title: Impaired glucose metabolism and bronchial hyperresponsiveness in obese prepubertal asthmatic children.
abstract: The prevalence of asthma and obesity has risen in parallel over the last decades, but the exact mechanisms linking these two diseases still remain unclear. The aim of the present study was to investigate the associations between bronchial hyperresponsiveness (BHR), impaired glucose metabolism, obesity, and asthma in prepubertal children.
  
  
  
  A total of 71 prepubertal children were included in the study and divided in four groups according to the presence of asthma and their Body Mass Index (BMI): Group 1-Healthy Controls (HC), Group 2-Non Obese Asthmatics (NOA), Group 3-Obese Non Asthmatics (ONA), Group 4-Obese Asthmatics (OA) Αll children underwent spirometry and bronchial hyperresponsiveness testing by using the cumulative Provoking Dose of mannitol (PD15,primary study variable); homeostasis model assessment-estimated insulin resistance (HOMA-IR) index was calculated in order to evaluate insulin resistance. Obese children also underwent an oral glucose tolerance testing (OGTT).
  
  
  
  A statistically significant difference in bronchial hyperreactivity (mean ± SD) was detected in the group of obese asthmatic children who had lower values ​​of PD15, (174.16 ± 126.42) as compared to normal weight asthmatic children (453.93 ± 110.27), (P < 0.001). Moreover, obese asthmatic children with confirmed insulin resistance (HOMA-IR ≥2.5), had significantly lower PD15values (89.05 ± 42.75) as ​​compared to those with HOMA-IR <2.5 (259.27 ± 125.75), (P = 0.006). Finally, obese asthmatic children with impaired OGTT had likewise significantly lower PD15(81.02 ± 42.16) measurements as compared to children with normal OGTT (267.3 ± 112.62), (P = 0.001).
  
  
  
  Our findings suggest that obesity per se does not correlate to airway hyperreactivity unless it is accompanied by glucose intolerance and insulin resistance. Pediatr Pulmonol. 2017;52:160-166. © 2016 Wiley Periodicals, Inc.
authors.affiliation: 4th Department of Pediatrics, Medical School, Papageorgiou General Hospital of Thessaloniki, Aristotle University of Thessaloniki, Thessaloniki, Greece.
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Karampatakis
authors.affiliation: Department of Clinical Microbiology, Hippokration General Hospital of Thessaloniki, Thessaloniki, Greece.
authors.forename: Theodoros
authors.initials: T
authors.lastname: Karampatakis
authors.affiliation: 4th Department of Pediatrics, Medical School, Papageorgiou General Hospital of Thessaloniki, Aristotle University of Thessaloniki, Thessaloniki, Greece.
authors.forename: Assimina
authors.initials: A
authors.lastname: Galli-Tsinopoulou
authors.affiliation: 4th Department of Pediatrics, Medical School, Papageorgiou General Hospital of Thessaloniki, Aristotle University of Thessaloniki, Thessaloniki, Greece.
authors.forename: Eleni P
authors.initials: EP
authors.lastname: Kotanidou
authors.affiliation: Department of Clinical Microbiology, Hippokration General Hospital of Thessaloniki, Thessaloniki, Greece.
authors.forename: Katerina
authors.initials: K
authors.lastname: Tsergouli
authors.affiliation: 4th Department of Pediatrics, Medical School, Papageorgiou General Hospital of Thessaloniki, Aristotle University of Thessaloniki, Thessaloniki, Greece.
authors.forename: Maria
authors.initials: M
authors.lastname: Eboriadou-Petikopoulou
authors.affiliation: 4th Department of Pediatrics, Medical School, Papageorgiou General Hospital of Thessaloniki, Aristotle University of Thessaloniki, Thessaloniki, Greece.
authors.forename: Katerina
authors.initials: K
authors.lastname: Haidopoulou
mesh_terms: D001249:Asthma / Q000453:epidemiology / Q000378:metabolism* / Q000503:physiopathology; D001786:Blood Glucose / Q000378:metabolism*; D015992:Body Mass Index; D016535:Bronchial Hyperreactivity / Q000453:epidemiology / Q000378:metabolism* / Q000503:physiopathology; D002648:Child; D005260:Female; D018149:Glucose Intolerance / Q000453:epidemiology / Q000378:metabolism*; D005951:Glucose Tolerance Test; D006801:Humans; D007333:Insulin Resistance; D008297:Male; D009765:Obesity / Q000453:epidemiology / Q000378:metabolism*; D015995:Prevalence; D013147:Spirometry
chemical_list: D001786:Blood Glucose
keywords: asthma; children; insulin resistance; mannitol challenge test; obesity