Abdominal adiposity and obstructive airway disease: testing insulin resistance and sleep disordered breathing mechanisms

BMC Pulmonary Medicine

Robyn A McDermott⁶  Anne W Taylor⁴  Jonathan Newbury³  Peter RC Howe¹  Jonathan D Buckley¹  Janet F Grant⁴  Richard E Ruffin⁵  Tracey-Jayne Paterson²  Gary Misan²  Matthew T Haren² 

[1] Nutrition Physiology Research Centre, University of South Australia, Adelaide, SA, Australia;Centre for Rural Health and Community Development (CRHaCD), University of South Australia, Whyalla Norrie, SA, Australia;Spencer Gulf Rural Health School (SGRHS), University of South Australia and The University of Adelaide, Whyalla Norrie, SA, Australia;Population Research and Outcomes Studies, Discipline of Medicine, The University of Adelaide, Adelaide, SA, Australia;Discipline of Medicine, The University of Adelaide, Adelaide, SA, Australia;Sansom Institute for Health Research, Division of Health Sciences, University of South Australia, Adelaide, SA, Australia

关键词: Sleep disordered breathing;    Abdominal adiposity;    Asthma;    Forced Vital Capacity;    Forced Expiratory Volume;    Airway obstruction;   

Others  :  1161088
DOI  :  10.1186/1471-2466-12-31

 received in 2012-01-17, accepted in 2012-06-17,  发布年份 2012

【 摘 要 】

Background

This study examined associations of abdominal adiposity with lung function, asthma symptoms and current doctor-diagnosed asthma and mediation by insulin resistance (IR) and sleep disordered breathing (SDB).

Methods

A random sample of 2500 households was drawn from the community of Whyalla, South Australia (The Whyalla Intergenerational Study of Health, WISH February 2008 - July 2009). Seven-hundred twenty-two randomly selected adults (≥18 years) completed clinical protocols (32.2% response rate). Lung function was measured by spirometry. Post-bronchodilator FEV₁/FVC was used to measure airway obstruction and reversibility of FEV₁ was calculated. Current asthma was defined by self-reported doctor-diagnosis and evidence of currently active asthma. Symptom scores for asthma (CASS) and SDB were calculated. Intra-abdominal fat (IAF) was estimated using dual-energy x-ray absorptiometry (DXA). IR was calculated from fasting glucose and insulin concentrations.

Results

The prevalence of current doctor-diagnosed asthma was 19.9% (95% CI 16.7 – 23.5%). The ratio of observed to expected cases given the age and sex distribution of the population was 2.4 (95%CI 2.1, 2.9). IAF was not associated with current doctor-diagnosed asthma, FEV₁/FVC or FEV₁ reversibility in men or women but was positively associated with CASS independent of IR and SDB in women. A 1% increase in IAF was associated with decreases of 12 mL and 20 mL in FEV₁ and FVC respectively in men, and 4 mL and 7 mL respectively in women. SDB mediated 12% and 26% of these associations respectively in men but had minimal effects in women.

Conclusions

In this population with an excess of doctor-diagnosed asthma, IAF was not a major factor in airway obstruction or doctor-diagnosed asthma, although women with higher IAF perceived more severe asthma symptoms which did not correlate with lower FEV₁. Higher IAF was significantly associated with lower FEV₁ and FVC and in men SDB mechanisms may contribute up to one quarter of this association.

【 授权许可】

   
2012 Haren et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1 .

Figure 2 .

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