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Prevalence of Metabolic Abnormalities and their Effect on Asthma Symptom Control in Children
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  • Ketan Kumar,
  • RAKESH LODHA,
  • Kana Jat,
  • Vandana Jain,
  • Sushil Kabra
Ketan Kumar
All India Institute of Medical Sciences

Corresponding Author:ketankrpatwari@gmail.com

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RAKESH LODHA
All India Institute of Medical Sciences
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Kana Jat
All India Institute of Medical Sciences
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Vandana Jain
All India Institute of Medical Sciences
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Sushil Kabra
All India Institute of Medical Sciences
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Abstract

Objective The objectives of this study were to determine the prevalence of insulin resistance (IR), dyslipidemia and metabolic syndrome (MS) in children with asthma, aged 10 to 15 years and to determine if these metabolic abnormalities showed an association with asthma symptom control and lung function. Methods We conducted a cross-sectional study at a tertiary centre in north India. Consecutive children with physician diagnosed asthma were enrolled. Asthma symptom control over previous four weeks was assessed as per GINA recommendations. Fasting plasma glucose, serum insulin and lipid levels were estimated. HOMA-IR was used as a marker of IR. Spirometry was performed for assessing lung function. Results Eighty-three children were enrolled. Median (IQR) age was 12.0 (11.0, 13.5) years and mean (SD) BMI z score was -0.42 (1.0). Median (IQR) Homeostasis Model Assessment- Insulin Resistance (HOMA-IR) was 1.65 (1.06, 2.39). Prevalence of IR was 42.3% (95% CI: 31.7-52.9%). Number of children with elevated triglycerides, total cholesterol, and LDL-cholesterol was 4 (4.8%), 4 (4.8%) and 5 (6%), respectively. 67 (80.7%) children had low HDL-cholesterol. Only one subject was found to have MS. Presence of IR and elevation in serum insulin and triglycerides were associated with poorer asthma control, independent of BMI. None of the metabolic parameters were associated with lung function, after adjusting for height. Conclusions A high proportion of children with asthma aged 10-15 years had IR but not MS currently. Increasing serum insulin, triglycerides, and presence of IR were associated with poorer asthma control, after adjusting for BMI.