. Mitochondrial dysfunction in metabolic syndrome and asthma. J Allergy (Cairo) 2013; 2013:340476. [PMID: 23840225 PMCID: PMC3687506 DOI: 10.1155/2013/340476] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2013] [Accepted: 05/21/2013] [Indexed: 01/15/2023] Open
Abstract
Though severe or refractory asthma merely affects less than 10% of asthma population, it consumes significant health resources and contributes significant morbidity and mortality. Severe asthma does not fell in the routine definition of asthma and requires alternative treatment strategies. It has been observed that asthma severity increases with higher body mass index. The obese-asthmatics, in general, have the features of metabolic syndrome and are progressively causing a significant burden for both developed and developing countries thanks to the westernization of the world. As most of the features of metabolic syndrome seem to be originated from central obesity, the underlying mechanisms for metabolic syndrome could help us to understand the pathobiology of obese-asthma condition. While mitochondrial dysfunction is the common factor for most of the risk factors of metabolic syndrome, such as central obesity, dyslipidemia, hypertension, insulin resistance, and type 2 diabetes, the involvement of mitochondria in obese-asthma pathogenesis seems to be important as mitochondrial dysfunction has recently been shown to be involved in airway epithelial injury and asthma pathogenesis. This review discusses current understanding of the overlapping features between metabolic syndrome and asthma in relation to mitochondrial structural and functional alterations with an aim to uncover mechanisms for obese-asthma.
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Affiliation(s)
- Ulaganathan Mabalirajan
- Molecular Immunogenetics Laboratory and Centre of Excellence for Translational Research in Asthma & Lung Disease, CSIR-Institute of Genomics and Integrative Biology, Mall Road, Delhi 110007, India
| | - Balaram Ghosh
- Molecular Immunogenetics Laboratory and Centre of Excellence for Translational Research in Asthma & Lung Disease, CSIR-Institute of Genomics and Integrative Biology, Mall Road, Delhi 110007, India
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Abstract
Asthma is a chronic disorder affecting millions of people worldwide. The prevalence of asthma is around 300 million and is expected to increase another 100 million by 2025. Obesity, on the other hand, also affects a large number of individuals. Overweight in adults is defined when body mass index (BMI) is between 25 to 30 kg/m(2) and obesity when the BMI >30 kg/m(2). It has been a matter of interest for researchers to find a relation between these two conditions. This knowledge will provide a new insight into the management of both conditions. At present, obese asthma patients may be considered a special category and it is important to assess the impact of management of obesity on asthma symptoms.
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Ruotsalainen M, Hyvärinen MK, Saari A, Piippo-Savolainen E, Korppi M. No association between overweight and asthma or allergy in adolescence after wheezing in infancy. Acta Paediatr 2013. [PMID: 23190250 DOI: 10.1111/apa.12082] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
AIMS The aim of the study was to evaluate the association between weight status and asthma, allergy and respiratory symptoms in adolescents with bronchiolitis in infancy. SUBJECTS AND METHODS At age 15-18 years, a questionnaire was sent to 96 study subjects hospitalized for wheezing at age <24 months and followed up subsequently. Sixty-seven (70%) of them answered. Weight and height data for body mass index (BMI) calculation were available in 60 (63%) cases. Asthma, allergy, respiratory symptoms and the use of asthma medication were compared between overweight or obese and normal weight groups constructed by age- and sex-specific BMI standard deviation scores (BMI-SDS). Population controls matched for sex, and birth month and place, were recruited for this study phase at age 15-18 years. RESULTS Eleven (18.3%) study subjects were overweight (BMI-SDS >0.78 in males and >1.16 in females) and only 3 (5.0%) were obese (BMI-SDS >1.70 in males and >2.10 in females) at 16.5 (median) years of age. Overweight or obesity had no significant association with doctor-diagnosed or self-reported asthma, allergy or the use of inhaled corticosteroids. The negative results were confirmed by adjusted analyses. CONCLUSION Weight status had no association with asthma or allergy in adolescence after wheezing in infancy.
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Affiliation(s)
- Marja Ruotsalainen
- Department of Pediatrics; University of Eastern Finland and Kuopio University Hospital; Kuopio; Finland
| | - Mari K Hyvärinen
- Department of Pediatrics; University of Eastern Finland and Kuopio University Hospital; Kuopio; Finland
| | - Antti Saari
- Department of Pediatrics; University of Eastern Finland and Kuopio University Hospital; Kuopio; Finland
| | - Eija Piippo-Savolainen
- Department of Pediatrics; University of Eastern Finland and Kuopio University Hospital; Kuopio; Finland
| | - Matti Korppi
- Pediatric Research Centre; Tampere University and Tampere University Hospital; Tampere; Finland
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Silva RDCR, Assis AMO, Goncalves MS, Fiaccone RL, Matos SMA, Barreto ML, Pinto EDJ, Silva LAD, Rodrigues LC, Alcantara-Neves NM. The prevalence of wheezing and its association with body mass index and abdominal obesity in children. J Asthma 2013; 50:267-73. [PMID: 23368279 DOI: 10.3109/02770903.2012.757774] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To evaluate the relative importance of body mass index (BMI) and abdominal obesity in the prevalence of wheezing in Brazilian children. MATERIALS AND METHODS This is a cross-sectional study of male and female students, 6-12 years old, from the public elementary schools of São Francisco do Conde, Bahia, Northeast Brazil. Reports of wheezing in the past 12 months were collected using a questionnaire from the International Study of Asthma and Allergies in Childhood Program (ISAAC) phase III, adapted to Portuguese. Anthropometric, demographic, and socioeconomic information was collected. Multivariate logistic regression analyses were used to assess the associations of interest. RESULTS Of the children surveyed, 10.6% reported wheezing. Excess weight was observed in 16.2%, 10.5%, and 7.9% of the sample, measured by BMI, waist circumference (WC), and the waist-to-height ratio (WHtR), respectively. The percentage of patients with wheezing attributable to BMI ≥ 85th percentile (8.2%) slightly exceeded those identified with abdominal obesity, WC ≥ 80th percentile (7.3%) and WHtR > 0.5 (7.1%). CONCLUSION The results suggest that an excess of fat deposits, either in the abdominal region or elsewhere in the body, increased the risk of wheezing. Since obesity is an important public health problem worldwide, control of this problem may partially reduce the occurrence of wheezing in youth.
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Childhood Overweight/Obesity and Asthma: Is There a Link? A Systematic Review of Recent Epidemiologic Evidence. J Acad Nutr Diet 2013; 113:77-105. [DOI: 10.1016/j.jand.2012.08.025] [Citation(s) in RCA: 102] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2011] [Accepted: 08/22/2012] [Indexed: 11/23/2022]
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Guerra S, Sartini C, Mendez M, Morales E, Guxens M, Basterrechea M, Arranz L, Sunyer J. Maternal prepregnancy obesity is an independent risk factor for frequent wheezing in infants by age 14 months. Paediatr Perinat Epidemiol 2013; 27:100-8. [PMID: 23215717 DOI: 10.1111/ppe.12013] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Maternal prepregnancy obesity has been linked to the offspring's risk for subsequent asthma. We determined whether maternal obesity is associated with increased risk of wheezing phenotypes early in life. METHODS We used data on 1107 mother-child pairs from two birth cohorts from the INMA-INfancia y Medio Ambiente project. Maternal height was measured and prepregnancy weight self-reported at enrolment (on average at 13.7 ± 2 weeks of gestation). Maternal prepregnancy body mass index was categorised as underweight, normal, overweight and obese according to WHO recommendations. Information on child's wheezing was obtained through questionnaires up to the age of 14 (± 1) months. Wheezing was classified as infrequent (<4 reported wheezing episodes) or frequent (≥ 4 episodes). Weight and length of infants were measured by trained study staff at 14.6 (± 1) months of age and weight-for-length z-scores computed. RESULTS Although maternal obesity did not increase the risk of the child to have any or infrequent wheezing, children of obese mothers were more likely to have frequent wheezing than children of normal-weight mothers (11.8% vs. 3.8%; P = 0.002). In fully adjusted multinomial logistic regression models, including infants' weight-for-length z-scores and other covariates, maternal prepregnancy obesity was associated with increased risk of frequent [adjusted relative risk (RR) 4.18, 95% confidence interval (CI) 1.55, 11.3] but not infrequent (RR 1.05 [95% CI 0.55, 2.01]) wheezing in their children. CONCLUSIONS Maternal prepregnancy obesity is independently associated with an increased risk of frequent wheezing in the infant by the age of 14 months. These findings add evidence on the potential effects of in utero exposures on asthma-related phenotypes.
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Affiliation(s)
- Stefano Guerra
- Centre for Research in Environmental Epidemiology, Barcelona, Spain.
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31
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Halfon N, Larson K, Slusser W. Associations between obesity and comorbid mental health, developmental, and physical health conditions in a nationally representative sample of US children aged 10 to 17. Acad Pediatr 2013. [PMID: 23200634 DOI: 10.1016/j.acap.2012.10.007] [Citation(s) in RCA: 281] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE This large population-based study of US children considered the association of obesity with a broad range of comorbidities. This study examined relationships between weight status and health for US children. METHODS We performed cross-sectional analysis of data on 43,297 children aged 10 to 17 from the 2007 National Survey of Children's Health. Weight status was calculated from parent report of child height and weight. Logistic regression models assessed associations between weight status and 21 indicators of general health, psychosocial functioning, and specific health disorders, adjusting for sociodemographic factors. RESULTS Using body mass index (BMI) percentiles for age and sex, 15% of US children were considered overweight (BMI 85th to <95th percentile), and 16% were obese (BMI ≥95th percentile). Compared with children classified as not overweight, obese children were more likely to have reported good/fair/poor health (adjusted odds ratio [AOR] 2.18, 95% confidence interval [CI] 1.76-2.69), activity restrictions (AOR 1.39, 95% CI 1.10-1.75), internalizing problems (AOR 1.59, 95% CI 1.04-2.45), externalizing problems (AOR 1.33, 95% CI 1.07-1.65), grade repetition (AOR 1.57, 95% CI 1.24-1.99), school problems, and missed school days. Attention deficit/hyperactivity disorder, conduct disorder, depression, learning disability, developmental delay, bone/joint/muscle problems, asthma, allergies, headaches, and ear infections were all more common in obese children. CONCLUSIONS Obese children have increased odds of worse reported general health, psychosocial functioning, and specific health disorders. Physicians, parents, and teachers should be informed of the specific comorbidities associated with childhood obesity to target interventions that could enhance well-being. Future research should examine additional comorbidities and seek to confirm associations using longitudinal data and clinical measures of height and weight.
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Affiliation(s)
- Neal Halfon
- UCLA Center for Healthier Children, Families, and Communities, Los Angeles, CA 90024, USA.
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Ramalho R, Almeida J, Beltrão M, Pirraco A, Costa R, Sokhatska O, Guardão L, Palmares C, Guimarães JT, Delgado L, Moreira A, Soares R. Substance P antagonist improves both obesity and asthma in a mouse model. Allergy 2013; 68:48-54. [PMID: 23176443 DOI: 10.1111/all.12052] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/20/2012] [Indexed: 11/30/2022]
Abstract
BACKGROUND Evidence suggests a causal relationship between obesity and asthma; however, the underlying mechanisms remain unknown. Substance P (SP), involved in neurogenic inflammation by acting through its receptor NK1-R, seems to participate in obese-asthma phenotype in mice. OBJECTIVES To evaluate the effect of a selective substance P receptor antagonist on a mouse model of diet-induced obesity and asthma. METHODS Diet-induced obese Balb/c mice were sensitized and challenged with ovalbumin (OVA) and treated with a selective NK1-R antagonist or placebo. Serum glucose, insulin, IL-6, resistin, and OVA-specific IgE levels were quantified. A score for peribronchial inflammation in lung histology was used. Cells were counted in bronchoalveolar lavage fluid. Adipocyte sizes were measured. RESULTS Ovalbumin-obese mice treated with NK1-R antagonist had lower weight (P = 0.0002), reduced daily food intake (P = 0.0021), reduced daily energy intake (P = 0.0021), reduced surface adipocyte areas (P < 0.0001), lower serum glucose (P = 0.04), lower serum insulin (P = 0.03), lower serum IL-(P = 0.0022), lower serum resistin (P = 0.0043), lower serum OVA-specific IgE (P = 0.035), and lower peribronchial inflammation score (P < 0.0001) than nontreated OVA-obese mice. We observed an interaction between obesity, allergen sensitization, and treatment with NK1-R antagonist for metabolic and systemic biomarkers, and for allergen sensitization and bronchial inflammation, showing a synergy between these variables. CONCLUSION & CLINICAL RELEVANCE In an experimental model of obesity and asthma in mice, NK1-R blockade improved metabolic and systemic biomarkers, as well as allergen sensitization and bronchial inflammation. These positive effects support a common pathway in the obese-asthma phenotype and highlight SP as a target with potential clinical interest in the obese-asthma epidemics.
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Affiliation(s)
- R. Ramalho
- Immunology; Faculty of Medicine; University of Porto; Porto; Portugal
| | - J. Almeida
- Ciências Químicas e das Biomoléculas; Escola Superior de Tecnologia da Saúde do Porto; Instituto Politécnico do Porto; Porto; Portugal
| | - M. Beltrão
- Immunology; Faculty of Medicine; University of Porto; Porto; Portugal
| | - A. Pirraco
- Biochemistry (U38-FCT); Faculty of Medicine; University of Porto; Porto; Portugal
| | - R. Costa
- Biochemistry (U38-FCT); Faculty of Medicine; University of Porto; Porto; Portugal
| | - O. Sokhatska
- Immunology; Faculty of Medicine; University of Porto; Porto; Portugal
| | - L. Guardão
- Animal House Unit; Faculty of Medicine; University of Porto; Porto; Portugal
| | - C. Palmares
- Immunology; Faculty of Medicine; University of Porto; Porto; Portugal
| | | | | | | | - R. Soares
- Biochemistry (U38-FCT); Faculty of Medicine; University of Porto; Porto; Portugal
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Dietze J, Böcking C, Heverhagen JT, Voelker MN, Renz H. Obesity lowers the threshold of allergic sensitization and augments airway eosinophilia in a mouse model of asthma. Allergy 2012; 67:1519-29. [PMID: 23005257 DOI: 10.1111/all.12031] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/15/2012] [Indexed: 01/14/2023]
Abstract
BACKGROUND Clinical and epidemiological studies show a close association between obesity and the risk of asthma development. The underlying cause-effect relationship between metabolism, innate and adaptive immunity, and inflammation remains to be elucidated. METHODS We developed an animal model to study the interaction between metabolic abnormalities and experimentally induced asthma. Obesity-susceptible AKR mice were fed with high-fat diet (HFD) or normal low-fat diet (LFD) and subjected to a protocol of ovalbumin (OVA) sensitization and airway allergen challenges followed by assessment of inflammation and lung function. RESULTS AKR mice developed obesity and a prestage of metabolic syndrome following HFD. This phenotype was associated with an increase in proinflammatory macrophages (CD11b+/CD11c+) together with higher serum levels of interleukin 6. Obese mice showed increased susceptibility to allergic sensitization as compared to LFD animals. Anti-ovalbumin IgE antibody titers correlated positively and anti-OVA IgG2a antibodies titers correlated negatively with body weight. Airway eosinophilia showed a positive correlation with body weight, whereas mucus production did not change with obesity. CONCLUSIONS This obesity model demonstrates that HFD-induced obesity lowers the sensitization threshold in a model of asthma. This finding helps to understand why, particularly during childhood, obesity is a risk factor for the development of allergic asthma.
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Affiliation(s)
- J. Dietze
- Institute of Laboratory Medicine and Pathobiochemistry, Molecular Diagnostics; University Hospital Giessen and Marburg; Marburg; Germany
| | - C. Böcking
- Institute of Laboratory Medicine and Pathobiochemistry, Molecular Diagnostics; University Hospital Giessen and Marburg; Marburg; Germany
| | - J. T. Heverhagen
- Department of Diagnostic Radiology; Philipps University Hospital Giessen and Marburg; Marburg; Germany
| | - M. N. Voelker
- Department of Diagnostic Radiology; Philipps University Hospital Giessen and Marburg; Marburg; Germany
| | - H. Renz
- Institute of Laboratory Medicine and Pathobiochemistry, Molecular Diagnostics; University Hospital Giessen and Marburg; Marburg; Germany
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Ramalho R, Almeida J, Beltrão M, Pirraco A, Costa R, Sokhatska O, Guardão L, Palmares C, Guimarães JT, Delgado L, Moreira A, Soares R. Neurogenic inflammation in allergen-challenged obese mice: A missing link in the obesity-asthma association? Exp Lung Res 2012; 38:316-24. [PMID: 22734814 DOI: 10.3109/01902148.2012.699589] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
AIM A number of studies have shown an association between obesity and asthma. Controversy remains on the mechanisms supporting this association. In this study we aimed to assess neurogenic inflammation in a model of diet-induced obesity and allergen-challenged mice. METHODS High fat diet-induced (HFD) obese Balb/c mice were sensitized and challenged with ovalbumin (OVA). Glucose, insulin, OVA-specific IgE and substance P (SP), and the main tachykinin involved in neurogenic inflammation, were quantified in sera. Cell counts were performed in bronchoalveolar lavage fluid (BALF). The extent of peribronchial infiltrates was estimated on lung tissue sections and inflammation was score based on inflammatory cell counts surrounding the bronchi. RESULTS Obesity per se and allergen-sensitization per se increased serum SP (P = .027, P = .004, respectively). Further increased was observed in obese-sensitized mice (P = .007). Obese-sensitized mice also showed higher insulin (P = .0016), OVA-specific IgE (P = .016), peribronchial inflammatory score (P = .045), and tendency for higher glycemia. The interaction of obesity and asthma on SP levels was confirmed (P = .005, R(2) = 0.710). SP was positively correlated with metabolic (glycemia, r = 0.539, P = .007) and allergic inflammation parameters (BALF eosinophils, r = 0.445, P = 0.033; BALF mast cells, r = 0.574, P = .004; peribronchial inflammation score, r = 0.661, P < .001; and OVA-specific IgE, r = 0.714, P < .001). CONCLUSIONS Our findings provide support to the neurogenic inflammation link between obesity and asthma in mice. These two conditions independently increased SP and the presence of both pathologies further increased this level. Neurogenic inflammation may be a previously unrecognized mechanism beyond the obese-asthma phenotype. Further studies are need to confirm this role of SP in human obesity-asthma association.
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Affiliation(s)
- Renata Ramalho
- Department of Immunology, Faculty of Medicine, University of Porto, Porto, Portugal.
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Abstract
Obesity is associated with risk of pulmonary disease, and adversely affects lung function. The parallel increase in obesity and asthma suggests the two conditions are linked; indeed, they can worsen each other. Obesity and inadequate asthma control are associated with poor quality of life, and place a high economic burden on public health. Although the obesity-lung interaction is a major issue for basic research and clinical studies, various questions remain unanswered. Do intrauterine and early life factors impact on the development of obesity and lung disease? If so, can this be prevented? Asthma is generally more severe in obese subjects, but is adiposity a driver of a new asthma phenotype that features greater morbidity and mortality, worse control and decreased response to medications? Obese individuals have small lung volumes, hence their airway calibre is reduced and airway resistance is increased. What puzzles physicians is whether peripheral airways undergo remodelling, which would increase bronchoconstriction. Obese asthmatics respond suboptimally to anti-inflammatory treatment, which raises the question: 'what drug for what patient?' Life expectancy is decreased in obesity and in chronic pulmonary disorders, but does obesity protect against or trigger chronic obstructive pulmonary disease? The time has come to find answers to these questions.
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Affiliation(s)
- F Santamaria
- Department of Paediatrics, Federico II University, Naples, Italy
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Effects of obesity on lung function and airway reactivity in healthy dogs. Vet J 2012; 193:217-21. [DOI: 10.1016/j.tvjl.2011.10.013] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2010] [Revised: 10/13/2011] [Accepted: 10/14/2011] [Indexed: 11/23/2022]
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Hemminki K, Li X, Sundquist J, Sundquist K. Risk of asthma and autoimmune diseases and related conditions in patients hospitalized for obesity. Ann Med 2012; 44:289-95. [PMID: 21284531 DOI: 10.3109/07853890.2010.547515] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Although there are putative mechanistic links between obesity and autoimmune diseases, obesity is not considered a risk factor for most autoimmune diseases. METHODS Using the nation-wide Hospital Discharge Register we defined a cohort of 29,665 patients hospitalized for obesity since year 1964. The patients were followed for hospitalization for any of 34 autoimmune or related conditions through year 2007. Standardized incidence ratios (SIRs) were calculated for autoimmune diseases in obese individuals compared to those who had not been hospitalized for obesity. RESULTS Among 22 immune diseases diagnosed after hospitalization for obesity and in at least 5 patients, the overall SIR was 2.05. Of the individual diseases studied, the risk of 16 was significantly increased; none displayed a decreased risk. Psoriasis (4.54) and Behçet's disease (4.49) exhibited the highest risks, followed by Hashimoto's disease/hypothyroidism (4.12) and asthma (3.39). Small but significant increases in SIRs were also noted for the common autoimmune diseases Graves's disease/hyperthyroidism (1.28) and rheumatoid arthritis (1.37). CONCLUSIONS The present population of obese individuals, subsequently diagnosed with a number of autoimmune diseases and related conditions, was hospitalized at a relatively young age. Further studies are needed to describe the morbidity in the obese population at large.
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Affiliation(s)
- Kari Hemminki
- Division of Molecular Genetic Epidemiology, German Cancer Research Center, Heidelberg, Germany.
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Ciprandi G, Caimmi D, Raschetti R, Miraglia Del Giudice M, Salpietro C, Caimmi S, Castellazzi AM. Adipokines and their role in allergies. Int J Immunopathol Pharmacol 2011; 24:13-6. [PMID: 22032780 DOI: 10.1177/03946320110240s403] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Both allergic disorders and obesity keep increasing in industrialized countries. Even though a strong association between obesity and allergy- related diseases has been reported in several studies, no published data show a scientific and firm link in-between the two conditions. In general, obesity and weight gain have been associated with an increased risk of asthma and allergic rhinitis. Asthma, allergic rhinitis and obesity have a common inflammatory pattern that could therefore justify their association. In fact, the chronic inflammation that characterizes the increase in white adipose tissue typically pushes the immune system toward a Th2 pattern. Such a polarization might, consequentially, worsen a pre-existing allergic disease or even stimulate the evolution from a sensitization to a respiratory form of allergy. Several studies have been published on the role of different adipokines on allergic diseases. We focus our review on the role of adipokines on asthma and allergic rhinitis.
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Affiliation(s)
- G Ciprandi
- Department of Internal Medicine, IRCCS Azienda Ospedaliera Universitaria San Martino, Genoa, Italy.
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Fida NG, Enquobahrie DA, Gelaye B, Qiu C, Williams MA. Associations of asthma with body mass index and adult weight change among reproductive age women. J Asthma 2011; 48:701-6. [PMID: 21854322 DOI: 10.3109/02770903.2011.604885] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To evaluate the cross-sectional relationship between asthma and pre-gravid body mass index (BMI), and to assess the risk of adult weight change among women with history of asthma diagnosed in childhood or adulthood, respectively. STUDY DESIGN Study participants were 3737 pregnant women enrolled in a cohort study. Information on history of asthma, pre-gravid BMI, adult weight change (difference between BMI at age 18 and pre-gravid BMI), and other sociodemographic characteristics was collected using interviewer-administered questionnaires. Pre-gravid BMI was categorized into lean (BMI < 18.5 kg/m(2)), overweight (BMI = 25-24.9 kg/m(2)), and obese (BMI ≥ 30 kg/m(2)). Logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS Approximately 13.1% of study participants reported history of asthma. Compared with the reference group (BMI = 18.5-24.9 kg/m(2)), the odds of asthma was higher among overweight (OR = 1.51; 95% CI = 1.18-1.93) and obese (OR = 1.47; 95% CI = 1.06-2.03) women while it was lower among lean women (OR = 0.42; 95% CI = 0.21-0.84) (trend p-value <.001). Women who gained ≥20 kg compared with those who maintained their weight (±2.5 kg) had a 2.7-fold increased odds of asthma (95% CI = 1.02-7.00). CONCLUSIONS Overweight and obese women were more likely to have a history of asthma. Adult weight gain was positively associated with asthma diagnosis. Longitudinal studies designed to prospectively assess patterns of adult weight change in relation to asthma are warranted.
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Affiliation(s)
- Neway Gessesse Fida
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA 98195, USA.
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McCloud E, Papoutsakis C. A medical nutrition therapy primer for childhood asthma: current and emerging perspectives. ACTA ACUST UNITED AC 2011; 111:1052-64. [PMID: 21703384 DOI: 10.1016/j.jada.2011.04.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2010] [Accepted: 12/22/2010] [Indexed: 10/18/2022]
Abstract
Asthma is the most common chronic disease in children. Prevalence has increased in the past 2 decades and has reached a plateau of approximately 9% of children in the United States, affecting about 6.7 million children. The increased prevalence of childhood asthma has paralleled the increased prevalence in childhood obesity. Changes in diet have also been implicated in the increased prevalence of asthma, among other risk factors. The main symptoms of asthma (ie, wheezing, coughing, and chest tightness) require medical evaluation and monitoring. The cornerstone of asthma management is medication therapy, frequently consisting of inhaled bronchodilators and corticosteroids and, when needed, therapy of corticosteroids by mouth. As part of the multidisciplinary management of this chronic disease, nutrition assessment and follow-up in childhood asthma is necessary to identify and address relevant nutrition-related problems. These problems can involve food-medication interactions, obesity, gastroesophageal reflux disease, food allergies, and other issues; therefore, individualized medical nutrition therapy is warranted. Finally, counseling to achieve a healthy balanced diet is recommended for overall health and weight management. A recent but small number of descriptive investigations agree that adherence to a Mediterranean dietary pattern can be associated with a decreased risk of current asthma symptoms in children. Although this evidence is promising, food interventions are required to substantiate an evidence-based foundation for medical nutrition therapy in childhood asthma. At this time, there is no known health risk if a Mediterranean diet is adopted.
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Thomsen SF, Duffy DL, Kyvik KO, Skytthe A, Backer V. Risk of asthma in adult twins with type 2 diabetes and increased body mass index. Allergy 2011; 66:562-8. [PMID: 21083567 DOI: 10.1111/j.1398-9995.2010.02504.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
AIM To examine the relationship between asthma, type 2 diabetes and increased body mass index (BMI) in adult twins. METHODS We performed record linkage between questionnaire-defined asthma and BMI, and hospital discharge diagnoses of type 2 diabetes in 34,782 Danish twins, 20-71 years of age. RESULTS The risk of asthma was increased in subjects with type 2 diabetes relative to nondiabetic subjects both in men (13.5%vs 7.5%), P = 0.001 and in women (16.6%vs 9.6%), P = 0.001. The result remained significant after adjustment for age, BMI, smoking, symptoms of chronic bronchitis, marital status and zygosity, men: OR = 1.70 (1.07-2.70), P = 0.026; women: OR = 1.88 (1.24-2.85), P = 0.003. In this analysis, BMI remained a highly significant predictor for asthma independently of diabetes status in women, P < 0.000 but not in men, P = 0.336. Significant positive genetic correlations were found between asthma and type 2 diabetes, 0.20 (0.01-0.40), P = 0.047; between asthma and BMI in women, 0.15 (0.07-0.22), P < 0.000; and between BMI and type 2 diabetes, 0.40 (0.29-0.43), P < 0.000. CONCLUSIONS Asthma, type 2 diabetes and increased BMI are strongly associated in adults, particularly in women. These results suggest a common aetiology for asthma and metabolic syndrome.
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Affiliation(s)
- S F Thomsen
- Department of Respiratory Medicine, Bispebjerg Hospital, Copenhagen, Denmark.
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Wood LG, Garg ML, Gibson PG. A high-fat challenge increases airway inflammation and impairs bronchodilator recovery in asthma. J Allergy Clin Immunol 2011; 127:1133-40. [PMID: 21377715 DOI: 10.1016/j.jaci.2011.01.036] [Citation(s) in RCA: 195] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2010] [Revised: 01/13/2011] [Accepted: 01/17/2011] [Indexed: 02/07/2023]
Abstract
BACKGROUND Dietary fat activates systemic innate immune responses, but the effect on airway responses is unknown. OBJECTIVE To examine effects of a high-fat versus low-fat meal on systemic and airway inflammation in asthma. METHODS Nonobese subjects with asthma were randomized to consume a high-fat (n = 19; 48% [49 g] fat) or low-fat (n = 18; 15% [3 g] fat) meal. Fourteen obese patients with asthma and 21 healthy controls also consumed a high-fat meal. Another group of patients with asthma consumed a high-trans (n = 5; 5.2 g trans fat) or nontrans (n = 5, <0.3 g trans fat) fatty acid meal. Lung function was measured at baseline (prebronchodilator) and 2, 3, and 4 hours after bronchodilator. Airway inflammation was assessed by using induced sputum cell counts and Toll-like receptor 4 mRNA expression by real-time PCR. Systemic inflammation was measured by ELISA quantification of plasma TNF-α, high-sensitivity C-reactive protein, and IL-6 concentrations. RESULTS In patients with asthma, at 4 hours postmeal, increases in sputum % neutrophils and Toll-like receptor 4 mRNA expression were higher and increases in FEV(1)/forced vital capacity (FVC) were lower in the high-fat versus low-fat groups. Changes in plasma fatty acids correlated with changes in sputum % neutrophils and were negatively associated with changes in % FEV(1), % FVC, and FEV(1)/FVC. After the high-trans fatty acid meal, sputum % neutrophils were significantly higher than after the nontrans meal. CONCLUSION A high-fat meal augments neutrophilic airway inflammation, with the effect dependent on the type of fat consumed. A high-fat meal also suppresses bronchodilator recovery in asthma. Modifying dietary fat intake may be useful in asthma.
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Affiliation(s)
- Lisa G Wood
- Centre for Asthma and Respiratory Disease, Hunter Medical Research Institute, University of Newcastle, Newcastle, Australia.
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Tesse R, Schieck M, Kabesch M. Asthma and endocrine disorders: shared mechanisms and genetic pleiotropy. Mol Cell Endocrinol 2011; 333:103-11. [PMID: 21134413 DOI: 10.1016/j.mce.2010.11.032] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2010] [Revised: 11/23/2010] [Accepted: 11/27/2010] [Indexed: 01/07/2023]
Abstract
Asthma is a common inflammatory disease for which the cause is not yet known. Studies of the epidemiology and natural history of childhood asthma into adulthood demonstrate a change in gender prevalence with age. Hormones and inflammation may interact in asthma pathogenesis and determine its course. The same may be true for some endocrine disorders, including diabetes and obesity. Obesity plays a major role in the development of the metabolic syndrome and has been identified as an important risk factor for chronic diseases such as type 2 diabetes mellitus. The prevalence of asthma has paralleled the rise in obesity, suggesting that shared environmental factors could affect both conditions. In addition, endocrine diseases and asthma may share common genetic determinants. In the first part of this review we assess endocrine influences on asthma and overlaps between endocrine disorders and asthma while in the second part we explore the potential benefit of comparative genetic analyses between asthma and endocrine diseases.
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Affiliation(s)
- Riccardina Tesse
- Department of Pediatric Pneumology, Allergy and Neonatology, Hannover Medical School, Hannover, Germany
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Current world literature. Curr Opin Endocrinol Diabetes Obes 2011; 18:83-98. [PMID: 21178692 DOI: 10.1097/med.0b013e3283432fa7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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[Body mass index in asthmatic children before and after one year inhaled glucocorticosteroids therapy BMI]. ACTA ACUST UNITED AC 2011; 63:409-13. [PMID: 21186556 DOI: 10.2298/mpns1006409k] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Asthma is the most frequent children's disease, with a tendency of further growth. Bearing in mind controversial data on obesity of asthmatic children and a possible effect of inhaled corticosteroids (ICS) on children's growth, the aim of our study was to determine the body mass index (BMI) in asthmatic children at the beginning of the therapy and to study the effect of the continuous application of ICS on growth and BMI during the period of 1 year. MATERIAL AND METHODS The study included 100 children aged 7 to 18 diagnosed to have partly controlled and uncontrolled allergic asthma, who were continuously given ICS as a prevention against asthma attacks at Pediatric Clinic of the Clinical Center in Kragujevac for the period of 1 year. Children with BMI < p10 by their age and gender were considered to be underweight, children with p10-84 as of normal weight, children with p85-97 as overweight and children with BMI > p97 as obese. RESULTS The highest percentage of children with asthma was within normal parameters (70%), 10% of the children were underweight (boys: n = 8/60, 13.3% vs. girls: n = 2/40, 5%), and 18% were overweight/obese. Monovariable analysis of variant with repeated measurements have shown a statistically significant difference in the height of children in all age groups after a year of continuous therapy of ICS (p = 0.000), except in girls aged 15-18, who did not show any significant difference in body height after the therapy (p > 0.05). CONCLUSION Asthmatic children with partly controlled and uncontrolled asthma have mostly normal BMI and ICS can be safely administered in asthmatic children.
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Park SY, Park JW, Oh YM, Rhee YK, Lee YM, Park YB, Lim SY. The Association of Obesity, Airway Hyperresponsiveness and Atopy in Chronic Cough Patients: Results of a Two-Center Study. Tuberc Respir Dis (Seoul) 2011. [DOI: 10.4046/trd.2011.71.1.24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- So Yong Park
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Hallym University College of Medicine, Seoul, Korea
| | - Jong Won Park
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Hallym University College of Medicine, Seoul, Korea
| | - Yeon Mok Oh
- Department of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Yang Keun Rhee
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Chonbuk National University Medical School, Jeonju, Korea
| | - Young Mok Lee
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Soonchunhyang University College of Medicine, Seoul, Korea
| | - Yong Bum Park
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Hallym University College of Medicine, Seoul, Korea
| | - Seong Yong Lim
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University College of Medicine, Seoul, Korea
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Abstract
BACKGROUND The roles of obesity and insulin resistance in asthma and atopy are not well understood. We investigated whether there is an association of obesity and insulin resistance with asthma and atopy prevalence in US adults. METHODS Data from the 2005-2006 National Health and Nutrition Examination Survey were analyzed by multivariate logistic regression, controlling for sex, age, ethnicity, income, and smoking status. Obesity was measured by body mass index (BMI) and waist circumference, and insulin resistance by the homeostasis model assessment. Asthma was defined by self-report of ever receiving a diagnosis and still having asthma currently, and atopy by any positive specific serum IgE responses to a panel of aeroallergens. RESULTS Neither obesity measure nor insulin resistance was associated with atopy. Obesity was positively associated with asthma overall (odds ratio [OR] for obese vs normal BMI = 2.28, 95% CI: 1.76, 2.96; OR for obese vs normal waist circumference = 1.75; 95% CI: 1.22, 2.51) but insulin resistance was not (OR = 1.26; 95% CI: 0.80, 1.98). Obesity was also associated with nonatopic asthma (OR for obese vs normal BMI = 2.5; 95% CI: 1.2, 5.2; OR for obese vs normal waist circumference = 2.07, 95% CI: 1.21, 3.54), while obese BMI was also associated with atopic asthma (OR = 2.04, 95% CI: 1.37, 3.03). Obesity remained independently associated with all asthma outcomes after controlling for insulin resistance. CONCLUSION Obesity was independently associated with asthma, and atopic and nonatopic asthma, after controlling for insulin resistance and socio-demographic factors. There was no evidence that insulin resistance was associated with atopy or asthma.
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Affiliation(s)
- J Ma
- Department of Health Services Research, Palo Alto Medical Foundation Research Institute, Palo Alto, CA, USA.
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Pinto Pereira LM, Seemungal TA. Comorbid disease in asthma: the importance of diagnosis. Expert Rev Respir Med 2010; 4:271-4. [PMID: 20524908 DOI: 10.1586/ers.10.31] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
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Agrawal A, Mabalirajan U, Ahmad T, Ghosh B. Emerging interface between metabolic syndrome and asthma. Am J Respir Cell Mol Biol 2010; 44:270-5. [PMID: 20656947 DOI: 10.1165/rcmb.2010-0141tr] [Citation(s) in RCA: 75] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
There is growing epidemiological evidence that obesity increases the risk of developing asthma. In some studies, insulin resistance or metabolic syndrome is a stronger risk factor than body mass. The obese-asthma subphenotype is marked by a paucity of inflammation but also by marked symptoms, poor response to glucocorticoids, and peripheral airway dysfunction. Although obesity may predispose to increased Th2 inflammation or atopic tendencies, other mechanisms that are independent of inflammatory cells need to be considered. There is growing evidence of the influence of hyperglycemia, hyperinsulinemia, and insulin-like growth factors on airway structure and function. Also, studies from mouse models of asthma have highlighted the importance of nitric oxide-arginine metabolism abnormalities and oxonitrosative stress in lungs. Such changes are well established features of the metabolic syndrome and may represent an interface between these diseases that can be therapeutically targeted. Such therapies, including administration of l-arginine or statins, increasing endothelial nitric oxide synthase, or the use of arginase inhibitors, have been successful in experimental models but have not yet translated to the clinical arena. We review the current understanding of the potential mechanistic links between obesity and asthma, emphasizing the potential influence of metabolic abnormalities on asthmatic processes, therapeutic implications, and expected challenges.
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Affiliation(s)
- Anurag Agrawal
- Centre for Translational Research in Asthma & Lung disease, Institute of Genomics & Integrative Biology, Delhi, India.
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Abstract
OVERVIEW More than 16 million U.S. adults have asthma, a condition that prompts 2 million ED visits and nearly half a million hospital admissions annually. Management of this potentially deadly, chronic inflammatory disease depends on early diagnosis, accurate classification, appropriate treatment, and targeted patient education. This article outlines current guideline recommendations for asthma and reviews what clinicians need to teach patients about its pathophysiology, pharmacotherapy, self monitoring, and environmental control. The authors discuss the classic clinical presentation of the disease, describe how to assess severity and control, and explain how such assessments can guide management.
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