Asthma and insulin resistance in children.
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-alpha, 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-alpha (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.
Arshi
Mandana
M
The University of Queensland, Children's Nutrition Research Centre, Discipline, Royal Children's Hospital, Brisbane, Queensland, Australia. m.arshi@uq.edu.au
Cardinal
John
J
Hill
Rebecca J
RJ
Davies
Peter S W
PS
Wainwright
Claire
C
D000293:Adolescent; D001249:Asthma / Q000097:blood / Q000453:epidemiology*; D001315:Australia / Q000453:epidemiology; D001786:Blood Glucose / Q000032:analysis; D015992:Body Mass Index; D002648:Child; D005260:Female; D006801:Humans; D007328:Insulin / Q000097:blood; D007333:Insulin Resistance; D007378:Interleukins / Q000097:blood; D020738:Leptin / Q000097:blood; D008297:Male; D008353:Mannitol; D009569:Nitric Oxide / Q000032:analysis; D009765:Obesity / Q000097:blood / Q000453:epidemiology*; D052243:Resistin / Q000097:blood; D012307:Risk Factors; D012882:Skin Tests; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
D001786:Blood Glucose; D007328:Insulin; D007378:Interleukins; D020738:Leptin; D052243:Resistin; D014409:Tumor Necrosis Factor-alpha; D009569:Nitric Oxide; D008353:Mannitol