- Title
- Systemic inflammation mediates the detrimental effects of obesity on asthma control
- Creator
- Zhang, Xin; Zheng, Jing; Zhang, Li; Liu, Ying; Chen, Gai Ping; Zhang, Hong Ping; Wang, Lei; Kang, De Ying; Wood, Lisa G.; Wang, Gang
- Relation
- Allergy and Asthma Proceedings Vol. 39, Issue 1, p. 43-50
- Publisher Link
- http://dx.doi.org/10.2500/aap.2018.39.4096
- Publisher
- OceanSide Publications
- Resource Type
- journal article
- Date
- 2018
- Description
- Background: Obesity negatively impacts asthma control, but the inflammatory mechanisms are poorly understood. Objective: To explore which systemic inflammatory mediators mediate the effects of obesity on asthma control. Methods: The subjects with stable asthma (n = 108) underwent assessment of clinical characteristics, which included using The Asthma Control Questionnaire (ACQ)-6. Obesity was defined as a body mass index (BMI) of ≥30 kg/m2, overweight was defined as BMI between 25 to 29.9 kg/m2, and lean weight was defined as BMI < 25 kg/m2. Body composition, including fat mass (FM), visceral fat area (VFA), and percentage body fat (PBF) was analyzed by bioimpedance. Serum interleukin (IL) 4, IL-5, IL-8, IL-13, IL-17, chemokine (C-C motif) ligand (CCL) 17, CCL22, leptin, adiponectin, C-reactive protein (CRP), and interferon (IFN) gamma were measured by using ELISA. Linear regression models were fitted according to the Baron and Kenny procedures for mediation analysis. Results: FM (12.73 ± 3.95 versus 18.59 ± 2.95 versus 27.82 ± 5.17 kg; p < 0.0001), VFA (65.99 ± 23.17 versus 93.96 ± 10.28 versus 123.10 ± 18.34 cm2; p < 0.0001), PBF (23.86 ± 7.46 versus 30.74 ± 5.08 versus 36.21 ± 6.28 %; p = 0.0003) and ACQ-6 values (0.83 [0, 1.17]) versus 1.15 [0.50, 1.75] versus 1.33 [0.83, 1.83] score; p = 0.002) were different among lean (n = 52), overweight (n = 37), and obese (n = 19) subjects. Serum levels of leptin, IL-5, IL-13, IL-17, CCL17, CRP, and IFN-gamma in the obese group were significantly elevated compared with the subjects who were lean or overweight (all p < 0.05). The mediation analyses found that the effect of obesity, assessed by BMI, on ACQ-6 was significantly mediated through IL-13 and CCL17. Furthermore, IL-13 and CCL17 mediated the effects of body composition (FM, VFA and PBF) on ACQ-6. The effects of obesity assessed by body composition, but not by using BMI, on ACQ-6 were mediated by leptin. Conclusion: Our mediation analysis confirmed that systemic inflammation biomarkers, such as leptin, CCL17, IL-4, and IL-13, mediated the effects of obesity on asthma control. This warrants prospective exploration in this distinct asthma phenotype in the future.
- Subject
- asthma; asthma control; body composition; body mass index; mediation analysis; obesity; systemic inflammation; SDG 3; Sustainable Development Goals
- Identifier
- http://hdl.handle.net/1959.13/1466445
- Identifier
- uon:47551
- Identifier
- ISSN:1088-5412
- Language
- eng
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