title: Adiponectin in Asthma and Obesity: Protective Agent or Risk Factor for More Severe Disease?
abstract: OBJECTIVE
  The relationship between asthma and obesity is well established, although the pathophysiological mechanisms linking both diseases remain unknown. Adiponectin is a hormone secreted by adipose cells, plays a role in the modulation of inflammation and may be the key linking these two types of inflammation.
  
  
  METHODS
  We conducted a cross-sectional study with asthma with different body mass indices (BMI); the patients were classified as eutrophic, overweight, or obese. We assessed disease control using the GINA consensus, and the levels of adiponectin, C-reactive protein (CRP) and interleukin 33 (IL-33) in each of the patients.
  
  
  RESULTS
  We evaluated 75 of the 96 patients eligible for the study, including 25 in each BMI group. The CRP levels were significantly higher in the obese patients compared with both the eutrophic (p = 0.01) and the overweight (p = 0.03) patients. The mean adiponectin level was 21.82 ± 9.93 mg/L for the eutrophic asthmatics, which is a level that was significantly higher than in the overweight (15.31 ± 6.27 mg/L, p = 0.0140) and the obese (16.69 ± 11.45 mg/L, p = 0.0287) patients. The patients with higher adiponectin levels exhibited smaller FEV1 (p = 0.02) and lower FVC (p = 0.003). The IL-33 levels were not different between the groups.
  
  
  CONCLUSIONS
  Adiponectin does not protect against the development of inflammation in the setting of asthma and may in fact exacerbate the disease via its anti-TH1 inflammatory effects, allowing for increased TH2 differentiation and a more severe allergic response.
authors: Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, CEP 20551-030, Brazil.
authors: Renato
authors: R
authors: de Lima Azambuja
authors: Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, CEP 20551-030, Brazil.
authors: Layla Salomao Eulalio
authors: LS
authors: da Costa Santos Azambuja
authors: Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, CEP 20551-030, Brazil.
authors: Cláudia
authors: C
authors: Costa
authors: Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, CEP 20551-030, Brazil. rrufino.uerj@gmail.com.|Pulmonology Department, Hospital Universitário Pedro Ernesto, Avenida 28 de Setembro, 77, Rio de Janeiro, RJ, CEP 20551-030, Brazil. rrufino.uerj@gmail.com.
authors: Rogério
authors: R
authors: Rufino
mesh_terms: D052242:Adiponectin / Q000097:blood*; D000328:Adult; D000368:Aged; D001249:Asthma / Q000097:blood* / Q000150:complications / Q000503:physiopathology; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000378:metabolism; D003430:Cross-Sectional Studies; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D056865:Ideal Body Weight / Q000502:physiology; D007249:Inflammation / Q000097:blood* / Q000150:complications; D000067596:Interleukin-33 / Q000097:blood; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000097:blood* / Q000150:complications / Q000503:physiopathology; D050177:Overweight / Q000097:blood; D065840:Protective Factors; D011897:Random Allocation; D012307:Risk Factors; D012720:Severity of Illness Index
chemical_list: D052242:Adiponectin; D000067596:Interleukin-33; D002097:C-Reactive Protein
keywords: Adiponectin; Asthma; Interleukin 33; Obesity; TH2 inflammation