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

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, p<0.05) and metabolic syndrome (OR=3.26, 95%CI: 1.21-8.80, p<0.05). 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, p<0.05), 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, p<0.05) and metabolic syndrome (OR=2.86, 95% CI: 1.04-7.87, p<0.05).;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.