Obesity Moderates Association Between Asthma and Metabolic Syndrome in Adolescents and Young Adults

• Published in: Obesity (Silver Spring, Md.) Md.), 2023-11, Vol.31, p.132-133
• Main Authors: Xie, Luyu, Chandrasekhar, Aparajita, Ernest, Deepali, Afolabi, Folashade, Almandoz, Jaime, Fernandez, Tanya Martinez, Gelfand, Andrew, Messiah, Sarah
• Format: Article
• Language: English
• Subjects: Asthma; Metabolic syndrome; Obesity; Teenagers; Young adults
• ISSN: 1930-7381; 1930-739X

Background: Studies suggest asthma and metabolic syndrome (MetS) are associated but the role of obesity in this relationship remains unclear. Methods: Adolescents and young adults (AYAs) aged 12-25 years who participated in the 2011-2020 National Health and Nutrition Examination Survey were included in this cross-sectional analysis. The moderating effect of obesity (body mass index [BMI] > 95th%ile for adolescents or > 30 kg/m2 for adults) on asthma was evaluated in three groups: (1) both asthma and obesity (obesity-associated asthma [OAA]); (2) asthma but no obesity (no OAA); (3) no asthma. Prevalence estimates of MetS and its components were calculated and compared by asthma and obesity status. Logistic regression analyses generated the odds ratios (aOR) of MetS, adjusting for demographics and food insecurity. Results: The majority (89.8%) of the sample (N = 5374, mean age 18.5 [SE 0.12] years, 49.4% girls, 20.9% Hispanic, 55.3% non-Hispanic White, and 14.6% non-Hispanic Black) had no asthma, 3.2% had OAA, and 7.0% no OAA. The prevalence of MetS was greater among AYAs with OAA (4.5%, 95% Cl 1.7%-7.3%) than those with no OAA (0.2%, 95% Cl 0%-0.5%) or no asthma (1.8%, 95% Cl 1.2%-2.3%) (all p < 0.001). Compared to those without asthma, AYAs with OAA had ~3 times higher odds of having MetS (aOR 2.7, 95% Cl 1.2-6.0) while those with no OAA had ~90% fewer odds (aOR 0.1, 95% Cl 0-0.5). The odds for high triglycerides (aOR 2.4, 95% Cl 1.1-5.1) and low HDL cholesterol (OR 2.3, 95% Cl 1.6-3.1) were higher among AYAs with OAA compared to those without asthma, respectively. Sensitivity analysis showed among AYAs with obesity (n = 1902), the estimated prevalence of MetS did not differ between those with and without asthma (4.5% vs. 5.4%, p = 0.584). Conclusions: The association between asthma and MetS is moderated by obesity status. Screening for MetS in people with obesity and asthma in addition to the prevention and treatment of obesity in AYAs with asthma may improve cardiometabolic outcomes.