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Asthma and insulin resistance in children

Authors

  • Mandana ARSHI,

    Corresponding author
    1. The University of Queensland, Children's Nutrition Research Centre, Discipline, Royal Children's Hospital,
      Mandana Arshi, Children's Nutrition Research Centre, Discipline of Paediatrics and Child Health, Royal Children's Hospital, Brisbane, Qld 4029, Australia. Email: m.arshi@uq.edu.au
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  • John CARDINAL,

    1. Department of Chemical Pathology, Queensland Health Pathology Services,
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  • Rebecca J. HILL,

    1. The University of Queensland, Children's Nutrition Research Centre, Discipline, Royal Children's Hospital,
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  • Peter S.W. DAVIES,

    1. The University of Queensland, Children's Nutrition Research Centre, Discipline, Royal Children's Hospital,
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  • Claire WAINWRIGHT

    1. Queensland Children's Respiratory Centre, Royal Children's Hospital, and
    2. The University of Queensland, Discipline of Paediatrics and Child Health, Royal Children's Hospital, Brisbane, Queensland, Australia
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Mandana Arshi, Children's Nutrition Research Centre, Discipline of Paediatrics and Child Health, Royal Children's Hospital, Brisbane, Qld 4029, Australia. Email: m.arshi@uq.edu.au

ABSTRACT

Background and objective:  Increased BMI is a risk factor for asthma in children and may be related to adipokines. Adipokines affect insulin-stimulated glucose uptake in vitro but, to date there is little evidence for such a role in vivo. We explored relationships between obesity and allergic asthma in children.

Methods:  Twenty-one allergic asthmatics (AA) and 10 non-allergic healthy controls, aged 6–17.9 years were studied. AA group included children with a positive mannitol challenge test, >25 ppb of exhaled nitric oxide and a positive skin prick test. BMI z-scores were calculated. Blood levels of insulin, glucose, leptin, resistin, tumour necrosis factor-α, IL-4, IL-5 and IL-6 were measured. Insulin resistance (IR) was estimated using the homeostasis model assessment (HOMA).

Results:  There was no significant difference in BMI z-scores between AA and healthy controls (mean: 0.01 vs −0.10). However, significant differences were found in the blood levels of IL-6 (P = 0.05), IL-4 (P = 0.04), IL-5 (P = 0.01) and leptin (P = 0.02). IR was only found in the AA group (42.85%). Homeostasis model assessment insulin resistance (HOMA-IR) was significantly related to IL-6 (r = 0.44, P = 0.05) and tumour necrosis factor-α (r = −0.45, P = 0.05).

Conclusions:  IR was observed in AA. Our findings are suggestive of a complex interaction between the inflammatory state and adiposity, allergy and asthma.

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