Original articleAsthma, lower airway diseaseSerum leptin and adiponectin levels correlate with exercise-induced bronchoconstriction in children with asthma
Introduction
Exercise-induced bronchoconstriction (EIB) refers to a condition in which vigorous physical exertion triggers acute airway narrowing in individuals with heightened bronchial hyperresponsiveness (BHR). Exercise-induced bronchoconstriction occurs in approximately half of children with asthma.1
Epidemiological studies have shown that the prevalence of asthma is increasing concomitantly with obesity.2 Emerging data suggest a link between asthma and obesity3 and indicate that the mechanical, immunological, hormonal and inflammatory effects of obesity play a role in the development and persistence of asthma.2, 4, 5, 6 Adipose tissue releases a variety of proinflammatory adipokines, including leptin, adiponectin, interleukin (IL) 6, tumor necrosis factor alpha (TNF-α), plasminogen activator inhibitor 1, eotaxin, vascular endothelial growth factor, and monocyte chemotactic protein (MCP)-1.3, 7 Studies in mouse models8, 9, 10, 11 have demonstrated that obesity and adipokines enhance BHR, airway inflammation, and allergic responses. However, obesity- and adipokine-related effects on inflammation and BHR have not yet been demonstrated in the human airway. The aim of this study was to address the relationship between the adipocyte-derived hormones leptin and adiponectin and EIB in children with asthma.
Section snippets
Subjects and Protocol
The subjects were recruited from the outpatient clinics in Hanyang University Hospital, Korea. Study participants were 85 prepubertal children between the ages of 6 and 10 years who were classified into one of the following groups: obese subject with asthma (n = 19), normal-weight subject with asthma (n = 23), obese subject without asthma (n = 23), and healthy (n = 20). Age- and sex-specific body mass index (BMI) percentiles were calculated based on raw height and weight according to the
Characteristics of Study Subjects
The demographic data for the 85 subjects are shown in Table 1. Of the 42 subjects with asthma, 7 had mild intermittent asthma (3 obese and 4 normal-weight), 14 had mild persistent asthma (7 obese and 7 normal-weight), and 21 had moderate asthma (10 obese and 11 normal-weight) according to the Global Initiative for Asthma guidelines. No significant differences were seen in asthma severity between the obese and normal-weight subjects with asthma. Mean values of age, height, and sex distribution
Discussion
We have shown that levels of the adipocyte-derived hormones leptin and adiponectin were higher and lower, respectively, in obese subjects with asthma than in normal-weight subjects with asthma, and were significantly correlated with BHR induced by exercise challenge.
Some studies have concluded that obesity is a risk factor for BHR to methacholine,20, 21 but others have reported no increase in BHR to methacholine with increasing BMI.22, 23 The studies that used exercise challenge to examine BHR
Acknowledgments
We thank our pediatric patients and their parents for generous donation of study samples, Mr. Soon-H.O. Koo for technical assistance, and Professor Yeong-Gwan Im and Mr. Han-Sang Baek for data management. We also thank Aerocrine for their support of NIOX MINO for eNO measurement.
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2020, Respiratory MedicineCitation Excerpt :Furthermore, in a study including obese and non-obese asthmatic children, leptin was positively and adiponectin negatively associated with a decrease in FEV1 after a standardised exercise challenge [26]. In the present study, leptin increased by higher BMI, in accordance with other studies [8, 14, 26]. The results from our previous study and from others, suggest that BMI and accelerated growth in early life, at least up to a given threshold, are positively associated with lung function [4–6].
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Funding Sources: Self-funded.
Disclosures: The authors have nothing to disclose.