학술논문
The Impact of Insulin Resistance on Loss of Lung Function and Response to Treatment in Asthma.
Document Type
article
Author
Peters, Michael C; Schiebler, Mark L; Cardet, Juan Carlos; Johansson, Mats W; Sorkness, Ronald; DeBoer, Mark D; Bleecker, Eugene R; Meyers, Deborah A; Castro, Mario; Sumino, Kaharu; Erzurum, Serpil C; Tattersall, Matthew C; Zein, Joe G; Hastie, Annette T; Moore, Wendy; Levy, Bruce D; Israel, Elliot; Duvall, Melody G; Phillips, Brenda R; Mauger, David T; Wenzel, Sally E; Fajt, Merritt L; Koliwad, Suneil K; Denlinger, Loren C; Woodruff, Prescott G; Jarjour, Nizar N; Fahy, John V; Schiebler, Mark; Carlos Cardet, Juan; Duvall, Melody
Source
American Journal of Respiratory and Critical Care Medicine. 206(9)
Subject
Language
Abstract
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 (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