Independent and Synergistic Associations of Asthma and Obesity with Systemic Inflammation in Adolescents

Abstract

Introduction. Both asthma and obesity often occur in the same individual. Each increases the risk of cardiovascular disease (CVD) with systemic inflammation likely playing a vital role. We examined the independent and synergistic associations of asthma and obesity with systemic inflammation using high-sensitivity C-reactive protein (hs-CRP) levels in adolescents. Methods. This study involves the cross-sectional design carried out in the adolescent and respiratory medicine practices in a children’s hospital. Out of 124 adolescents (mean age 16.1 ± 2.3 years), who were either of obese (N = 75) or of normal weight (N = 49). 51 had asthma (18 normal weight and 33 obese). Results. hs-CRP levels were higher in obese versus normal weight groups (geometric mean ± SD: 2.38 ± 2.91 vs. 0.72 ± 3.54; p < .001), and in the asthmatic versus non-asthmatic groups (geometric mean ± SD: 1.21 ± 3.71 vs.1.96 ± 3.28; p = .039). We found a trend of increasing hs-CRP levels across the four groups (p < .001), with the obese asthmatic group having the highest level. In multivariate regression, we found a strong association between obesity and log-CRP (β ± SE: 1.43 ± 0.23; p < .001) and a moderate association between asthma and log-CRP (β ± SE: 0.48 ± 0.21; p < .028), with additive synergy between obesity and asthma. Conclusions. Both asthma and obesity are independently and synergistically associated with systemic inflammation. These findings underline the need of a multifaceted approach to address CVD risk in adolescence.

• adolescents
• asthma
• high-sensitivity C reactive protein
• obesity

Acknowledgments

The authors thank the research associates: Christopher Andrade, Daniel Angeli, Sanuja Decosta, Aaron Greenberg, Temima Strauss, and all the adolescents who participated in the study.

Declaration of Interest

The authors U.I. Khan, C.R. Isasi, D. Rastogi, and S.M. Coupey have no potential, perceived, or real conflicts of interest to disclose.

This study was supported in part by the Michael I. Cohen, MD Fund for Adolescent Medicine and by the CTSA Grant UL1 RR025750 and KL2 RR025749 and TL1 RR025748 from the National Center for Research Resources (NCRR), a component of the National Institutes of Health (NIH), and from NIH Roadmap for Medical Research, respectively. The content is the sole responsibility of the authors and do not necessarily represent the official view of the NCRR or NIH. Additional support for U. Khan’s time comes from NHLBI 1K23HL105790–01 award.