Abstract
BackgroundIn recent years, there has been increasing evidence that asthma is associated with atherosclerosis and cardiovascular disease. However, data in children and adolescents are scarce and conflicting. We aimed to assess the impact of asthma with and without an allergic component on the carotid intima-media thickness in a large pediatric population.MethodsThe community-based early vascular ageing-Tyrol cohort study was performed between May 2015 and July 2018 in North, East (Austria) and South Tyrol (Italy) and recruited youngster aged 14 years and above. Medical examinations included anthropometric measurements, fasting blood analysis, measurement of the carotid intima-media thickness by high-resolution ultrasound, and a physician guided interview.ResultsThe mean age of the 1506 participants was 17.8 years (standard deviation 0.90). 851 (56.5%) participants were female. 22 subjects had a physician diagnosis of non-allergic asthma, 268 had inhalative allergies confirmed by a positive radio-allergo-sorbent-test and/or prick test, and 58 had allergic asthma. Compared to healthy controls, participants with non-allergic asthma (411.7 vs. 411.7 µm; p = 0.932) or inhalative allergy (420.0 vs. 411.7 µm; p = 0.118) did not have significantly higher carotid intima-media thickness (cIMT). However, participants with allergic asthma had significantly higher cIMT (430.8 vs. 411.7; p = 0.004) compared to those without and this association remained significant after multivariable adjustment for established cardiovascular risk factors.ConclusionAllergic asthma in the youth is associated with an increased carotid intima-media thickness. Physicians should therefore be aware of allergic asthma as a potential cardiovascular risk factor in children and adolescents.Trial Registration Number The EVA-Tyrol Study has been retrospectively registered at clinicaltrials.gov under NCT03929692 since April 29, 2019.
Highlights
In recent years, there has been increasing evidence that asthma is associated with atherosclerosis and cardiovascular disease
Asthma has been associated with several cardiovascular risk factors (CVRF) such as elevated bodymass index (BMI) [16, 17] and biomarkers that were associated with cardiovascular disease (CVD) like high levels of tumor necrosis factor-α [18, 19], Interleukin 6 [20], and fibrinogen [5, 21]
With data of the Atherosclerosis Risk Factors in Male Youngsters (ARMY) study and the Bruneck study, we have previously demonstrated a significant association between atherosclerosis and the common allergic diseases asthma and allergic rhinitis [24]
Summary
There has been increasing evidence that asthma is associated with atherosclerosis and cardiovascular disease. Data in children and adolescents are scarce and conflicting. Asthma and cardiovascular disease (CVD) are highly prevalent conditions worldwide [1, 2]. Evidence has accumulated that asthma is associated with CVD [3,4,5,6,7,8,9,10]. Atherosclerosis may originate in childhood [23], data on atherosclerotic vascular changes in children and adolescents with asthma are scarce and conflicting [24,25,26,27,28]
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