Prevalence of Metabolic Abnormalities and their Effect on Asthma Symptom
Control in Children
Abstract
Objective The objectives of this study were to determine the
prevalence of insulin resistance (IR), dyslipidemia and metabolic
syndrome (MS) in children with asthma, aged 10 to 15 years and to
determine if these metabolic abnormalities showed an association with
asthma symptom control and lung function. Methods We conducted
a cross-sectional study at a tertiary centre in north India. Consecutive
children with physician diagnosed asthma were enrolled. Asthma symptom
control over previous four weeks was assessed as per GINA
recommendations. Fasting plasma glucose, serum insulin and lipid levels
were estimated. HOMA-IR was used as a marker of IR. Spirometry was
performed for assessing lung function. Results Eighty-three
children were enrolled. Median (IQR) age was 12.0 (11.0, 13.5) years and
mean (SD) BMI z score was -0.42 (1.0). Median (IQR) Homeostasis Model
Assessment- Insulin Resistance (HOMA-IR) was 1.65 (1.06, 2.39).
Prevalence of IR was 42.3% (95% CI: 31.7-52.9%). Number of children
with elevated triglycerides, total cholesterol, and LDL-cholesterol was
4 (4.8%), 4 (4.8%) and 5 (6%), respectively. 67 (80.7%) children had
low HDL-cholesterol. Only one subject was found to have MS. Presence of
IR and elevation in serum insulin and triglycerides were associated with
poorer asthma control, independent of BMI. None of the metabolic
parameters were associated with lung function, after adjusting for
height. Conclusions A high proportion of children with asthma
aged 10-15 years had IR but not MS currently. Increasing serum insulin,
triglycerides, and presence of IR were associated with poorer asthma
control, after adjusting for BMI.