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Association of systemic inflammation, adiposity, and metabolic dysregulation with asthma burden among Hispanic adults.

TitleAssociation of systemic inflammation, adiposity, and metabolic dysregulation with asthma burden among Hispanic adults.
Publication TypePublication
Year2017
AuthorsRastogi D, Jung M, Strizich G, Shaw PA, Davis SM, Klein OL, Penedo FJ, Ries AL, Daviglus ML, Moreiras JJ, Salathe MA, Celedón JC, Isasi CR, Kaplan RC
JournalRespir Med
Volume125
Pagination72-81
Date Published2017 04
ISSN1532-3064
Keywordsadiposity, Adolescent, Adult, Aged, Aged, 80 and over, asthma, Body mass index, C-Reactive Protein, Cholesterol, HDL, Cost of Illness, Female, Forced Expiratory Volume, Hispanic Americans, Humans, Inflammation, insulin resistance, Male, Metabolic Diseases, Middle Aged, Obesity, Prevalence, Respiratory Function Tests, Risk Factors, spirometry, Vital Capacity, Young Adult
Abstract

RATIONALE: Obesity-related asthma is associated with higher disease burden than normal-weight asthma among Hispanics. Adiposity, metabolic dysregulation, and inflammation are all implicated in pathogenesis of obesity-related asthma, but their independent contributions are poorly understood.OBJECTIVE: To examine the independent contributions of body fat distribution, metabolic abnormalities and inflammation on asthma symptoms and pulmonary function among Hispanics.METHODS: Participants of the Hispanic Community Health Study/Study of Latinos with doctor-diagnosed asthma who completed an asthma symptom questionnaire and performed a valid spirometry were included in the analysis (n = 1126). Multivariate analysis was used to examine the independent association of general adiposity (assessed using body mass index), truncal adiposity (assessed by waist circumference), metabolic dysregulation (presence of insulin resistance and low HDL) and inflammation (high-sensitivity C-Reactive Protein≥3 mg/L) with reported asthma symptoms or pulmonary function measures (FEV, and FVC) while adjusting for demographic and clinical covariates.RESULTS: Of the 1126 participants, 334 (29.5%) were overweight, and 648 (57.8%) were obese. FEV and FVC were lower in obese compared to normal-weight asthmatics. In analyses controlling for metabolic and adiposity factors, high hs-CRP (>7 mg/L) was associated with more symptoms (prevalence-ratio 1.27 (95%CI 1.05, 1.54), and lower FVC (β -138 ml (95%CI -27 ml, -249 ml)) and FEV (β -155 ml (95% CI -38 ml, -272 ml). Low HDL was also associated with lower FVC (β -111 ml (-22 ml, -201 ml) and FEV (β -100 ml (-12 ml, -188 ml)). Results were similar in men and women.CONCLUSIONS: Our findings suggest that hs-CRP and low HDL, rather than general and truncal adiposity, are associated with asthma burden among overweight and obese Hispanic adults.

DOI10.1016/j.rmed.2017.03.003
Alternate JournalRespir Med
PubMed ID28340865
PubMed Central IDPMC5395248
Grant ListN01 HC065234 / HC / NHLBI NIH HHS / United States
K23 HL118733 / HL / NHLBI NIH HHS / United States
N01HC65236 / HL / NHLBI NIH HHS / United States
N01HC65235 / HL / NHLBI NIH HHS / United States
N01HC65234 / HL / NHLBI NIH HHS / United States
N01HC65233 / HL / NHLBI NIH HHS / United States
N01HC65237 / HL / NHLBI NIH HHS / United States
P30 DK020541 / DK / NIDDK NIH HHS / United States
N01 HC065235 / HC / NHLBI NIH HHS / United States
MS#: 
0260
Manuscript Lead/Corresponding Author Affiliation: 
Field Center: Bronx (Einstein College of Medicine)
ECI: 
Yes
Manuscript Status: 
Published