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Sci Rep. 2018;8(1):9378.

The relationship between metabolic syndrome and asthma in the elderly.

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제1저자 박상신 · 교신저자 이창훈

PMID 29925841 PMC6010438 DOI 10.1038/s41598-018-26621-z IF 4.9 호흡기내과
소속 (5)
  1. Center for International Health Research, Rhode Island Hospital, The Warren Alpert Medical School of Brown University, Providence, Rhode Island, United States.
  2. Department of Pediatrics, The Warren Alpert Medical School of Brown University, Providence, Rhode Island, United States.
  3. Department of Health Convergence, Ewha Womans University, Seoul, Republic of Korea.
  4. Division of Allergy and Pulmonology, Department of Internal Medicine, Catholic University of Korea Daejeon St. Mary's Hospital, Daejeon, Republic of Korea.
  5. Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea. kauri670@empal.com.

Abstract

The burden of asthma in the elderly is increasing, but the etiology of asthma in the elderly is not clearly understood. Recent studies have reported the epidemiological link between metabolic syndrome (MS) and asthma, but it has rarely been studied in the elderly. This study investigated the association between MS and asthma and the contribution of insulin resistance (IR) and systemic inflammation to this MS-asthma association in the elderly. Our study analyzed 4,060 elderly participants (≥65 years old) from a cross-sectional survey, the Korean National Health and Nutritional Examination Survey 2007-2012. Mediation analyses were performed to examine whether IR and systemic inflammation mediates the MS-asthma association. Participants with MS had significantly higher prevalence of asthma (adjusted odds ratio = 1.34; 95% confidence interval = 1.09-1.64), and those who had greater waist circumference and lower HDL-C were especially likely to have asthma. Participants with IR and systemic inflammation were associated with higher prevalence of asthma. Prevalence of IR and systemic inflammation were higher in participants with MS or with each MS component. The MS-asthma association was substantially mediated by IR and systemic inflammation. Our study showed a significant association between MS and asthma in the elderly. MS might affect asthma through both IR and systemic inflammation.

Figures

Figure 1
Figure 1 Prevalence of asthma according to the status of metabolic syndrome (MS), MS components, homeostasis model assessment of insulin resistance (HOMA-IR), and white blood cell (WBC) count. MS and MS components were defined according to the Joint Interim Statement clinical criteria with Korean-specific abdominal obesity criteria. Abnormal HOMA-IR, termed “insulin resistance,” was determined when HOMA-IR was greater than 3.06 (75th percentile). Abnormal WBC count, termed “systemic inflammation,” was determined when the WBC count greater than 6,830/µL (>75th percentile). The error bars represent 95% confidence intervals. P values were derived from Chi-square test. WC, waist circumference; BP, blood pressure; TG, triglyceride; HDL-C, high-density lipoprotein cholesterol; FG, fasting glucose. **P value < 0.01; ***P value < 0.001.
Figure 2
Figure 2 Mediation models of (A) HOMA-IR or IR and (B) WBC count or systemic inflammation in the relationship between MS and MS components, and asthma; examples† for mediation models of (C) IR and (D) systemic inflammation. IR was defined as HOMA-IR >3.06 (75th percentile). Systemic inflammation was also defined as WBC count >6,830/µL (75th percentile). Pathways and odds ratios are indicated with letters: pathway a represents the direct effect of the predictors (MS and MS components) on the mediators (HOMA-IR, IR, WBC count, and systemic inflammation); pathway b represents the direct effect of the mediators on the outcome (asthma); pathway c represents the direct effect of the predictors on the outcome. †Indirect and mediation effects for these examples are shown in Table 3. MS, metabolic syndrome; HOMA-IR, homeostasis model assessment of insulin resistance (IR); WBC, white blood cell.
Figure 3
Figure 3 Flow of participants.

그림 출처: PubMed Central 공개 논문 (PMC6010438)

Conflict of interest statement

The authors declare no competing interests.

그 밖의 정보
출판 형태
Journal Article
저널
Scientific reports · eISSN 2045-2322
전자 출판
2018-06-20
MeSH
Aged · Aged, 80 and over · Asthma / blood / epidemiology / immunology · Cholesterol, HDL / blood · Cross-Sectional Studies · Female · Humans · Inflammation / blood / epidemiology / immunology · Insulin Resistance / physiology · Male · Metabolic Syndrome / blood / epidemiology / immunology · Waist Circumference / physiology
Substances
Cholesterol, HDL
참고문헌
38편