Abstract
The burden of asthma in the elderly is increasing, but the etiology of asthma in the elderly is not clearly understood. Recent studies have reported the epidemiological link between metabolic syndrome (MS) and asthma, but it has rarely been studied in the elderly. This study investigated the association between MS and asthma and the contribution of insulin resistance (IR) and systemic inflammation to this MS-asthma association in the elderly. Our study analyzed 4,060 elderly participants (≥65 years old) from a cross-sectional survey, the Korean National Health and Nutritional Examination Survey 2007–2012. Mediation analyses were performed to examine whether IR and systemic inflammation mediates the MS-asthma association. Participants with MS had significantly higher prevalence of asthma (adjusted odds ratio = 1.34; 95% confidence interval = 1.09–1.64), and those who had greater waist circumference and lower HDL-C were especially likely to have asthma. Participants with IR and systemic inflammation were associated with higher prevalence of asthma. Prevalence of IR and systemic inflammation were higher in participants with MS or with each MS component. The MS-asthma association was substantially mediated by IR and systemic inflammation. Our study showed a significant association between MS and asthma in the elderly. MS might affect asthma through both IR and systemic inflammation.
Highlights
The burden of asthma in the elderly is increasing, but the etiology of asthma in the elderly is not clearly understood
This study showed that having metabolic syndrome (MS) is significantly associated with asthma defined as a self-reported wheezy episode in people aged ≥65 years
The presence of MS and the number of MS components were significantly associated with both insulin resistance (IR) and systemic inflammation
Summary
The burden of asthma in the elderly is increasing, but the etiology of asthma in the elderly is not clearly understood. While investigators observed clinical and physiological similarities between asthma in the elderly and that in younger patients[7], several studies reported that the characteristics of asthma in the elderly were distinct from the disease when found in young adults[8]. Some studies reported that patients with late-onset asthma show lower prevalence of positive skin test response when compared with early-onset asthmatics[9] Such results suggest that non-allergic mechanisms might contribute more substantially to the development of asthma in the elderly. The aims of our study were to (1) investigate the associations between MS and asthma and (2) examine whether potential mediators, such as insulin resistance (IR) and systemic inflammation, mediate this MS-asthma association in Korean elderly participants of a nationwide survey
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