Children of any weight who have an imbalanced metabolism due to poor diet or exercise may be at increased risk of asthma, according to new research at West Virginia University. The findings, derived from data on nearly 18,000 West Virginia children, challenge the widespread assumption that obesity itself is a risk factor for asthma.

“Our research showed that early abnormalities in lipid and/or glucose metabolism may be associated to the development of asthma in childhood,” said Giovanni Piedimonte, M.D., chairman of pediatrics at WVU and physician-in-chief at WVU Children’s Hospital, who led the study. “Our findings also imply a strong and direct influence of metabolic pathways on the immune mechanisms involved in the pathogenesis of asthma in children.”

The research, which was published online Sept. 16 ahead of the print edition of the American Thoracic Society’s American Journal of Respiratory and Critical Care Medicine, implicates metabolic disorders directly in the development of asthma, and points to a new way of viewing diet and lifestyle as risk factors for asthma, even in children who are not obviously obese or overweight.

“The key takeaway message for parents is this: there’s one more good reason to make sure your children eat healthy and exercise,” said WVU pediatric researcher Lesley Cottrell, Ph.D. “Even healthy-looking children can be at higher risk for asthma if they are sedentary and have a poor diet.”

The researchers gathered demographic data, estimates of body mass index, and asthma prevalence on thousands of children who were 4 to 12 years old and were participating in WVU’s long-running Coronary Artery Risk Detection in Appalachian Communities Project. The large sample size is unusual in pediatric research.

The researchers found that while asthma prevalence generally increased with increasing BMI, asthma prevalence in obese and morbidly obese children was significantly higher than in children with healthy BMI. Simple overweight status did not appear to be linked to increased asthma prevalence. However, after controlling for BMI and other confounding variables, asthma prevalence was significantly associated with triglyceride levels and the presence of a biomarker for diabetes, regardless of body weight.

“The association between asthma risk, triglyceride levels, and the diabetes marker, even among children who are a healthy weight or underweight, suggests that a subtle metabolic dysfunction may exist that is a central hub from which the asthma-obesity-diabetes triad originates, at least in a subpopulation of patients,” said Dr. Piedimonte. “This opens a Pandora’s box of questions concerning the role of pre- and early post-natal nutrition as a critical determinant of chronic diseases throughout life.”

The article, “Metabolic Abnormalities in Children with Asthma,” was authored by Drs. Cottrell and Piedimonte, along with William Neal, M.D., Christa Ice, Ph.D. and Miriam Perez, M.D., all of the WVU Department of Pediatrics and Pediatric Research Institute.


CONTACT: Kim Fetty, HSC News Service