title: Asthma and insulin resistance in obese children and adolescents.
abstract: BACKGROUND
  Obese children and adolescents have an increased risk for asthma. A few studies have evaluated the association of insulin resistance and asthma in obese pediatric populations. We examined whether there was a relationship between high degrees of insulin resistance and the presence of asthma in obese children and adolescents.
  
  
  METHODS
  A total of 153 patients aged 4-15 years with at or above the 95th percentile BMI for age were prospectively recruited. Assessments included diagnosis of asthma, skin prick test reactivity to common environmental aeroallergens, and HOMA estimated insulin resistance, with the median (2.22) used as a cutoff value to categorize insulin resistance.
  
  
  RESULTS
  There were 56 (36.6%) asthmatic and 97 (63.4%) non-asthmatic patients. HOMA values were significantly associated with positive skin tests (p = 0.008) and allergic asthma diagnosis (p = 0.016). Baseline insulin value was significantly associated with the risk of presenting asthma with positive skin testing (odds ratio 1.084, p = 0.037). Differences in age, BMI, and waist circumference were found between the groups of HOMA-IR <2.22 and ≥2.22. Waist circumference (WC) was significantly associated with FVC (p = 0.0001) and FEV1 (p < 0.0003); the greater the WC, the lower FVC and FEV1 values.
  
  
  CONCLUSIONS
  Insulin resistance is a risk for allergic asthma in obese children and adolescents. Waist circumference was related to CVF and FEV1 impairment.
authors.affiliation: Service of Pediatrics, Units of Pediatric Pneumology, Pediatric Endocrinology, Pneumology and Immunoallergy, Hospital Comarcal Sant Jaume de Calella, Corporació de Salut del Maresme i La Selva, Barcelona, Spain.
authors.forename: José
authors.initials: J
authors.lastname: Sánchez Jiménez
authors.forename: F Javier
authors.initials: FJ
authors.lastname: Herrero Espinet
authors.forename: José M
authors.initials: JM
authors.lastname: Mengibar Garrido
authors.forename: Josep
authors.initials: J
authors.lastname: Roca Antonio
authors.forename: Sara
authors.initials: S
authors.lastname: Peños Mayor
authors.forename: María del Mar
authors.initials: Mdel M
authors.lastname: Peñas Boira
authors.forename: Amadeu
authors.initials: A
authors.lastname: Roca Comas
authors.forename: Anna
authors.initials: A
authors.lastname: Ballester Martínez
mesh_terms: D000293:Adolescent; D000393:Air Pollutants / Q000276:immunology; D000485:Allergens / Q000276:immunology; D001249:Asthma / Q000453:epidemiology*; D015992:Body Mass Index; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007333:Insulin Resistance; D008297:Male; D009765:Obesity / Q000453:epidemiology*; D011446:Prospective Studies; D012882:Skin Tests; D013147:Spirometry
chemical_list: D000393:Air Pollutants; D000485:Allergens
keywords: adolescents; asthma; body mass index; children; insulin; insulin resistance; obesity