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Association between insulin resistance, metabolic syndrome, asthma and the other asthma phenotypes.

机译：胰岛素抵抗，代谢综合征，哮喘和其他哮喘表型之间的关联。

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摘要

Background: Obesity is a well known and documented risk factor for developing insulin resistance and metabolic syndrome. Published literature also suggests that obesity can be a risk factor for asthma. Recent published research articles showed an association between obesity, insulin resistance and asthma.;Methods: Data were obtained from the SAGE case-control study of the 1995 Manitoba birth cohort. Fasting blood glucose and insulin were taken to calculate the H&barbelow;omeostasis M&barbelow;odel A&barbelow;ssessment of I&barbelow;nsulin R&barbelow;esistance (HOMA-IR). Metabolic syndrome (defined by deFerranty et al.) was established if a child had 3 out of 5 criteria: increased blood glucose, blood pressure, triglycerides, waist circumference and decreased HDL-c. Asthma was diagnosed by a pediatric allergist and AHR was measured using the methacholine challenge test. Atopic asthma was established if a child had asthma and positive skin prick test. Overweight and obesity were defined as a body mass index (BMI) > 85th and 95 th percentile respectively (equivalent to a z-score of 1.04 and 1.64). The association between insulin resistance, metabolic syndrome, asthma and the other asthma phenotypes was expressed as crude and adjusted odds ratio (OR) and 95% CI.;Results: Multivariate logistic regression analyses showed that atopic asthma was found to be a statistically significant risk factor for having insulin resistance (OR=2.74, 95%CI: 1.02-7.35, p0.05) and metabolic syndrome (OR=3.26, 95%CI: 1.21-8.80, p0.05). In overweight/obese children asthma was found to be a statistically significant risk factor for having insulin resistance (OR=2.84, 95% CI: 1.09-7.41, p0.05), but not for metabolic syndrome. In this group of children atopic asthma was also a statistically significant risk factor for having insulin resistance (OR=3.84, 95% CI: 1.32-11.22, p0.05) and metabolic syndrome (OR=2.86, 95% CI: 1.04-7.87, p0.05).;Conclusion: In this study we provide evidence that atopic asthma between the ages of 7 and 10 was associated with having insulin resistance and metabolic syndrome two years later. We also found that overweight/obese children with asthma were at increased risk of having insulin resistance two years later. No association was found between AHR and asthma+AHR and insulin resistance and metabolic syndrome at that age. We found a borderline association between atopy and insulin resistance two years later.;Primary objective of this research study was to assess if asthma between the ages of 7 and 10 is associated with insulin resistance and metabolic syndrome two years later. Secondary objectives were to determine if other asthma phenotypes (airway hyper responsiveness-AHR, asthma plus AHR and atopic asthma) and atopy between the ages of 7 and 10 are associated with insulin resistance and metabolic syndrome two years later; and to determine the risk of having insulin resistance and metabolic syndrome two years later in children with asthma, atopy and the other asthma phenotypes stratified by weight.
机译：背景：肥胖是胰岛素抵抗和代谢综合征发展的众所周知的危险因素。出版的文献还表明，肥胖可能是哮喘的危险因素。最近发表的研究文章显示肥胖，胰岛素抵抗和哮喘之间存在关联。方法：数据来自1995年马尼托巴省出生队列的SAGE病例对照研究。摄取空腹血糖和胰岛素以计算H＆barostososasis odel A＆barses; Isbar＆amp; insulin R＆barististance（HOMA-IR）。如果儿童符合5个标准中的3个，则将建立代谢综合症（由deFerranty等人定义）：血糖升高，血压，甘油三酸酯，腰围和HDL-c降低。哮喘由小儿过敏症诊断，并使用乙酰甲胆碱激发试验测定AHR。如果儿童患有哮喘且皮肤点刺试验呈阳性，则表明患有特应性哮喘。超重和肥胖分别定义为体重指数（BMI）> 85％和95％（相当于Z值1.04和1.64）。胰岛素抵抗，代谢综合征，哮喘和其他哮喘表型之间的关联表示为粗略和调整后的优势比（OR）和95％CI。结果：多因素Logistic回归分析显示特应性哮喘具有统计学意义的风险具有胰岛素抵抗的因素（OR ＝ 2.74，95％CI：1.02-7.35，p ＜0.05）和代谢综合征（OR ＝ 3.26，95％CI：1.21-8.80，p ＜0.05）。在超重/肥胖儿童中，发现哮喘是具有胰岛素抵抗的统计学显着危险因素（OR = 2.84，95％CI：1.09-7.41，p <0.05），但不是代谢综合征。在这组儿童中，特应性哮喘也是具有胰岛素抵抗（OR = 3.84，95％CI：1.32-11.22，p <0.05）和代谢综合征（OR = 2.86，95％CI：1.04-7.87）的统计学上显着的危险因素。 ，p <0.05）。结论：本研究提供的证据表明，两年后7至10岁的特应性哮喘与胰岛素抵抗和代谢综合征相关。我们还发现，两年后超重/肥胖儿童哮喘患胰岛素抵抗的风险增加。在那个年龄段，AHR和哮喘+ AHR与胰岛素抵抗和代谢综合征之间没有关联。两年后，我们发现特应性与胰岛素抵抗之间存在临界关联。本研究的主要目的是评估两年后7至10岁的哮喘是否与胰岛素抵抗和代谢综合征相关。次要目标是确定两年后，其他哮喘表型（气道高反应性-AHR，哮喘加AHR和特应性哮喘）和7岁至10岁之间的特应性是否与胰岛素抵抗和代谢综合征相关；并确定两年后哮喘，特应性和其他按体重分层的哮喘表型患儿患胰岛素抵抗和代谢综合征的风险。

著录项

  • 作者

    Saurek-Aleksandrovska, Natalija.;

  • 作者单位

    University of Manitoba (Canada).;

  • 授予单位 University of Manitoba (Canada).;
  • 学科 Health Sciences Public Health.;Health Sciences Epidemiology.
  • 学位 M.Sc.
  • 年度 2010
  • 页码 128 p.
  • 总页数 128
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类
  • 关键词

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