The Association between Asthma and Obesity in Children – Inflammatory and Mechanical Factors

BACKGROUND: Association of asthma and obesity has been demonstrated in numerous epidemiological studies. However, the underlying mechanisms of the association are not well understood. Both conditions are characterised by chronic tissue inflammation, which includes numerous different inflammatory markers, and possible atopy. AIM: The study aimed to investigate the association between asthma and obesity in children and assess several of potential underlying mechanisms, including the parameters of systemic inflammation (CRP, fibrinogen) and the mechanical effect of obesity on the respiratory system through parameters of lung function. An additional aim was to examine the role of atopy in overweight children with asthma and to investigate the type of respiratory inflammation. MATERIAL AND METHODS: This prospective study included 72 patients in the age group of 7-15 years, including 38 with high body mass index (BMI), 16 with asthma and normal BMI, and 18 with asthma and high BMI for sex and age. Non-specific inflammatory markers (fibrinogen, CRP), eosinophilia, and total serum IgE were investigated. The patients underwent a skin prick test (SPT) with standard inhalant allergen extracts, measurement of fractional exhaled nitric oxide Fe (NO), and an assessment of lung function. RESULTS: In overweight groups of children we determined significantly higher values (p < 0.001) of both acute inflammatory reactants, CRP and fibrinogen, with no difference between children with and without asthma. There was a significant increase in eosinophilia, total IgE, and positive SPT in the asthmatic groups compared to the group of non-asthmatic patients (p < 0.001 for the three parameters). Compared to the group composed of overweight patients without asthma, the asthmatic patients had higher NO values (p < 0.001). No significant difference in the lung function parameters was found between the three groups (p > 0.05). CONCLUSION: A positive association between asthma and obesity with inflammation as an underlying mechanism, eosinophilic one in asthmatic patients and non-eosinophilic one in overweight patients, was determined. It seems that the lung function parameters did not differ between asthmatic patients and overweight patients. No influence of atopy in the association between asthma and obesity was verified. Further analyses of specific inflammatory markers, for an in-depth evaluation of the mechanisms leading to the association of obesity and asthma, are warranted.

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Relationship between pulmonary function tests, sputum eosinophilia and total serum IgE levels among asthmatic patients in Duhok, Iraq

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20202239 ◽

2020 ◽

Vol 8 (6) ◽

pp. 2033

Author(s):

Hamdia Yousif Issa ◽

Ali A. Ramadhan ◽

Abdulazeez S. Safo ◽

Omar A. M. Al Habib

Keyword(s):

Pulmonary Function ◽

Severe Asthma ◽

Inflammatory Markers ◽

Pulmonary Function Tests ◽

Asthma Severity ◽

Total Serum ◽

Serum Ige ◽

Sputum Eosinophilia ◽

Asthmatic Patients ◽

Function Tests

Background: Bronchial asthma is a disease characterized by reversible airway obstruction, airway inflammation; and hyper-responsiveness. The prevalence of asthma is high, and both its prevalence and burden have increased over the last several decades. The study of inflammatory markers has implications for the appropriate management of this disease. Inflammatory markers has implications for the appropriate management of this disease. Objective of the study is to determine the correlation between asthma severity using pulmonary function tests with sputum eosinophilia and total serum IgE levels.Methods: This case-control study was conducted from March 2017 to September 2018 in the respiratory unit of Azadi general teaching hospital. It included 42 asthmatic patients and 18 healthy subjects. They underwent pulmonary function tests and measurement of total serum IgE levels. Induced sputum was done for asthmatic patients.Results: The age of asthmatic patients ranged from 16-70 years (mean 42±19 years). The asthmatic patient’s female: male ratio was 1.8. Mild asthma was the most common severity group (N=18, 43%) followed by moderate asthma (N=14, 33%) then severe asthma (N=10, 24%). Abnormal sputum eosinophilia (≥3%) was detected in 90% of severe asthma (N=9) compared to 36% in moderate asthma (N=5) and 5.6% in mild asthma (N=1). There was significant statistical association between asthma severity and sputum eosinophilia (p=0.00004). The association between asthma severity and total serum IgE levels was highly significant (p<0.0000) with levels of total serum IgE increasing as the severity of asthma increases.Conclusions: Severe asthma is the least common severity group in this study. Both abnormal sputum eosinophilia and total serum IgE levels are associated with the severity of asthma.

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IL1RL1 single nucleotide polymorphisms are associated with asthma in the Iranian population

Monaldi Archives for Chest Disease ◽

10.4081/monaldi.2021.1697 ◽

2021 ◽

Author(s):

Maral Ranjbar ◽

Mojdeh Matloubi ◽

Shaghayegh Sadegh ◽

Morteza Fallahpour ◽

Leila Janani ◽

...

Keyword(s):

Single Nucleotide Polymorphisms ◽

Genetic Factors ◽

Inflammatory Responses ◽

Interleukin 1 ◽

Positive Association ◽

Iranian Population ◽

Total Serum ◽

Nucleotide Polymorphisms ◽

Single Nucleotide ◽

Prick Test

Asthma is a chronic and multifactorial disease which is known to result from environmental and genetic factors. Interleukin 1 receptor-like 1 (IL1RL1) is a receptor, which promotes inflammatory responses after binding to its ligand IL-33. Several studies have shown that IL1RL1 gene polymorphisms are related to susceptibility or protection to asthma. The objective of this study was to evaluate the association between two IL1RL1 single nucleotide polymorphisms (rs10208293 and rs1041973) and the risk of asthma in the Iranian population. We performed genotyping of the IL1RL1 SNPs in 126 adult asthmatics and 300 healthy controls using TaqMan genotyping assay. Moreover, total serum IgE level, eosinophil count, and skin prick test were accomplished. The results indicated that the AA genotype of rs10208293 was positively associated with asthma susceptibility (p=0.028). We did not find any association between rs1041973 and asthma. Overall, our findings indicate that rs10208293 has a positive association with asthma in the Iranian population.

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The Influence of the Duration of Breastfeeding on the Infant’s Metabolic Epigenome

Nutrients ◽

10.3390/nu11061408 ◽

2019 ◽

Vol 11 (6) ◽

pp. 1408 ◽

Cited By ~ 8

Author(s):

Sara Pauwels ◽

Lin Symons ◽

Eva-Lynn Vanautgaerden ◽

Manosij Ghosh ◽

Radu Corneliu Duca ◽

...

Keyword(s):

Dna Methylation ◽

Maternal Nutrition ◽

Positive Association ◽

Postnatal Period ◽

Infant Growth ◽

Breastfeeding Duration ◽

Epigenetic Changes ◽

Significant Difference ◽

Underlying Mechanisms ◽

Duration Of Breastfeeding

Nutrition in the postnatal period is associated with metabolic programming. One of the presumed underlying mechanisms involves epigenetic modifications (e.g., DNA methylation). Breastfeeding has an unknown impact on DNA methylation at a young age. Within the Maternal Nutrition and Offspring’s Epigenome (MANOE) study, we assessed the effect of breastfeeding duration on infant growth and buccal methylation in obesity-related genes (n = 101). A significant difference was found between infant growth and buccal RXRA and LEP methylation at 12 months of breastfeeding. For RXRA CpG2 methylation, a positive association was found with duration of breastfeeding (slope = 0.217; 95% confidence interval (CI) 1.03, 0.330; p < 0.001). For RXRA CpG3 and CpG, mean methylation levels were significantly lower when children were breastfed for 4–6 months compared to non-breastfed children (only CpG3), and those breastfed for 7–9 months, 10–12 months, or 1–3 months. On the other hand, higher LEP CpG3 methylation was observed when mothers breastfed 7–9 months (6.1%) as compared to breastfeeding for 1–3 months (4.3%; p = 0.007) and 10–12 months (4.6%; p = 0.04). In addition, we observed that infant weight was significantly lower when children were breastfed for 10–12 months. Breastfeeding duration was associated with epigenetic variations in RXRA and LEP at 12 months and with infant biometry/growth. Our results support the hypothesis that breastfeeding could induce epigenetic changes in infants.

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Pulmonary Outcomes in Children Born Extremely and Very Preterm at 11 Years of Age

Frontiers in Pediatrics ◽

10.3389/fped.2021.635503 ◽

2021 ◽

Vol 9 ◽

Author(s):

Paola Di Filippo ◽

Cosimo Giannini ◽

Marina Attanasi ◽

Giulia Dodi ◽

Alessandra Scaparrotta ◽

...

Keyword(s):

Lung Function ◽

Gestational Age ◽

Blood Count ◽

Positive Association ◽

Diffusing Capacity ◽

Preterm Children ◽

Prick Test ◽

Very Preterm ◽

Preterm Group ◽

Respiratory Outcomes

Background: There is increasing evidence of prematurity being a risk factor for long-term respiratory outcomes regardless the presence of bronchopulmonary dysplasia (BPD).Aim: To assess the effect of prematurity on respiratory outcomes in children born ≤32 weeks of gestational age at 11 years of age.Materials and Methods: Fifty five ex-preterm children (≤ 32 weeks of gestational age), born in Chieti between January 1, 2006 and December 31, 2007, performed lung function and diffusing capacity test (DLCO) at 11 years of age. Furthermore, allergy evaluation by skin prick test (SPT), eosinophil blood count and assessment of eosinophilic airways inflammation by exhaled nitric oxide (FeNO) were performed. The ex-preterm group was compared to an age- and sex-matched group of term children.Results: No difference for atopic and respiratory medical history was found between ex-preterm children and term controls, except for preschool wheezing that resulted more frequent in ex-preterm children. No difference neither in school-aged asthma frequency nor in lung function assessment at 11 years of age was found between the two groups. Lower DLCO values in ex-preterm children compared to term controls regardless the presence of BPD were found; furthermore, we showed a positive association between DLCO and gestational age. Eosinophil blood count, positive SPTs and FeNO values were similar between the two groups.Conclusions: Diffusing lung capacity was decreased in ex-preterm children at 11 years of age in the absence of lung function impairment and eosinophil airway inflammation, suggesting a non-eosinophilic pattern underlying pulmonary alterations. It could be desirable to include the diffusing capacity assessment in follow-up evaluation of all ex-preterm children.

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Leptin, Obesity Parameters, and Atopy Among Children with Asthma

PRILOZI ◽

10.2478/prilozi-2021-0024 ◽

2021 ◽

Vol 42 (2) ◽

pp. 79-88

Author(s):

Valentina Cvejoska Cholakovska ◽

Emilija Vlashki ◽

Mirjana Kochova ◽

Vesna Velikj Stefanovska ◽

Aleksandar Petlichkovski

Keyword(s):

Pulmonary Function Tests ◽

Underlying Mechanism ◽

Total Serum ◽

Normal Body Mass Index ◽

Overweight Children ◽

Serum Leptin ◽

Prick Test ◽

Significant Difference ◽

Median Level ◽

Children With Asthma

Abstract Leptin, as a major adipokine, positively correlates with the body’s fat, while atopy is an important feature in the development of childhood asthma. We aimed to evaluate the relationship between leptin, parameters of obesity, and atopy in children with asthma. The study included 112 children (73 boys, 39 girls, mean age 11.1±2.4). 41 were overweight, 38 had asthma and a normal body mass index (BMI), and 33 were overweight asthmatics. Serum leptin levels, BMI, waist circumference (WC), and waist to hips ratio (WHR) were measured. Skin prick test (SPT)/CAP, total serum IgE, fractional exhaled nitric oxide (FeNO), and pulmonary function tests were performed. In asthmatic children, serum leptin median level was 9.2±16.2 ng/ml, in overweight children was 30.6±21.6 ng/ml, and in overweight asthmatics was 31.1±20.3 ng/ml with a significant difference between the groups (p=0.0374), yet with a significantly lower median level in the group of children with asthma compared to the overweight children: with asthma (p=0.00001) and without asthma (p=0.00001). In the three groups of patients, BMI and WC displayed a significant positive correlation with leptin (for BMI r=0.652 vs. r=0.530 vs. r=0.563, respectively and for WC r=0.508 vs. r=0.426 vs. r=0.527, respectively). No significant correlations of leptin within atopy parameters (Eo, IgE, SPT/CAP, FeNO) in all three analyzed groups (p>0.05) was detected. Conclusion: Atopy was not confirmed as an underlying mechanism of the association between asthma and being overweight. Leptin had a significant linear correlation as a parameter of central obesity with BMI and WC in all three groups, but not with WHR.

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Increased Serum IL 6 Associated With Mortality and Cognitive Impairment in Elderly Brazilians

Innovation in Aging ◽

10.1093/geroni/igaa057.396 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 120-121

Author(s):

Marcelo Caldeira ◽

Milena Brunialti ◽

Reinaldo Salomão ◽

Clineu Almada Filho ◽

Maysa Cendoroglo

Keyword(s):

Cognitive Impairment ◽

Longitudinal Study ◽

Chronic Inflammation ◽

Inflammatory Markers ◽

Oldest Old ◽

Positive Association ◽

Tnf Alpha ◽

P Value ◽

Cognitive Changes ◽

Significant Difference

Abstract Immunological and inflammatory changes are gaining importance in aging as they are associated with functional limitations and mortality. Chronic inflammation associated with aging (Inflammaging) is a systemic and subclinical condition, characterized by changes in the levels of interleukins such as IL1, IL4, IL6, IL8, IL10 and TNF alpha, associated with genetic, physiological and environmental factors, whose importance is to be directly associated with morbidity and mortality in the elderly. Objective: To evaluate, through a longitudinal study, the relationship between chronic inflammation associated with aging and possible outcomes, such as cognitive changes and mortality in independent oldest old adults. Methods: were evaluated 201 elderly, aged 80 years or older, community residents, with preserved cognition, without acute diseases and with controlled chronic diseases. In a 02 years of interval, laboratory collections of inflammatory markers (IL 1, IL 4, IL6, IL10, TNF alpha and CRP) were performed and outcomes such as cognitive impairment and deaths were evaluated. Results: There was a correlation between increased serum IL6 and cognitive impairment, in the group of women (p-value = 0.008) and in the group All (p-value = 0.022). In the group of men, there was a significant difference between the increase in IL6 values (p-value = 0.028) and CRP (p-value = 0.016) in relation to deaths. Conclusion: The results of this longitudinal study showed and confirmed the positive association between changes in inflammatory markers such as IL6 and outcomes such as cognitive impairment and mortality also in elderly Brazilians.

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Air Trapping Is Associated with Heterozygosity for Alpha-1 Antitrypsin Mutations in Patients with Asthma

Respiration ◽

10.1159/000513072 ◽

2021 ◽

pp. 1-10

Author(s):

Marina Aiello ◽

Marianna Ghirardini ◽

Laura Marchi ◽

Annalisa Frizzelli ◽

Roberta Pisi ◽

...

Keyword(s):

Lung Function ◽

Serum Concentration ◽

Forced Expiratory Volume ◽

Small Airway ◽

University Hospital ◽

Air Trapping ◽

Asthmatic Patients ◽

Alpha 1 Antitrypsin Deficiency ◽

Alpha 1 Antitrypsin ◽

Few Data

Background: Alpha-1 antitrypsin deficiency (AATD) is a hereditary disorder involving lungs, characterized by low serum concentration of the protein alpha-1 antitrypsin (AAT) also called proteinase inhibitor (PI). Asthma is common in AATD patients, but there are only few data on respiratory function in asthmatic patients with AATD. Objectives: The aim of the study was to evaluate lung function in asthmatic outpatients with mutation in the SERPINA1 gene coding for AAT versus asthmatic subjects without mutation. Methods: We performed the quantitative analysis of the serum concentration of AAT in 600 outpatients affected by mild to moderate asthma from the University Hospital of Parma, Italy. Fifty-seven of them underwent the genetic analysis subsequently; they were subdivided into mutated and non-mutated subjects. All the mutated patients had a heterozygous genotype, except 1 (PI*SS). We assessed the lung function through a flow-sensing spirometer and the small airway parameters through an impulse oscillometry system. Results: The values of forced vital capacity (% predicted) and those of the residual volume to total lung capacity ratio (%) were, respectively, lower and higher in patients mutated versus patients without mutation, showing a significantly greater air trapping (p = 0.014 and p = 0.017, respectively). Moreover, patients with mutation in comparison to patients without mutation showed lower forced expiratory volume in 3 s (% predicted) and forced expiratory volume in 6 s (L) spirometric values, reflecting a smaller airways contribution. Conclusions: In asthmatic patients, heterozygosity for AAT with PI*MZ and PI*MS genotypes was associated with small airway dysfunction and with lung air trapping.

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Effects of Obesity on Airway and Systemic Inflammation in Asthmatic Children

International Archives of Allergy and Immunology ◽

10.1159/000513809 ◽

2021 ◽

pp. 1-11

Author(s):

Emine Vezir ◽

Ersoy Civelek ◽

Emine Dibek Misirlioglu ◽

Muge Toyran ◽

Murat Capanoglu ◽

...

Keyword(s):

Airway Inflammation ◽

Systemic Inflammation ◽

Adiponectin Level ◽

Inflammatory Cells ◽

Prick Test ◽

Asthmatic Children ◽

Asthmatic Patients ◽

Reactive Protein ◽

Type 2 Cytokines ◽

Asthma In Children

Background: Obese asthma is a complex syndrome with certain phenotypes that differ in children and adults. There is no clear evidence regarding the presence of additive or synergistic pathological interaction between obesity and asthma in children. Objectives: Our aim was to demonstrate the interaction of obesity and asthma in children in terms of airway and systemic inflammation by a controlled observational study. Methods: Four groups were formed: asthma obese (AO), asthma nonobese (ANO), non-AO (NAO), nonasthma nonobese (NANO). Spirometry test, fractional exhaled nitric oxide (FeNO) test, skin prick test, serum inflammatory biomarkers (C-reactive protein, C3, C4, adiponectin, leptin, resistin, periostin, YKL-40, Type 1, and Type 2 cytokines) were conducted and evaluated in all participants. Sputum inflammatory cells (sputum eosinophils and neutrophils) were evaluated in patients who could produce induced sputum and obesity-asthma interactions were determined. Results: A total of 153 participants aged 6–18 years were included in the study, including the AO group (n = 46), the ANO group (n = 45), the NAO group (n = 30), and the NANO group (n = 32). IL-4 (p < 0.001), IL-5 (p < 0.001), IL-13 (p < 0.001), resistin (p < 0.001), and YKL-40 (p < 0.001) levels were higher in patients with asthma independent of obesity. The lowest adiponectin level was found in the AO group and obesity-asthma interaction was detected (p < 0.001). Sputum eosinophilia (p < 0.01), sputum neutrophilia (p < 0.01), and FeNO levels (p = 0.07) were higher in asthmatic patients independent of obesity. In the group with paucigranulocytic inflammation, resistin and YKL-40 levels were significantly lower than in the group without paucigranulocytic inflammation (p < 0.01). Conclusion: No interaction was found between obesity and asthma in terms of airway inflammation. Interaction between obesity and asthma was shown in terms of adiponectin level and resistin/adiponectin and leptin/adiponectin ratios. It was found that serum YKL-40 and resistin levels could be associated with airway inflammation.

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Mother Phubbing and Adolescent Cyberbullying: The Mediating Role of Perceived Mother Acceptance and the Moderating Role of Emotional Stability

Journal of Interpersonal Violence ◽

10.1177/0886260520983905 ◽

2020 ◽

pp. 088626052098390

Author(s):

Jiahui Qu ◽

Li Lei ◽

Xingchao Wang ◽

Xiaochun Xie ◽

Pengcheng Wang

Keyword(s):

High School Students ◽

Positive Association ◽

Emotional Stability ◽

School Students ◽

Mediation Analyses ◽

Mediating Role ◽

Indirect Path ◽

Underlying Mechanisms ◽

The Relationship

Previous studies have found some risk factors of cyberbullying. However, little is known about how mother phubbing may influence adolescent cyberbullying, and the mediating and moderating mechanisms underlying this relationship. “Phubbing,” which is a portmanteau of “phone” and “subbing,” refers to snubbing other people and focus on smartphones in social interactions. This study examined whether mother phubbing, which refers to being phubbed by one’s mother, would be positively related to adolescent cyberbullying, whether perceived mother acceptance would mediate the relationship between mother phubbing and adolescent cyberbullying, and whether emotional stability would moderate the pathways between mother phubbing and adolescent cyberbullying. The sample consisted of 4,213 Chinese senior high school students (mean age 16.41 years, SD = 0.77, 53% were female). Participants completed measurements regarding mother phubbing, cyberbullying, perceived mother acceptance, and emotional stability. The results indicated that mother phubbing was positively related to cyberbullying, which was mediated by perceived mother acceptance. Further, moderated mediation analyses showed that emotional stability moderated the direct path between mother phubbing and cyberbullying and the indirect path between mother phubbing and perceived mother acceptance. This study highlighted the harmful impact of mother phubbing on adolescents by showing a positive association between mother phubbing and adolescent cyberbullying, as well as the underlying mechanisms between mother phubbing and adolescent cyberbullying.

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Secular Trends of Underweight, Overweight, and Obesity in Children and Adolescents from Ukraine

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18063302 ◽

2021 ◽

Vol 18 (6) ◽

pp. 3302

Author(s):

Katarzyna Dereń ◽

Justyna Wyszyńska ◽

Serhiy Nyankovskyy ◽

Olena Nyankovska ◽

Marta Yatsula ◽

...

Keyword(s):

Children And Adolescents ◽

Age Groups ◽

Overweight And Obesity ◽

The Body ◽

World Health ◽

Public Health Issue ◽

Significant Difference ◽

Significant Public Health ◽

Health Organization ◽

Obesity In Children

Overweight and obesity, as well as underweight in children and adolescents, pose a significant public health issue. This study aimed to investigate the secular trend of the incidence of underweight, overweight, and obesity in children from Ukraine in 2013/2014 and 2018/2019. The studies were conducted in randomly selected primary and secondary schools in Ukraine. In total, 13,447 children (6468 boys and 6979 girls) participated in the study in 2013/2014 and 18,144 children (8717 boys and 9427 girls) participated in 2018/2019. Measurements of body weight and height were performed in triplicate. Underweight, overweight, and obesity were diagnosed according to the standards of the World Health Organization (WHO). In the group of girls, a significant difference between 2013/2014 and 2018/2019 measurements was found only among 7-year-olds. The percentage of girls at this age exceeding the body mass index (BMI) norm was lower in the 2018/2019 study. In boys, a significant difference was also found in 7-year-olds, and, as in girls, a lower share of overweight and obesity was found in 2018/2019. But for the ages of 12, 13, and 15, the significant differences had a different character—more overweight or obese boys were found in the 2018/2019 study. The proportion of underweight children was similar for the majority of age groups in both genders and did not differ in a statistically significant way.

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