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. 2022 Mar;10(3):785-792.e5.
doi: 10.1016/j.jaip.2021.09.047. Epub 2021 Oct 14.

High Insulin in Early Childhood Is Associated with Subsequent Asthma Risk Independent of Body Mass Index

Tara F Carr  1 , Raquel Granell  2 , Debra A Stern  3 , Stefano Guerra  3 , Anne Wright  3 , Marilyn Halonen  3 , John Henderson  2 , Fernando D Martinez  3
Affiliations

High Insulin in Early Childhood Is Associated with Subsequent Asthma Risk Independent of Body Mass Index

Tara F Carr et al. J Allergy Clin Immunol Pract. 2022 Mar.

Abstract

Background: Asthma and obesity are major, interconnected public health challenges that usually have their origins in childhood, and for which the relationship is strengthened among those with insulin resistance.

Objective: To determine whether high insulin in early life confers increased longitudinal risk for asthma independent of body mass index.

Methods: The study used data from the Tucson Children's Respiratory Study (TCRS) and the Avon Longitudinal Study of Parents and Children (ALSPAC). Nonfasting insulin was measured in TCRS participants at age 6 years and fasting insulin in ALSPAC participants at age 8 years. Physician-diagnosed active asthma was determined at baseline and at subsequent assessments up to age 36 years in TCRS and 17 years in ALSPAC.

Results: In TCRS, high insulin (upper quartile) at age 6 years was associated with increased odds of having active asthma from ages 8 to 36 years compared with low insulin (odds ratio,1.98; 95% CI, 1.28-3.05; P = .002). Similarly, in ALSPAC, high insulin was associated with a significantly higher risk of active asthma from ages 11 to 17 years compared with low insulin (odds ratio, 1.59; 95% CI, 1.12-2.27; P = .009). These findings were independent of baseline body mass index in both cohorts, and were not related to other demographic and asthma risk factors nor other tested markers of systemic inflammation and metabolic syndrome.

Conclusions: In 2 separate birth cohorts, higher blood insulin level in early childhood was associated with increased risk of active asthma through adolescence and adulthood, independent of body mass index. High insulin indicates a novel mechanism for asthma development, which may be a target for intervention.

Keywords: Asthma; Insulin; Metabolic syndrome; Obesity.

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Figures

Figure 1.
Figure 1.
TCRS: Proportion of participants with asthma at each age, by low vs. high non-fasting insulin, in the TCRS cohort. Number of participants in the low and high insulin groups are shown in italics.
Figure 2.
Figure 2.
ALSPAC: The proportion of participants with asthma at each age, by low vs. high fasting insulin, in the ALSPAC cohort. Number of participants in the low and high insulin groups are shown in italics
See this image and copyright information in PMC

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