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Insulin resistance, metabolic syndrome linked with worsened lung function in obese adolescents

Insulin resistance and metabolic syndrome correlated with worsened lung function in obese adolescents, and the effect of metabolic syndrome was worse among those with asthma, according to study results.

“Among adolescents with and without asthma, we found that insulin resistance is associated with decreased [forced expiratory volume in 1 second (FEV₁)] and [forced vital capacity (FVC)] values and that the [metabolic syndrome (MS)] is associated with lower FEV₁/FVC ratio,” Erick Forno, MD, MPH, of the Children’s Hospital of Pittsburgh, and colleagues wrote. “Both findings were significant only in overweight or obese adolescents and were more pronounced for FEV₁ and FEV₁/FVC ratio among adolescents with asthma.”

Erick Forno

The researchers conducted a cross-sectional study of 1,429 adolescents aged 12 to 17 years in the 2007-2010 National Health and Nutrition Examination Survey to assess associations between obesity, insulin sensitivity, MS and lung function in adolescents with and without asthma.

Insulin sensitivity was associated with higher FEV₁ (range of estimated effect, 28.6-46.1 mL per each unit increment) and FVC values among overweight or obese adolescents.

In assessing MS in all evaluable participants (n = 545) or those without asthma (n = 519), MS was associated with a 2.34% to 2.04% decline in FEV₁/FVC ratio but not with FEV₁ or FVC values. MS was linked with a 12.56% decline in FEV₁/FVC ratio and a 530-mL decrease in FEV₁ among participants with asthma (n = 95).

MS also was linked with a 2.33% decrease in FEV₁/FVC ratios in participants who were overweight or obese.

Study limitations included the number of participants with current asthma (n = 28) and how MS was defined. “The definition we used had less stringent criteria and thus allowed us to classify more subjects as having MS,” the researchers wrote.

“Insulin resistance and the MS might affect lung function in adolescents. Management of these conditions should be part of the treatment of obese asthmatic children and adolescents.” –by Ryan McDonald

Disclosure: Forno reports receiving grant support from the NIH. Celedón reports receiving grant support from the NIH and an endowment from the Heinz Foundation. All other authors report no relevant financial disclosures.