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. 2012 Oct;87(10):953-60.
doi: 10.1016/j.mayocp.2012.05.020. Epub 2012 Sep 12.

Asthma and proinflammatory conditions: a population-based retrospective matched cohort study

Hyun D Yun  1 , Erin Knoebel, Yilma Fenta, Sherine E Gabriel, Cynthia L Leibson, Edward V Loftus Jr, Veronique Roger, Barbara P Yawn, Bill Li, Young J Juhn
Affiliations

Asthma and proinflammatory conditions: a population-based retrospective matched cohort study

Hyun D Yun et al. Mayo Clin Proc. 2012 Oct.

Abstract

Objective: To determine the association between asthma and proinflammatory conditions.

Participants and methods: This population-based retrospective matched cohort study enrolled all asthmatic patients among Rochester, Minnesota, residents between January 1, 1964, and December 31, 1983. For each asthmatic patient, 2 age-and sex-matched nonasthmatic individuals were drawn from the same population. The asthmatic and nonasthmatic cohorts were followed forward in the Rochester Epidemiology Project diagnostic index for inflammatory bowel disease (IBD), rheumatoid arthritis (RA), diabetes mellitus (DM), and coronary heart disease (CHD) as outcome events. Data were fitted to Cox proportional hazards models.

Results: We identified 2392 asthmatic patients and 4784 nonasthmatic controls. Of the asthmatic patients, 1356 (57%) were male, and mean age at asthma onset was 15.1 years. Incidence rates of IBD, RA, DM, and CHD in nonasthmatic controls were 32.8, 175.9, 132.0, and 389.7 per 100,000 person-years, respectively; those for asthmatic patients were 41.4, 227.9, 282.6, and 563.7 per 100,000 person-years, respectively. Asthma was associated with increased risks of DM (hazard ratio, 2.11; 95% confidence interval, 1.43-3.13; P<.001) and CHD (hazard ratio, 1.47; 95% confidence interval, 1.05-2.06; P=.02) but not with increased risks of IBD or RA.

Conclusion: Although asthma is a helper T cell type 2-predominant condition, it may increase the risks of helper T cell type 1-polarized proinflammatory conditions, such as CHD and DM. Physicians who care for asthmatic patients need to address these unrecognized risks in asthmatic patients.

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Figures

FIGURE 1
FIGURE 1
Cumulative incidence of diabetes mellitus (DM) in the asthmatic and nonasthmatic groups (P<.001 based on univariate Cox regression). The median (95% confidence interval) follow-up durations for the asthmatic and nonasthmatic groups were 7 (2.9-13.2) and 5.7 (1.9-12.0) years, respectively.
FIGURE 2
FIGURE 2
Cumulative incidence of coronary heart disease (CHD) in the asthmatic and nonasthmatic groups (P=.04 based on univariate Cox regression). The median (95% confidence interval) follow-up durations for the asthmatic and nonasthmatic groups were 7 (2.9-13.2) and 5.7 (1.9-12.0) years, respectively.
FIGURE 3
FIGURE 3
Cumulative incidence of inflammatory bowel disease (IBD) (A) and rheumatoid arthritis (RA) (B) in the asthmatic and nonasthmatic groups (no statistically significant differences). The median (95% confidence interval) follow-up durations for the asthmatic and nonasthmatic groups were 7 (2.9-13.2) and 5.7 (1.9-12.0) years, respectively.
See this image and copyright information in PMC

Comment in

  • Should we consider asthma as a risk factor for diabetes mellitus?
    Mirrakhimov AE, Kwatra SG, Shah TS. Mirrakhimov AE, et al. Mayo Clin Proc. 2013 Feb;88(2):211. doi: 10.1016/j.mayocp.2012.11.009. Mayo Clin Proc. 2013. PMID: 23374624 No abstract available.
  • In reply.
    Yun HD, Yawn BP, Leibson CL, Juhn YJ. Yun HD, et al. Mayo Clin Proc. 2013 Feb;88(2):211-2. doi: 10.1016/j.mayocp.2012.11.008. Mayo Clin Proc. 2013. PMID: 23374625 No abstract available.

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