1
|
Daley-Yates P, Keppler B, Brealey N, Shabbir S, Singh D, Barnes N. Inhaled glucocorticoid-induced metabolome changes in asthma. Eur J Endocrinol 2022; 187:413-427. [PMID: 35900313 PMCID: PMC9346266 DOI: 10.1530/eje-21-0912] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 07/04/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The aim of this study was toidentify dose-related systemic effects of inhaled glucocorticoids (GCs) on the global metabolome. DESIGN AND METHODS Metabolomics/lipidomic analysis from plasma was obtained from 54 subjects receiving weekly escalating doses (µg/day) of fluticasone furoate (FF; 25, 100, 200, 400 and 800), fluticasone propionate (FP; 50, 200, 500, 1000 and 2000), budesonide (BUD; 100, 400, 800, 1600 and 3200) or placebo. Samples (pre- and post-dose) were analysed using ultrahigh-performance liquid chromatography-tandem mass spectroscopy and liquid chromatography-mass spectrometry. Ions were matched to library standards for identification and quantification. Statistical analysis involved repeated measures ANOVA, cross-over model, random forest and principal component analysis using log-transformed data. RESULTS Quantifiable metabolites (1971) had few significant changes (% increases/decreases; P < 0.05) vs placebo: FF 1.34 (0.42/0.92), FP 1.95 (0.41/1.54) and BUD 2.05 (0.60/1.45). Therapeutic doses had fewer changes: FF 0.96 (0.36/0.61), FP 1.66 (0.44/1.22) and BUD 1.45 (0.56/0.90). At highest/supratherapeutic doses, changes were qualitatively similar: reduced adrenal steroids, particularly glucuronide metabolites of cortisol and cortisone and pregnenolone metabolite DHEA-S; increased amino acids and glycolytic intermediates; decreased fatty acid β-oxidation and branched-chain amino acids. Notable qualitative differences were lowered dopamine metabolites (BUD) and secondary bile acid profiles (BUD/FF), suggesting CNS and gut microbiome effects. CONCLUSIONS Dose-dependent metabolomic changes occurred with inhaled GCs but were seen predominately at highest/supratherapeutic doses, supporting the safety of low and mid therapeutic doses. At comparable therapeutic doses (FF 100, FP 500 and BUD 800 µg/day), FF had the least effect on the most sensitive markers (adrenal steroids) vs BUD and FP.
Collapse
Affiliation(s)
- Peter Daley-Yates
- Clinical Pharmacology and Experimental Medicine, GSK, Uxbridge, UK
- Correspondence should be addressed to P Daley-Yates;
| | - Brian Keppler
- Discovery and Translational Sciences, Metabolon Inc., Morrisville, North Carolina, USA
| | | | | | - Dave Singh
- Medicines Evaluation Unit, University of Manchester, Manchester University NHS Foundation Trust, Manchester, UK
| | - Neil Barnes
- Global Medical Franchise, GSK, Brentford, UK
- William Harvey Institute, Bart’s and the London School of Medicine and Dentistry, London, UK
| |
Collapse
|
2
|
Mey JT, Matuska B, Peterson L, Wyszynski P, Koo M, Sharp J, Pennington E, McCarroll S, Micklewright S, Zhang P, Aronica M, Hoddy KK, Champagne CM, Heymsfield SB, Comhair SAA, Kirwan JP, Erzurum SC, Mulya A. Resting Energy Expenditure Is Elevated in Asthma. Nutrients 2021; 13:nu13041065. [PMID: 33805960 PMCID: PMC8064324 DOI: 10.3390/nu13041065] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 03/16/2021] [Accepted: 03/19/2021] [Indexed: 12/02/2022] Open
Abstract
Background: Asthma physiology affects respiratory function and inflammation, factors that may contribute to elevated resting energy expenditure (REE) and altered body composition. Objective: We hypothesized that asthma would present with elevated REE compared to weight-matched healthy controls. Methods: Adults with asthma (n = 41) and healthy controls (n = 20) underwent indirect calorimetry to measure REE, dual-energy X-ray absorptiometry (DEXA) to measure body composition, and 3-day diet records. Clinical assessments included spirometry, fractional exhaled nitric oxide (FENO), and a complete blood count. Results: Asthmatics had greater REE than controls amounting to an increase of ~100 kcals/day, even though body mass index (BMI) and body composition were similar between groups. Inclusion of asthma status and FENO in validated REE prediction equations led to improved estimates. Further, asthmatics had higher white blood cell (control vs. asthma (mean ± SD): 4.7 ± 1.1 vs. 5.9 ± 1.6, p < 0.01) and neutrophil (2.8 ± 0.9 vs. 3.6 ± 1.4, p = 0.02) counts that correlated with REE (both p < 0.01). Interestingly, despite higher REE, asthmatics reported consuming fewer calories (25.1 ± 7.5 vs. 20.3 ± 6.0 kcals/kg/day, p < 0.01) and carbohydrates than controls. Conclusion: REE is elevated in adults with mild asthma, suggesting there is an association between REE and the pathophysiology of asthma.
Collapse
Affiliation(s)
- Jacob T. Mey
- Pennington Biomedical Research Center, Baton Rouge, LA 70808, USA; (J.T.M.); (K.K.H.); (C.M.C.); (S.B.H.); (J.P.K.)
- Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44195, USA; (B.M.); (L.P.); (P.W.); (M.K.); (J.S.); (M.A.); (S.A.A.C.); (S.C.E.)
| | - Brittany Matuska
- Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44195, USA; (B.M.); (L.P.); (P.W.); (M.K.); (J.S.); (M.A.); (S.A.A.C.); (S.C.E.)
| | - Laura Peterson
- Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44195, USA; (B.M.); (L.P.); (P.W.); (M.K.); (J.S.); (M.A.); (S.A.A.C.); (S.C.E.)
| | - Patrick Wyszynski
- Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44195, USA; (B.M.); (L.P.); (P.W.); (M.K.); (J.S.); (M.A.); (S.A.A.C.); (S.C.E.)
| | - Michelle Koo
- Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44195, USA; (B.M.); (L.P.); (P.W.); (M.K.); (J.S.); (M.A.); (S.A.A.C.); (S.C.E.)
| | - Jacqueline Sharp
- Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44195, USA; (B.M.); (L.P.); (P.W.); (M.K.); (J.S.); (M.A.); (S.A.A.C.); (S.C.E.)
| | - Emily Pennington
- Respiratory Institute, Cleveland Clinic, Cleveland, OH 44195, USA; (E.P.); (S.M.); (S.M.); (P.Z.)
| | - Stephanie McCarroll
- Respiratory Institute, Cleveland Clinic, Cleveland, OH 44195, USA; (E.P.); (S.M.); (S.M.); (P.Z.)
| | - Sarah Micklewright
- Respiratory Institute, Cleveland Clinic, Cleveland, OH 44195, USA; (E.P.); (S.M.); (S.M.); (P.Z.)
| | - Peng Zhang
- Respiratory Institute, Cleveland Clinic, Cleveland, OH 44195, USA; (E.P.); (S.M.); (S.M.); (P.Z.)
| | - Mark Aronica
- Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44195, USA; (B.M.); (L.P.); (P.W.); (M.K.); (J.S.); (M.A.); (S.A.A.C.); (S.C.E.)
- Respiratory Institute, Cleveland Clinic, Cleveland, OH 44195, USA; (E.P.); (S.M.); (S.M.); (P.Z.)
| | - Kristin K. Hoddy
- Pennington Biomedical Research Center, Baton Rouge, LA 70808, USA; (J.T.M.); (K.K.H.); (C.M.C.); (S.B.H.); (J.P.K.)
| | - Catherine M. Champagne
- Pennington Biomedical Research Center, Baton Rouge, LA 70808, USA; (J.T.M.); (K.K.H.); (C.M.C.); (S.B.H.); (J.P.K.)
| | - Steven B. Heymsfield
- Pennington Biomedical Research Center, Baton Rouge, LA 70808, USA; (J.T.M.); (K.K.H.); (C.M.C.); (S.B.H.); (J.P.K.)
| | - Suzy A. A. Comhair
- Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44195, USA; (B.M.); (L.P.); (P.W.); (M.K.); (J.S.); (M.A.); (S.A.A.C.); (S.C.E.)
| | - John P. Kirwan
- Pennington Biomedical Research Center, Baton Rouge, LA 70808, USA; (J.T.M.); (K.K.H.); (C.M.C.); (S.B.H.); (J.P.K.)
- Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44195, USA; (B.M.); (L.P.); (P.W.); (M.K.); (J.S.); (M.A.); (S.A.A.C.); (S.C.E.)
| | - Serpil C. Erzurum
- Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44195, USA; (B.M.); (L.P.); (P.W.); (M.K.); (J.S.); (M.A.); (S.A.A.C.); (S.C.E.)
- Respiratory Institute, Cleveland Clinic, Cleveland, OH 44195, USA; (E.P.); (S.M.); (S.M.); (P.Z.)
| | - Anny Mulya
- Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic, Cleveland, OH 44195, USA; (B.M.); (L.P.); (P.W.); (M.K.); (J.S.); (M.A.); (S.A.A.C.); (S.C.E.)
- Correspondence: ; Tel.: +1-(216)-445-6625; Fax: +1-(216)-636-0104
| |
Collapse
|
3
|
Toivo K, Kannus P, Kokko S, Alanko L, Heinonen OJ, Korpelainen R, Savonen K, Selänne H, Vasankari T, Kannas L, Kujala UM, Villberg J, Niemelä O, Parkkari J. Haemoglobin, iron status and lung function of adolescents participating in organised sports in the Finnish Health Promoting Sports Club Study. BMJ Open Sport Exerc Med 2020; 6:e000804. [PMID: 33062301 PMCID: PMC7520547 DOI: 10.1136/bmjsem-2020-000804] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/19/2020] [Indexed: 02/06/2023] Open
Abstract
Objectives To compare laboratory test results and lung function of adolescent organised sports participants (SP) with non-participants (NP). Methods In this cross-sectional study, laboratory tests (haemoglobin, iron status), and flow-volume spirometry were performed on SP youths (199 boys, 203 girls) and their NP peers (62 boys, 114 girls) aged 14–17. Results Haemoglobin concentration <120/130 g/L was found in 5.8% of SP and 5.1% NP (OR 1.20, 95% CI 0.54 to 2.68). Ferritin concentration below 15 µg/L was found in 22.7% of both SP and NP girls. Among boys ferritin <30 µg/L was found in 26.5% of SP and 30.2% of NP (OR 0.76, 95% CI 0.40 to 1.47). Among SP iron supplement use was reported by 3.5% of girls and 1.5% of boys. In flow-volume spirometry with bronchodilation test, 7.0% of SP and 6.4% of NP had asthma-like findings (OR 1.17, 95% CI 0.54 to 2.54); those using asthma medication, that is, 9.8% of SP and 5.2% of NP were excluded from the analysis. Conclusions Screening for iron deficiency is recommended for symptomatic persons and persons engaging in sports. Lung function testing is recommended for symptomatic persons and persons participating in sports in which asthma is more prevalent.
Collapse
Affiliation(s)
- Kerttu Toivo
- Tampere Research Center of Sports Medicine, Ukk Institute, Tampere, Finland.,Ukk Institute for Health Promotion Research, Tampere, Finland
| | - Pekka Kannus
- Tampere Research Center of Sports Medicine, Ukk Institute, Tampere, Finland
| | - Sami Kokko
- Faculty of Sport and Health Sciences, University of Jyvaskyla, Jyvaskyla, Finland
| | - Lauri Alanko
- Clinic for Sports and Exercise Medicine, Helsingin Yliopisto, Helsinki, Finland.,Department of Sports and Exercise Medicine, Central Finland Central Hospital, Jyvaskyla, Finland
| | - Olli J Heinonen
- Paavo Nurmi Centre & Unit for Health and Physical Activity, University of Turku, Turku, Finland
| | - Raija Korpelainen
- Department of Sports and Exercise Clinic, Oulu Deaconess Foundation, Oulu, Finland.,Center for Life Course Health Research, University of Oulu, Oulu, Finland.,Medical Research Center, University of Oulu and University Hospital of Oulu, Oulu, Finland
| | - Kai Savonen
- Kuopio Research Institute of Exercise Medicine, Kuopio, Finland.,Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital, Kuopio, Finland
| | - Harri Selänne
- Department of Psychology, University of Jyväskylä, Jyvaskyla, Finland
| | - Tommi Vasankari
- Ukk Institute for Health Promotion Research, Tampere, Finland
| | - Lasse Kannas
- Faculty of Sport and Health Sciences, University of Jyvaskyla, Jyvaskyla, Finland
| | - Urho M Kujala
- Faculty of Sport and Health Sciences, University of Jyvaskyla, Jyvaskyla, Finland
| | - Jari Villberg
- Faculty of Sport and Health Sciences, University of Jyvaskyla, Jyvaskyla, Finland
| | - Onni Niemelä
- Department of Laboratory Medicine and Medical Research Unit, Seinajoki Central Hospital and University of Tampere, Seinajoki, Finland
| | - Jari Parkkari
- Tampere Research Center of Sports Medicine, Ukk Institute, Tampere, Finland.,Ukk Institute for Health Promotion Research, Tampere, Finland.,The Research Services, Tampere University Hospital, Tampere, Finland
| |
Collapse
|
4
|
Goutaki M, Halbeisen FS, Spycher BD, Maurer E, Belle F, Amirav I, Behan L, Boon M, Carr S, Casaulta C, Clement A, Crowley S, Dell S, Ferkol T, Haarman EG, Karadag B, Knowles M, Koerner-Rettberg C, Leigh MW, Loebinger MR, Mazurek H, Morgan L, Nielsen KG, Phillipsen M, Sagel SD, Santamaria F, Schwerk N, Yiallouros P, Lucas JS, Kuehni CE. Growth and nutritional status, and their association with lung function: a study from the international Primary Ciliary Dyskinesia Cohort. Eur Respir J 2017; 50:50/6/1701659. [PMID: 29269581 DOI: 10.1183/13993003.01659-2017] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Accepted: 09/15/2017] [Indexed: 01/02/2023]
Abstract
Chronic respiratory disease can affect growth and nutrition, which can influence lung function. We investigated height, body mass index (BMI), and lung function in patients with primary ciliary dyskinesia (PCD).In this study, based on the international PCD (iPCD) Cohort, we calculated z-scores for height and BMI using World Health Organization (WHO) and national growth references, and assessed associations with age, sex, country, diagnostic certainty, age at diagnosis, organ laterality and lung function in multilevel regression models that accounted for repeated measurements.We analysed 6402 measurements from 1609 iPCD Cohort patients. Height was reduced compared to WHO (z-score -0.12, 95% CI -0.17 to -0.06) and national references (z-score -0.27, 95% CI -0.33 to -0.21) in male and female patients in all age groups, with variation between countries. Height and BMI were higher in patients diagnosed earlier in life (p=0.026 and p<0.001, respectively) and closely associated with forced expiratory volume in 1 s and forced vital capacity z-scores (p<0.001).Our study indicates that both growth and nutrition are affected adversely in PCD patients from early life and are both strongly associated with lung function. If supported by longitudinal studies, these findings suggest that early diagnosis with multidisciplinary management and nutritional advice could improve growth and delay disease progression and lung function impairment in PCD.
Collapse
Affiliation(s)
- Myrofora Goutaki
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland.,Paediatric Respiratory Medicine, Children's University Hospital of Bern, University of Bern, Bern, Switzerland
| | - Florian S Halbeisen
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Ben D Spycher
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Elisabeth Maurer
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Fabiën Belle
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | | | - Laura Behan
- Primary Ciliary Dyskinesia Centre, NIHR Respiratory Biomedical Research Centre, University of Southampton, Southampton, UK.,School of Applied Psychology, University College Cork, Cork, Ireland
| | - Mieke Boon
- Dept of Paediatrics, University Hospital Gasthuisberg, Leuven, Belgium
| | - Siobhan Carr
- Primary Ciliary Dyskinesia Centre, Dept of Paediatrics, Royal Brompton and Harefield Foundation Trust, London, UK
| | | | | | - Suzanne Crowley
- Unit for Paediatric Heart, Lung, Allergic Diseases, Rikshospitalet, Oslo, Norway
| | - Sharon Dell
- Dept of Pediatrics, SickKids Hospital, University of Toronto, Toronto, Canada
| | - Thomas Ferkol
- Dept of Pediatrics, School of Medicine, Washington University, St Louis, MO, USA
| | - Eric G Haarman
- Dept of Pediatric Pulmonology, VU University Medical Center, Amsterdam, The Netherlands
| | - Bulent Karadag
- Dept of Pediatric Pulmonology, School of Medicine, Marmara University, Istanbul, Turkey
| | - Michael Knowles
- Dept of Medicine, Marsico Lung Institute, School of Medicine, University of North Carolina, Chapel Hill, NC, USA
| | | | - Margaret W Leigh
- Dept of Pediatrics, Marsico Lung Institute, School of Medicine, University of North Carolina, Chapel Hill, NC, USA
| | - Michael R Loebinger
- Host Defence Unit, Royal Brompton and Harefield NHS Foundation Trust, London, UK
| | - Henryk Mazurek
- Dept of Pneumonology and Cystic Fibrosis, Institute of Tuberculosis and Lung Disorders, Rabka-Zdrój, Poland
| | - Lucy Morgan
- Dept of Respiratory Medicine, Concord Hospital Clinical School, University of Sydney, Sydney, Australia
| | - Kim G Nielsen
- Danish PCD Centre Copenhagen, Paediatric Pulmonary Service, Copenhagen University Hospital, Copenhagen, Denmark
| | - Maria Phillipsen
- Danish PCD Centre Copenhagen, Paediatric Pulmonary Service, Copenhagen University Hospital, Copenhagen, Denmark
| | - Scott D Sagel
- Dept of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA
| | | | - Nicolaus Schwerk
- Clinic for Paediatric Pulmonology, Allergiology and Neonatology, Hannover Medical School, Hannover, Germany
| | | | - Jane S Lucas
- Primary Ciliary Dyskinesia Centre, NIHR Respiratory Biomedical Research Centre, University of Southampton, Southampton, UK
| | - Claudia E Kuehni
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | | | | | | |
Collapse
|
5
|
Abstract
BACKGROUND Obesity is more prevalent in asthmatics. Sleep duration is a novel risk factor for obesity in general populations. OBJECTIVE We tested the association of sleep duration and asthma characteristics with obesity. METHODS Adults at tertiary clinics were surveyed on asthma symptoms and habitual sleep duration. Medical records were used to assess asthma severity step (1-4), extract height and weight, current medications and diagnosed comorbid conditions. BMI ≥30 kg/m(2) defined obesity. Habitual sleep was categorized as <6 (very short), 6 to <7 h (short), 7-8 h (normal), >8 to ≤9 h (long) and >9 h (very long). Inhaled corticosteroid doses were categorized as low, moderate and high. RESULTS Among 611 participants (mean BMI 30 ± 8), 249 (41%) were obese. After adjustment for covariates, obesity was associated with short and very long sleep: as compared to normal sleepers, the odds of being obese were on an average 66% higher ([95% CI: 1.07-2.57], p = 0.02) among short and 124% higher ([1.08-1.65], p = 0.03) among very long sleepers, and the association with very short sleep approached significance (1.74 [0.96-3.14], p = 0.06). Obesity was also significantly related to highest asthma step (1.87 [1.09-3.21], p = 0.02) and psychopathology (1.64 [1.08-2.48], p = 0.02), and a trend was seen with high-dose inhaled corticosteroids (1.82 [0.93-3.56], p = 0.08). CONCLUSIONS Obesity in asthmatics is associated with shorter and very long sleep duration, worse asthma severity, psychopathology and high-dose inhaled corticosteroids. Although this cross-sectional study cannot prove causality, we speculate that further investigation of sleep may provide new opportunities to reduce the rising prevalence of obesity among asthmatics.
Collapse
Affiliation(s)
- Mihaela Teodorescu
- James B. Skatrud Pulmonary/Sleep Research Laboratory, Medical Service, William S. Middleton Memorial Veterans Hospital, Madison, Wisconsin
- Division of Allergy, Pulmonary and Critical Care Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
- Center for Sleep Medicine and Sleep Research/Wisconsin Sleep, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - David A. Polomis
- Division of Allergy, Pulmonary and Critical Care Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Ronald E. Gangnon
- Departments of Biostatistics and Medical Informatics, and Population Health Sciences, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Flavia B. Consens
- Department of Neurology and Sleep Disorders Center, University of Michigan Health System, Ann Arbor, Michigan
| | - Ronald D. Chervin
- Department of Neurology and Sleep Disorders Center, University of Michigan Health System, Ann Arbor, Michigan
| | - Mihai C. Teodorescu
- James B. Skatrud Pulmonary/Sleep Research Laboratory, Medical Service, William S. Middleton Memorial Veterans Hospital, Madison, Wisconsin
- Center for Sleep Medicine and Sleep Research/Wisconsin Sleep, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
- Division of Geriatrics and Gerontology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| |
Collapse
|
6
|
|
7
|
Physical development in children and adolescents with bronchial asthma. Respir Physiol Neurobiol 2013; 187:108-13. [PMID: 23438789 DOI: 10.1016/j.resp.2013.02.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2012] [Revised: 02/15/2013] [Accepted: 02/15/2013] [Indexed: 11/22/2022]
Abstract
Bronchial asthma is the most common chronic disease in children of developmental age. Data from the auxological literature indicate that children with disturbances in growth may also suffer from atopic disorders. The aim of the present study was to evaluate somatic growth in children with bronchial asthma using anthropological methods. The study was carried out using anthropometric measurements and information on the severity and course of the disease on 261 children with bronchial asthma. Mean body height was lower than in healthy peers and about 5% of subjects were short. Mean BMI and skinfold thicknesses were significantly higher and lean body mass was lower in the study group. Seventeen percent of the children were overweight or obese, and 8% were underweight. Body build was more robust in the girls examined. Longitudinal studies will help determine to what degree the disease itself directly affects physical development, and to what degree treatment does.
Collapse
|
8
|
Agha MA, El Wahsh RA. Basal metabolic rate in bronchial asthma and chronic obstructive pulmonary disease patients. EGYPTIAN JOURNAL OF CHEST DISEASES AND TUBERCULOSIS 2013. [DOI: 10.1016/j.ejcdt.2013.01.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
|
9
|
Paludo J, Mocelin HT, Benedetti FJ, Mattiello R, Sarria EE, Mello EDD, Fischer GB. Balanço energético em crianças e adolescentes com bronquiolite obliterante pós-infecciosa. REV NUTR 2012. [DOI: 10.1590/s1415-52732012000200004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
OBJETIVOS: Quantificar o gasto e estimar a ingestão energética de crianças e adolescentes com bronquiolite obliterante pós-infecciosa e comparar com crianças e adolescentes hígidos. MÉTODOS: Estudo transversal com 72 crianças e adolescentes de 8 a 18 anos. Compararam-se dois grupos de 36 indivíduos - um com diagnóstico de bronquiolite obliterante e outro hígido -, os quais foram pareados pelo sexo, idade e classificação do índice de massa corporal. Para avaliação nutricional, utilizaram-se a antropometria e a composição corporal. O gasto energético foi medido pela calorimetria indireta; o fator atividade, pelo recordatório 24h de atividades físicas, e a ingestão energética, pelos inquéritos alimentares. RESULTADOS: O grupo com bronquiolite obliterante e o grupo-controle apresentaram respectivamente: índice de massa corporal de M=18,9, DP=4,0kg/m² e M=18,8, DP=3,4kg/m²; gasto energético de repouso de M=1717,6, DP=781,5 e M=2019,9, DP=819; gasto energético total de M=2677,5, DP=1514,0kcal/dia e M=3396,1, DP=1557,9kcal/dia; estimativa da ingestão energética de M=2294,1, DP=746,7kcal/dia e M=2116,5, DP=612,1kcal/dia. O gasto energético de repouso (p=0,102) e o gasto energético total (p=0,051) não foram diferentes entre os grupos, mesmo quando ajustados pela massa magra. Não houve diferenças estatisticamente significativas entre o o gasto energético total e o consumo energético no grupo com bronquiolite obliterante (p=0,202). O grupo-controle consumiu menos calorias do que o previsto pelo gasto energético total (p<0,001). CONCLUSÃO: O gasto energético de repouso e o gasto energético total foram semelhantes entre os grupos. A estimativa da ingestão energética dos hígidos foi menor que o gasto energético total. O grupo com bronquiolite obliterante apresentava um balanço energético adequado.
Collapse
Affiliation(s)
| | | | | | - Rita Mattiello
- Pontifícia Universidade Católica do Rio Grande do Sul, Brasil
| | | | - Elza Daniel de Mello
- Universidade Federal do Rio Grande do Sul, Brasil; Hospital de Clínicas de Porto Alegre, Brasil
| | | |
Collapse
|
10
|
Benedetti FJ, Bosa VL, Mocelin HT, Paludo J, Mello EDD, Fischer GB. Gasto energético em adolescentes asmáticos com excesso de peso: calorimetria indireta e equações de predição. REV NUTR 2011. [DOI: 10.1590/s1415-52732011000100003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJETIVO: Comparar o gasto energético medido por calorimetria indireta com o estimado por equações de predição entre adolescentes asmáticos e não asmáticos. MÉTODOS: Trata-se de estudo transversal com 69 adolescentes de 10 a 18 anos. Foram comparados três grupos pareados (asmáticos com excesso de peso, asmáticos eutróficos e não asmáticos com excesso de peso). Para avaliação nutricional utilizaram-se medidas antropométricas e de composição corporal. O gasto energético foi medido por calorimetria indireta e estimado por fórmulas de predição. RESULTADOS: Cada grupo foi composto por 23 adolescentes, dos quais 10 do sexo feminino, com média de idade de M=12,4, DP=2,4 anos. O gasto energético de repouso, pela calorimetria indireta nos asmáticos com excesso de peso, foi de M=1550,2, DP=547,2kcal/dia; nos asmáticos eutróficos, M=1540,8, DP=544,2kcal/dia; e nos não asmáticos com excesso de peso, M=1697,2, DP=379,8kcal/dia, com resultado semelhante entre os grupos, mesmo quando ajustado pela massa magra e massa gorda (f=0,186; p=0,831). Obtiveram-se achados semelhantes entre o gasto energético medido pela calorimetria indireta e o estimado pelas fórmulas de predição, com exceção da fórmula de Harris-Benedict, que subestimou o gasto energético nos asmáticos eutróficos e nos não asmáticos com excesso de peso. CONCLUSÃO: O gasto energético de repouso não foi estatisticamente diferente entre os grupos asmáticos e não asmáticos, mesmo quando ajustado pela massa magra e massa gorda. Para os três grupos, as equações de predição são úteis para estimar o gasto energético de repouso e o gasto energético total.
Collapse
Affiliation(s)
| | - Vera Lúcia Bosa
- Universidade Federal do Rio Grande do Sul, Brasil; Universidade Federal do Rio Grande do Sul, Brasil
| | | | | | - Elza Daniel de Mello
- Universidade Federal do Rio Grande do Sul, Brasil; Universidade Federal do Rio Grande do Sul, Brasil
| | - Gilberto Bueno Fischer
- Universidade Federal do Rio Grande do Sul, Brasil; Hospital da Criança Santo Antônio, Brasil
| |
Collapse
|
11
|
Benedetti FJ, Mocelin HT, Bosa VL, de Mello ED, Fischer GB. Energy expenditure and estimated caloric intake in asthmatic adolescents with excess body weight. Nutrition 2010; 26:952-7. [PMID: 20171846 DOI: 10.1016/j.nut.2009.08.022] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2009] [Revised: 08/08/2009] [Accepted: 08/18/2009] [Indexed: 01/01/2023]
Abstract
OBJECTIVE To measure resting energy expenditure (REE) and to estimate caloric intake of asthmatic adolescents with excess body weight and compare results with those groups of eutrophic asthmatic adolescents and non-asthmatic adolescents with excess body weight. METHODS This cross-sectional study categorized 69 adolescents aged 10 to 18 y into three matched groups. Nutritional status was assessed using anthropometric and body composition measurements. Indirect calorimetry was used to measure energy expenditure, and caloric intake was estimated from dietary recalls. RESULTS In each group, there were 23 adolescents (10 girls) aged 12.39 ± 2.40 y. Results for each group were as follows. For asthmatic adolescents with excess body weight, body mass index (BMI) was 24.83 ± 2.73 kg/m(2), REEs were 1550.24 ± 547.23 kcal/d and 27.69 ± 11.33 kcal · kg(-1) · d(-1), and estimated caloric intake was 2068.75 ± 516.66 kcal/d; for eutrophic asthmatic adolescents, BMI was 19.01 ± 2.10 kg/m(2), REEs were 1540.82 ± 544.22 kcal/d and 36.65 ± 15.04 kcal · kg(-1) · d(-1), and estimated caloric intake was 2174.05 ± 500.55 kcal/d; and for non-asthmatic adolescents with excess body weight, BMI was 25.35 ± 3.66 kg/m(2), REEs were 1697.24 ± 379.84 kcal/d and 28.18 ± 6.70 kcal · kg(-1) · d(-1), and estimated caloric intake was 1673.17 ± 530.68 kcal/d. Absolute REE values between groups were not statistically different, even after correction for lean mass and fat mass (F = 0.186, P = 0.831). REE (kilocalories per kilogram per day) was significantly higher in the group of eutrophic asthmatic adolescents (P = 0.016). Estimated caloric intake was greater than REE only in the group of adolescents with asthma. CONCLUSION The REE was not significantly different among groups, and REE (kilocalories per kilogram per day) was higher in the group of eutrophic asthmatic adolescents. Estimated caloric intake was greater than REE in the group of adolescents with asthma.
Collapse
Affiliation(s)
- Franceliane Jobim Benedetti
- Medical Science and Pediatrics, Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil.
| | | | | | | | | |
Collapse
|
12
|
Hasan RA, Zureikat GY, Nolan BM, LaChance JL, Campe JL, Amin R. The relationship between asthma and overweight in urban minority children. J Natl Med Assoc 2006; 98:138-42. [PMID: 16708497 PMCID: PMC2595039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
BACKGROUND This study was performed to determine the relationship between overweight [body mass index (BMI) > or = 85th percentile] and asthma as determined by spirometry. METHOD Spirometry was performed according to the American Thoracic Society guidelines, and BMI was calculated. Asthma was defined as a forced expiratory volume in 1 second (FEV1) <80% predicted and FEV1/forced vital capacity (FVC) >5% lower than predicted for age and sex. RESULTS One-hundred-nine children (age 14.7 +/- 1.6 years) were enrolled. Eighty children (73%) were African-American, and 29 children (27%) were white. Fifty-eight (53%) children were overweight. Twelve (11%) children, of whom nine (75%) were overweight, met the criteria for asthma. Baseline FEV1 percent predicted (87 +/- 6% vs. 83 +/- 7%, p=0.03), FEV1/FVC (93 +/- 6 vs. 87 +/- 8, p<0.001), and FEV1 percent predicted following albuterol administration (94 +/- 7 vs. 89 +/- 7%, p=0.03) were all lower in overweight children. Children with asthma were almost 1.5 times more likely to be overweight compared with children without asthma (relative risk: 1.49, 95% confidence interval: 1.015-2.17). CONCLUSIONS Inner-city children are more likely to be overweight compared to the general population. Asthma is a risk factor for overweight in these children.
Collapse
Affiliation(s)
- Rashed A Hasan
- Michigan State University, Pediatric Critical Care and Pulmonary Medicine, Flint, MI, USA.
| | | | | | | | | | | |
Collapse
|
13
|
Abstract
The prevalence of both obesity and asthma has risen in recent years. We sought to investigate whether obesity may be related to asthma. We undertook a retrospective medical record review of patient records at an inner-city academic asthma center. Obesity was defined as a body mass index (BMI) greater than 30. Asthma severity was defined by using the National Heart Lung and Blood Institute 1997 guidelines. Adults with a history of cigarette smoking or other lung disease were excluded. A total of 143 individuals aged 18-88 with a mean age of 43.9 met the entry criteria. There were 113 females and 30 males. Seventy-two percent of the sample was obese. The Spearman correlation coefficient showed a linear relationship between asthma severity and BMI (r = 0.40, p < 0.0001). Females with asthma were significantly more overweight than males, mean BMI 35.9 vs. 32.14, respectively (p = 0.01). The prevalence of obesity in the 13 patients on long-term oral corticosteroids was 100%. Prevalence of obesity increases with increasing asthma severity in adults. The association of asthma severity with obesity suggests that obesity may be a potentially modifiable risk factor for asthma or asthma-like symptoms.
Collapse
|
14
|
Epstein LH, Wu YW, Paluch RA, Cerny FJ, Dorn JP. Asthma and maternal body mass index are related to pediatric body mass index and obesity: results from the Third National Health and Nutrition Examination Survey. OBESITY RESEARCH 2000; 8:575-81. [PMID: 11156433 DOI: 10.1038/oby.2000.74] [Citation(s) in RCA: 57] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Clinical research has shown an increased prevalence of obesity in children with asthma. This study was designed to assess the relationship between asthma and pediatric body mass index (BMI) in a national database and to examine factors that may modify this relationship. DESIGN The cross-sectional relationship between asthma and pediatric BMI and obesity (BMI > or = 85th percentile) was studied. Variables that may influence the relationship between asthma and pediatric BMI, such as race/ethnicity and television watching were included in the model for the total sample. A smaller sample of 3,009 white and African American youth were studied in regression models including maternal BMI. STUDY POPULATION A nationally representative cross-sectional sample of 5154 children and adolescents of 6 to 16 years of age from the Third National Health And Nutrition Examination Survey. RESULTS In the full sample, asthma and television watching were related to BMI, accounting for 3% of the variance in BMI. When maternal BMI was included in the non-Hispanic sample, television watching, maternal BMI, and the interaction of maternal BMI and asthma were related to youth BMI, accounting for 15% of the variance. The standardized BMI z-score for those youth without asthma and no maternal obesity was 0.06, which increased to 0.33 if the youth had asthma, to 0.70 if the youth did not have asthma but the mother was obese, and to 1.71 if the youth had asthma and the mother was obese. Asthma, television watching, and maternal BMI were independent predictors of youth obesity. CONCLUSIONS BMI and prevalence of obesity is higher in youth with asthma. Pediatric BMI, but not obesity, is also related to the interaction of asthma and maternal BMI in white and African American youth. Comorbidity of asthma and obesity may complicate treatment of either condition, and prevention of obesity should be encouraged for asthmatic children.
Collapse
Affiliation(s)
- L H Epstein
- Department of Pediatrics, State University of New York, Buffalo 14214-3000, USA.
| | | | | | | | | |
Collapse
|
15
|
Arpadi SM, Cuff PA, Kotler DP, Wang J, Bamji M, Lange M, Pierson RN, Matthews DE. Growth velocity, fat-free mass and energy intake are inversely related to viral load in HIV-infected children. J Nutr 2000; 130:2498-502. [PMID: 11015480 DOI: 10.1093/jn/130.10.2498] [Citation(s) in RCA: 61] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
The study objectives were to assess the relationships among human immunodeficiency virus (HIV) replication, energy balance, body composition and growth in children with HIV-associated growth failure (GF). Energy intake and expenditure, body composition and level of HIV RNA were measured in 16 HIV-infected children with growth failure (HIV+/GF+), defined as a 12-mo height velocity </= 5th percentile for age, and 26 HIV-infected children with normal rates of growth (HIV+/GF-). Energy intake was measured by repeated 24-h dietary recall, resting energy expenditure (REE) by indirect calorimetry and total energy expenditure (TEE) by the doubly labeled water method. Fat-free mass (FFM) was determined by dual X-ray energy absorptiometry and plasma HIV RNA by the polymerase chain reaction method. The mean plasma HIV RNA content among the HIV+/GF+ group was nearly 1.5 log higher than that of the HIV+/GF- group (4. 89 +/- 1.08 vs. 3.43 +/- 1.64 x10(2) copies/L, P: = 0.009). The mean daily energy intake, and age-adjusted REE and TEE were lower in HIV+/GF+ children (P: = 0.003, 0.06 and 0.16, respectively). HIV+/GF+ children had a mean daily energy deficit of 674 +/- 732 kJ/d compared with HIV+/GF- children who had a mean energy surplus of 1448 +/- 515 kJ/d (P: = 0.030). There were no differences in REE after adjustment for differences in FFM and age using multiple regression analysis (P: = 0.88). There was a significant inverse relationship between FFM and plasma HIV RNA [R:(2) = 0.64, standard error of the estimate (SEE) = 3.23] and between viral load and 12-mo growth velocity (R:(2) = 0.61, SE = 1.51). Viral load and energy intake were also inversely related (R(2) = 0.17, SEE = 573.2, P: = 0. 0125). In HIV-infected children, rate of growth, quantity of FFM and energy intake are closely related to the level of HIV replication. The energy intake of children with HIV-associated GF may not be adequate for supporting normal development of FFM and growth, despite possible decreases in total energy expenditure.
Collapse
Affiliation(s)
- S M Arpadi
- Department of Pediatrics and HIV Center, Columbia University College of Medicine,and School of Public Health, St. Luke's-Roosevelt Hospital Center, New York, NY, USA
| | | | | | | | | | | | | | | |
Collapse
|
16
|
|
17
|
Nir M, Lanng S, Johansen HK, Koch C. Long-term survival and nutritional data in patients with cystic fibrosis treated in a Danish centre. Thorax 1996; 51:1023-7. [PMID: 8977604 PMCID: PMC472653 DOI: 10.1136/thx.51.10.1023] [Citation(s) in RCA: 46] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND Adequate nutrition and optimal treatment of bronchopulmonary infections are both of critical importance in maintaining the health of patients with cystic fibrosis. The cystic fibrosis centre in Copenhagen has followed a regimen of very early and aggressive antimicrobial treatment, especially against Pseudomonas aeruginosa infection. An unrestricted diet of low fat and high protein without hyperalimentation was recommended before 1985 which was then changed to a high fat, high calorie intake. METHODS The overall impact of the treatment regimen was evaluated by a cross sectional analysis of all 223 patients who attended the centre in 1989. Growth and nutritional parameters were combined with lung function parameters and with a retrospective analysis of chronic P aeruginosa infection and its duration. Survival curves for all 313 patients treated at the centre since 1949 were calculated. RESULTS All the patients with cystic fibrosis had normal height, although the final height was achieved a little later than in healthy controls. Body weight was lower than normal in males above 15 and in females above 10 years of age. The body mass index (BMI), which was approximately 98% of normal in the younger patients, declined to 90% in adult men and to 83% in adult women with cystic fibrosis, and was strongly correlated with lung function parameters. In 1989 the median age of survival of all patients treated in the centre since 1949 was 30 years (32 years in males and 29 years in females). CONCLUSIONS The overall treatment regimen in the cystic fibrosis centre in Copenhagen is associated with growth and survival rates that are at least equal to those in other cystic fibrosis centres in other countries.
Collapse
Affiliation(s)
- M Nir
- Cystic Fibrosis Centre, Copenhagen, Department of Pediatrics, Rigshospitalet, National University Hospital, Denmark
| | | | | | | |
Collapse
|
18
|
Abstract
We measured growth hormone (GH) concentrations in first morning urine samples in 110 prepubertal children to determine whether asthma therapies affected GH secretion. The children with asthma were assigned to two groups depending on their asthma treatments: 1) 16 children with a history of asthma, currently not on any treatment, and 2) asthmatics taking inhaled corticosteroids (n = 37), short-term oral corticosteroids (n = 15), or long-term non-corticosteroidal therapies (n = 19). Results obtained from these children were compared with a control group of healthy prepubertal children (n = 23) without previous or current symptoms of asthma. Five consecutive urine samples were collected from each child, and GH concentrations (corrected for urine creatinine) were determined by an enzyme immunoassay. The mean (+/- SD) urine GH concentration determined in the control group (23 healthy prepubertal children) was 15.6 +/- 8.7 ng/L (1.88 +/- 1.29 ng GH/mmol creatinine). The mean (+/- SD) urine GH concentrations in overnight samples were similar in untreated asthmatics (14.1 +/- 6.1 ng/L) and in the treatment groups (14.1 +/- 7.7 ng/L, inhaled corticosteroids; 16.5 +/- 11.7 ng/L, oral corticosteroids; 15.9 +/- 9.8 ng/L, long-term non-corticosteroidal therapies). Irrespective of the manner of expression of urine GH (ng/L) or after correction for urine creatinine concentration (ng GH/mmol), no significant differences were found in the GH excretion among any of the groups. In this study, the intra-individual coefficient of variation for urine GH, expressed as ng/L, ranged between 11 and 87% (median, 32%). When the urine GH was expressed as ng GH/mmol creatinine, the coefficient of variation ranged between 12 and 92% (median, 35%), accounting for approximately 60% of the inter-individual coefficient of variation (mean CV, 56%) and 47% when the urine GH is expressed as ng GH/mmol creatinine. We were unable to determine any short-term differences in urine GH excretion between non-asthmatic children and asthmatics treated with inhaled corticosteroids, oral corticosteroids, or bronchodilators. Our results suggest that there is not an adverse effect of current corticosteroid therapies for childhood asthma on GH secretion.
Collapse
Affiliation(s)
- P C O'Leary
- University Department of Obstetrics and Gynaecology, Princess Margaret and King Edward Memorial Hospitals, Subiaco, Western Australia
| | | | | | | |
Collapse
|
19
|
|