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Interactive effects of adiposity and insulin resistance on the impaired lung function in asthmatic adults: cross-sectional analysis of NHANES data

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Sadeghimakki, Roham and McCarthy, H. David (2019) Interactive effects of adiposity and insulin resistance on the impaired lung function in asthmatic adults: cross-sectional analysis of NHANES data. Annals of Human Biology, 46 (1). pp. 56-62. ISSN 0301-4460

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Abstract

Background:
Obesity is considered a risk factor for both asthma and insulin resistance in adults. Insulin resistance(IR) also influences the pulmonary function in the non-obese population.

Objective:
To investigate the modifying effect of insulin resistance on the predictive role of anthropometric measures in the estimation of impaired lung function among asthmatic adults.

Methods:
A cross-sectional study of 1276 adults extracted from NHANES 2009-2012 database was performed. Adjusted multivariate linear regression was conducted to analyse the contributory role of obesity and IR in predicting lung function among asthmatic adults.

Results:
BMI, waist circumference (WC), and waist to height ratio (WHtR) showed significantly negative correlations with FVC (r=--0.24, -0.18, -0.39, respectively; p<0.001), FEV1(r=--0.24, -0.21, -0.40, respectively; p<0.001), and FEF 25-75% (r=--0.15, -0.18, -0.27, respectively; p<0.001). Even after adjustment for the covariates (age, gender, smoking history, and standing height), BMI and HOMA-IR had significant relationships with FVC ((β=-10.3; p<0.01) and (β=-16.0; p<0.05)) and FEV1((β=-8.7; p<0.01) and (β=-11.7; p<0.05)). BMI could significantly predict the decreased FVC (β=-13.7; p<0.01) and FEV1(β=-10.7; p<0.01) only in the insulin resistant asthmatics.

Conclusion:
WHtR and IR predict impaired lung function in overweight/obese asthmatic adults independently. IR also modifies the association between excessive adiposity and respiratory function in asthmatic adult.

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