Body mass index, adipokines and insulin resistance in asthmatic children and adolescents

Objective: This study aimed to describe the body mass index, insulin resistance, levels of adipokines and inflammatory markers in Brazilian asthmatic children and adolescents and to investigate their possible association with the severity and control of asthma. Methods: Cross-sectional study (n=92; age: 3-18 years). Assessed data: Body weight and height, used to calculate the body mass index (BMIZ) and height-for-age (HAZ). Laboratory measurements: Lipid profile; glycemia and insulin for homeostasis model assessment (HOMA); adipokines; tumor necrosis factor alpha (TNF-), C-reactive protein (CRP) and monocyte chemoattractant protein-1 (MCP-1); total immunoglobulin E (IgE) and specific IgE against aeroallergens. Results: The median age was 9.6 years (3.0-16.6); most participants were male (n=52, 56.5%), pre-pubertal (n=54, 58.6%) and had atopic asthma (n=85, 92.4%). Overweight/obesity (38%) showed an inverse correlation with age (adjusted odds ratio [OR]=0.781; 95% confidence interval [CI] 0.66-0.92) and a direct correlation with the leptin concentration (adjusted OR=1.13; 95% CI 1.04-1.22). Insulin concentration was independently associated with moderated persistent asthma (adjusted OR=1.31; 95% CI 1.09-1.52). HOMA showed a direct correlation with the leptin (=0.475; 95% CI 0.117-0.268) and total IgE (=0.197; 95% CI 0.002-0.096) levels and an inverse correlation with the TNF- levels (=-0.255; 95% CI;-0.366-0.055). Conclusions: Asthma was associated with insulin resistance and a systemic inflammatory response possibly mediated by adipokines, with leptin levels standing out among the participants with excess weight.