title: Abdominal aortic stiffness as a marker of atherosclerosis in childhood-onset asthma: a case-control study.
abstract: BACKGROUND
  Asthma is one of the chronic inflammatory diseases. It is known that chronic inflammation accelerates atherosclerosis. Abdominal aortic stiffness parameters can be used to detect the early development of atherosclerosis.
  
  
  OBJECTIVE
  In this study, we aimed to evaluate abdominal aortic stiffness parameters in childhood-onset asthma compared with a control group.
  
  
  METHODS
  In this cross-sectional, case-control study, we evaluated 50 patients with childhood-onset asthma, and 57 healthy children as controls. Patients with a diagnosis of asthma of at least three years' duration were included in the study. Children with hypertension, hyperlipidaemia, diabetes, a history of smoking contact, or systemic disease were excluded. The study and control groups were evaluated with transthoracic echocardiography, and abdominal aorta diameters were measured. Using the measured data, abdominal aortic stiffness parameters (aortic distensibility: DIS, aortic strain: S, pressure strain elastic modulus: Ep, and pressure strain normalised by diastolic pressure: Ep*) were calculated. Statistical evaluation was done with the Student's t-test, chisquared test and Pearson's correlation test.
  
  
  RESULTS
  The study group consisted of 50 children (24 female, 26 male) with asthma. According to the GINA guidelines, 26 of the patients had mild intermittant asthma, six had mild persistent asthma and 18 had intermediate persistent asthma. None of the patients had severe asthma. In 37 of the asthma patients, spIgE was positive and these patients were accepted as having atopic asthma; 27 of these patients received immunotherapy. We did not detect any differences between the study and control groups in terms of gender, age and body mass index. No differences were evident between the groups with regard to systolic and diastolic blood pressure, heart rate, blood cholesterol levels and respiratory function test parameters. There was no difference between the asthma and control groups in the measurement of abdominal aortic stiffness parameters. There was no significant correlation between aortic stiffness parameters and high-sensitivity C-reactive protein, blood total cholesterol, LDL cholesterol and HDL cholesterol levels.
  
  
  CONCLUSIONS
  We did not find any difference between the asthma patients and control group with regard to aortic stiffness parameters (DIS, S, Ep and Ep*) and there was no difference in these parameters when we compared patients with mild asthma with those with moderate asthma. These results may be due to the anti-inflamatory effect of inhaled steroids. Further studies are needed to validate these results.
authors.affiliation: Ege University Children's Hospital, Izmir, Bornova, Turkey. drzulger@hotmail.com.
authors.forename: Zülal
authors.initials: Z
authors.lastname: Ülger
authors.affiliation: Ege University Children's Hospital, Izmir, Bornova, Turkey.
authors.forename: Figen
authors.initials: F
authors.lastname: Gülen
authors.affiliation: Ege University Children's Hospital, Izmir, Bornova, Turkey.
authors.forename: Arif Ruhi
authors.initials: AR
authors.lastname: Özyürek
mesh_terms: D000293:Adolescent; D017668:Age of Onset; D018927:Anti-Asthmatic Agents / Q000627:therapeutic use; D001012:Aorta, Abdominal / Q000000981:diagnostic imaging / Q000503:physiopathology*; D001018:Aortic Diseases / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D062186:Arterial Pressure; D001249:Asthma / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D050197:Atherosclerosis / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D002648:Child; D003430:Cross-Sectional Studies; D055119:Elastic Modulus; D005260:Female; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D012307:Risk Factors; D012720:Severity of Illness Index; D013314:Stress, Mechanical; D014463:Ultrasonography; D059289:Vascular Stiffness
chemical_list: D018927:Anti-Asthmatic Agents