Asthma: the role of low high-density-lipoprotein cholesterol in childhood and adolescence.
BACKGROUND
Several studies have examined the relationship of asthma with serum dyslipidemia and reported positive, negative or no association. Most studies were limited by their cross-sectional design and the wide age range of the participants. In a cohort of children in Cyprus, we explored the association of asthma with serum high-density-lipoprotein cholesterol (HDL-C) at age 16-18 years (follow-up) independently of and in relation to HDL-C at age 11-12 years (baseline).


METHODS
In a case-control design, we recruited active asthmatics (AA; n = 68), current wheezers only (CWO; n = 123) and non-asthmatic controls (n = 660). Logistic regression models were used to evaluate associations of asthma with follow-up serum HDL-C and the role of baseline HDL-C.


RESULTS
At follow-up, mean HDL-C levels in AA and CWO patients were significantly lower than in the controls (47.9 and 49.7 vs. 53.4 mg/dl; p = 0.001 and p = 0.011). We observed significant associations of AA patients with low HDL-C (<15th percentile; OR 2.32, 95% CI 1.16-4.47) that remained significant after further adjustment for baseline HDL-C (OR 2.14, 95% CI 1.06-4.14). Stratification by baseline HDL-C indicated that the association was significant only in those with high baseline HDL-C (OR 2.40, 95% CI 1.03-5.20). Stratification by IgE sensitization showed that the association was pronounced only in subjects who were sensitized (OR 3.41, 95% CI 1.12-9.88).


CONCLUSIONS
Adolescent asthma is associated with low serum HDL-C independent of previous HDL-C levels in childhood. The association appears pronounced in those with a drop in HDL-C levels between childhood and adolescence and in those who have IgE sensitization.
Cyprus International Institute for Environmental and Public Health in association with Harvard School of Public Health, Cyprus University of Technology, Limassol, Cyprus.
Panayiotis K
PK
Yiallouros
Savvas C
SC
Savva
Ourania
O
Kolokotroni
Kleanthi
K
Dima
Aikaterini
A
Zerva
Panayiotis
P
Kouis
Jean
J
Bousquet
Nicos
N
Middleton
D000293:Adolescent; D000367:Age Factors; D001249:Asthma / Q000097:blood* / Q000453:epidemiology / Q000276:immunology; D016022:Case-Control Studies; D002648:Child; D008078:Cholesterol, LDL / Q000097:blood; D003535:Cyprus / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006306:Health Surveys; D006801:Humans; D007073:Immunoglobulin E / Q000276:immunology; D008055:Lipids / Q000097:blood; D008077:Lipoproteins, LDL / Q000097:blood*; D008297:Male; D016017:Odds Ratio; D012016:Reference Values; D012307:Risk Factors
D008078:Cholesterol, LDL; D008055:Lipids; D008077:Lipoproteins, LDL; D007073:Immunoglobulin E