The Impact of Insulin Resistance on Loss of Lung Function and Response to Treatment in Asthma
Rationale: The role of obesity-associated insulin resistance (IR) in airflow limitation in asthma is uncertain. Objectives: Using data in the Severe Asthma Research Program 3 (SARP-3), we evaluated relationships between homeostatic measure of IR (HOMA-IR), lung function (cross-sectional and longitudinal analyses), and treatment responses to bronchodilators and corticosteroids. Methods: HOMA-IR values were categorized as without (<3.0), moderate (3.0-5.0), or severe (>5.0). Lung function included FEV1 and FVC measured before and after treatment with inhaled albuterol and intramuscular triamcinolone acetonide and yearly for 5 years. Measurements and Main Results: Among 307 participants in SARP-3, 170 (55%) were obese and 140 (46%) had IR. Compared with patients without IR, those with IR had significantly lower values for FEV1 and FVC, and these lower values were not attributable to obesity effects. Compared with patients without IR, those with IR had lower FEV1 responses to β-adrenergic agonists and systemic corticosteroids. The annualized decline in FEV1 was significantly greater in patients with moderate IR (-41 ml/year) and severe IR (-32 ml/year,) than in patients without IR (-13 ml/year, P < 0.001 for both comparisons). Conclusions: IR is common in asthma and is associated with lower lung function, accelerated loss of lung function, and suboptimal lung function responses to bronchodilator and corticosteroid treatments. Clinical trials in patients with asthma and IR are needed to determine if improving IR might also improve lung function.
| Errataetall: |
CommentIn: Am J Respir Crit Care Med. 2022 Nov 1;206(9):1057-1058. - PMID 35819866 |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2022 |
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| Erschienen: |
2022 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:206 |
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| Enthalten in: |
American journal of respiratory and critical care medicine - 206(2022), 9 vom: 01. Nov., Seite 1096-1106 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Peters, Michael C [VerfasserIn] |
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| Links: |
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| Themen: |
Adrenal Cortex Hormones |
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| Anmerkungen: |
Date Completed 03.11.2022 Date Revised 26.04.2024 published: Print CommentIn: Am J Respir Crit Care Med. 2022 Nov 1;206(9):1057-1058. - PMID 35819866 Citation Status MEDLINE |
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| doi: |
10.1164/rccm.202112-2745OC |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM342087924 |
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| 100 | 1 | |a Peters, Michael C |e verfasserin |4 aut | |
| 245 | 1 | 4 | |a The Impact of Insulin Resistance on Loss of Lung Function and Response to Treatment in Asthma |
| 264 | 1 | |c 2022 | |
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| 500 | |a Date Revised 26.04.2024 | ||
| 500 | |a published: Print | ||
| 500 | |a CommentIn: Am J Respir Crit Care Med. 2022 Nov 1;206(9):1057-1058. - PMID 35819866 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Rationale: The role of obesity-associated insulin resistance (IR) in airflow limitation in asthma is uncertain. Objectives: Using data in the Severe Asthma Research Program 3 (SARP-3), we evaluated relationships between homeostatic measure of IR (HOMA-IR), lung function (cross-sectional and longitudinal analyses), and treatment responses to bronchodilators and corticosteroids. Methods: HOMA-IR values were categorized as without (<3.0), moderate (3.0-5.0), or severe (>5.0). Lung function included FEV1 and FVC measured before and after treatment with inhaled albuterol and intramuscular triamcinolone acetonide and yearly for 5 years. Measurements and Main Results: Among 307 participants in SARP-3, 170 (55%) were obese and 140 (46%) had IR. Compared with patients without IR, those with IR had significantly lower values for FEV1 and FVC, and these lower values were not attributable to obesity effects. Compared with patients without IR, those with IR had lower FEV1 responses to β-adrenergic agonists and systemic corticosteroids. The annualized decline in FEV1 was significantly greater in patients with moderate IR (-41 ml/year) and severe IR (-32 ml/year,) than in patients without IR (-13 ml/year, P < 0.001 for both comparisons). Conclusions: IR is common in asthma and is associated with lower lung function, accelerated loss of lung function, and suboptimal lung function responses to bronchodilator and corticosteroid treatments. Clinical trials in patients with asthma and IR are needed to determine if improving IR might also improve lung function | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, N.I.H., Extramural | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 650 | 4 | |a asthma | |
| 650 | 4 | |a insulin resistance | |
| 650 | 4 | |a lung function | |
| 650 | 4 | |a obesity | |
| 650 | 7 | |a Bronchodilator Agents |2 NLM | |
| 650 | 7 | |a Adrenal Cortex Hormones |2 NLM | |
| 700 | 1 | |a Schiebler, Mark L |e verfasserin |4 aut | |
| 700 | 1 | |a Cardet, Juan Carlos |e verfasserin |4 aut | |
| 700 | 1 | |a Johansson, Mats W |e verfasserin |4 aut | |
| 700 | 1 | |a Sorkness, Ronald |e verfasserin |4 aut | |
| 700 | 1 | |a DeBoer, Mark D |e verfasserin |4 aut | |
| 700 | 1 | |a Bleecker, Eugene R |e verfasserin |4 aut | |
| 700 | 1 | |a Meyers, Deborah A |e verfasserin |4 aut | |
| 700 | 1 | |a Castro, Mario |e verfasserin |4 aut | |
| 700 | 1 | |a Sumino, Kaharu |e verfasserin |4 aut | |
| 700 | 1 | |a Erzurum, Serpil C |e verfasserin |4 aut | |
| 700 | 1 | |a Tattersall, Matthew C |e verfasserin |4 aut | |
| 700 | 1 | |a Zein, Joe G |e verfasserin |4 aut | |
| 700 | 1 | |a Hastie, Annette T |e verfasserin |4 aut | |
| 700 | 1 | |a Moore, Wendy |e verfasserin |4 aut | |
| 700 | 1 | |a Levy, Bruce D |e verfasserin |4 aut | |
| 700 | 1 | |a Israel, Elliot |e verfasserin |4 aut | |
| 700 | 1 | |a Phillips, Brenda R |e verfasserin |4 aut | |
| 700 | 1 | |a Mauger, David T |e verfasserin |4 aut | |
| 700 | 1 | |a Wenzel, Sally E |e verfasserin |4 aut | |
| 700 | 1 | |a Fajt, Merritt L |e verfasserin |4 aut | |
| 700 | 1 | |a Koliwad, Suneil K |e verfasserin |4 aut | |
| 700 | 1 | |a Denlinger, Loren C |e verfasserin |4 aut | |
| 700 | 1 | |a Woodruff, Prescott G |e verfasserin |4 aut | |
| 700 | 1 | |a Jarjour, Nizar N |e verfasserin |4 aut | |
| 700 | 1 | |a Fahy, John V |e verfasserin |4 aut | |
| 700 | 0 | |a National Heart, Lung, and Blood Institute Severe Asthma Research Program-3 |e verfasserin |4 aut | |
| 700 | 1 | |a Peters, Michael C |e investigator |4 oth | |
| 700 | 1 | |a Schiebler, Mark |e investigator |4 oth | |
| 700 | 1 | |a Carlos Cardet, Juan |e investigator |4 oth | |
| 700 | 1 | |a Johansson, Mats W |e investigator |4 oth | |
| 700 | 1 | |a Sorkness, Ronald |e investigator |4 oth | |
| 700 | 1 | |a DeBoer, Mark D |e investigator |4 oth | |
| 700 | 1 | |a Bleecker, Eugene R |e investigator |4 oth | |
| 700 | 1 | |a Meyers, Deborah A |e investigator |4 oth | |
| 700 | 1 | |a Castro, Mario |e investigator |4 oth | |
| 700 | 1 | |a Sumino, Kaharu |e investigator |4 oth | |
| 700 | 1 | |a Erzurum, Serpil C |e investigator |4 oth | |
| 700 | 1 | |a Tattersall, Matthew C |e investigator |4 oth | |
| 700 | 1 | |a Zein, Joe G |e investigator |4 oth | |
| 700 | 1 | |a Hastie, Annette T |e investigator |4 oth | |
| 700 | 1 | |a Moore, Wendy |e investigator |4 oth | |
| 700 | 1 | |a Levy, Bruce D |e investigator |4 oth | |
| 700 | 1 | |a Israel, Elliot |e investigator |4 oth | |
| 700 | 1 | |a Duvall, Melody |e investigator |4 oth | |
| 700 | 1 | |a Phillips, Brenda R |e investigator |4 oth | |
| 700 | 1 | |a Mauger, David T |e investigator |4 oth | |
| 700 | 1 | |a Wenzel, Sally E |e investigator |4 oth | |
| 700 | 1 | |a Fajt, Merritt L |e investigator |4 oth | |
| 700 | 1 | |a Denlinger, Loren C |e investigator |4 oth | |
| 700 | 1 | |a Woodruff, Prescott G |e investigator |4 oth | |
| 700 | 1 | |a Jarjour, Nizar N |e investigator |4 oth | |
| 700 | 1 | |a Fahy, John V |e investigator |4 oth | |
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