Abstract
Background: Asthma and obesity are major, interconnected public health challenges that usually have their origins in childhood, and for which the relationship is strengthened among those with insulin resistance.
Objective: To determine whether high insulin in early life confers increased longitudinal risk for asthma independent of body mass index (BMI).
Methods: The study used data from the Tucson Children's Respiratory Study (TCRS) and the Avon Longitudinal Study of Parents and Children (ALSPAC). Non-fasting insulin was measured in TCRS participants at age 6 and fasting insulin in ALSPAC participants at age 8. Physician-diagnosed active asthma was determined at baseline and at subsequent assessments up to age 36 years in TCRS and 17 years in ALSPAC.
Results: In TCRS, high insulin (upper quartile) at age 6 was associated with increased odds of having active asthma from ages 8 to 36 compared to low insulin (OR 1.98, [1.28-3.05], p=0.002). Similarly, in ALSPAC, high insulin was associated with a significantly higher risk of active asthma from ages 11 to 17 compared to low insulin (1.59 [1.12-2.27], p=0.009). These findings were independent of baseline BMI in both cohorts, and were not related to other demographic and asthma risk factors nor other tested markers of systemic inflammation and metabolic syndrome.
Conclusions: In two separate birth cohorts, higher blood insulin level in early childhood was associated with increased risk of active asthma through adolescence and adulthood, independent of BMI. High insulin indicates a novel mechanism for asthma development, which may be a target for intervention.
Objective: To determine whether high insulin in early life confers increased longitudinal risk for asthma independent of body mass index (BMI).
Methods: The study used data from the Tucson Children's Respiratory Study (TCRS) and the Avon Longitudinal Study of Parents and Children (ALSPAC). Non-fasting insulin was measured in TCRS participants at age 6 and fasting insulin in ALSPAC participants at age 8. Physician-diagnosed active asthma was determined at baseline and at subsequent assessments up to age 36 years in TCRS and 17 years in ALSPAC.
Results: In TCRS, high insulin (upper quartile) at age 6 was associated with increased odds of having active asthma from ages 8 to 36 compared to low insulin (OR 1.98, [1.28-3.05], p=0.002). Similarly, in ALSPAC, high insulin was associated with a significantly higher risk of active asthma from ages 11 to 17 compared to low insulin (1.59 [1.12-2.27], p=0.009). These findings were independent of baseline BMI in both cohorts, and were not related to other demographic and asthma risk factors nor other tested markers of systemic inflammation and metabolic syndrome.
Conclusions: In two separate birth cohorts, higher blood insulin level in early childhood was associated with increased risk of active asthma through adolescence and adulthood, independent of BMI. High insulin indicates a novel mechanism for asthma development, which may be a target for intervention.
| Original language | English |
|---|---|
| Journal | Journal of Allergy and Clinical Immunology: In Practice |
| Early online date | 14 Oct 2021 |
| DOIs | |
| Publication status | Published - 14 Oct 2021 |
Bibliographical note
Funding Information:The Tucson Children's Respiratory Study is funded through the National Heart, Lung, and Blood Institute of the National Institutes of Health (grant no. HL132523). The UK Medical Research Council and Wellcome (grant reference no. 102215/2/13/2) and the University of Bristol provide core support for the Avon Longitudinal Study of Parents and Children. This publication is the work of the authors, and Dr Martinez will serve as guarantor for the contents of this article. Conflicts of interest: T. F. Carr reports consulting fees from AstraZeneca, Genentech, GlaxoSmithKline, Novartis, and Regeneron and royalties from UpToDate outside the submitted work. S. Guerra has received grants from the National Institutes of Health (NIH)/National Heart, Lung, and Blood Institute and the NIH/National Institute of Allergy and Infectious Diseases. F. D. Martinez has received grants from the NIH/National Heart, Lung, and Blood Institute, the NIH/National Institute of Allergy and Infectious Diseases, the NIH/Office of the Director, and OM Pharmaceuticals. The rest of the authors declare that they have no relevant conflicts of interest.
Funding Information:
The Tucson Children's Respiratory Study is funded through the National Heart, Lung, and Blood Institute of the National Institutes of Health (grant no. HL132523). The UK Medical Research Council and Wellcome (grant reference no. 102215/2/13/2) and the University of Bristol provide core support for the Avon Longitudinal Study of Parents and Children. This publication is the work of the authors, and Dr Martinez will serve as guarantor for the contents of this article.
Funding Information:
Conflicts of interest: T. F. Carr reports consulting fees from AstraZeneca, Genentech, GlaxoSmithKline, Novartis, and Regeneron and royalties from UpToDate outside the submitted work. S. Guerra has received grants from the National Institutes of Health (NIH)/National Heart, Lung, and Blood Institute and the NIH/National Institute of Allergy and Infectious Diseases. F. D. Martinez has received grants from the NIH/National Heart, Lung, and Blood Institute, the NIH/National Institute of Allergy and Infectious Diseases, the NIH/Office of the Director, and OM Pharmaceuticals. The rest of the authors declare that they have no relevant conflicts of interest.
Publisher Copyright:
© 2021 American Academy of Allergy, Asthma & Immunology
Research Groups and Themes
- ALSPAC
Keywords
- Asthma
- Metabolic syndrome
- Obesity
Access to Document
- Full-text PDF (author accepted manuscript)
This is the accepted author manuscript (AAM). The final published version (version of record) is available online via ELSEVIER at https://doi.org/10.1016/j.jaip.2021.09.047. Please refer to any applicable terms of use of the publisher.