Abstract
Objective The number of patients with type 2 diabetes has increased in Japan, and type 2 diabetes has attracted attention as a risk factor for asthma. However, the risk factors for the development of asthma in patients with type 2 diabetes have not been determined. This study was performed to clarify whether visceral fat accumulation (VFA) and insulin resistance are risk factors for the development of asthma in patients with type 2 diabetes. Materials and Methods A cross-sectional study was conducted. The study group comprised 15 patients with type 2 diabetes with asthma, and the control group comprised 145 patients with type 2 diabetes without asthma. Their fat distribution was evaluated by measuring the VFA by abdominal computed tomography at the umbilical level. Their glucose status was assessed by measuring the fasting plasma glucose (FPG) concentration, fasting immunoreactive insulin concentration, homeostasis model assessment (HOMA) index, and hemoglobin A1c concentration. Results Among patients with type 2 diabetes, VFA was significantly greater in patients with asthma than those without asthma (P < 0.0001). The FPG concentration, fasting immunoreactive insulin concentration, and HOMA index were higher in patients with asthma than those without asthma (P < 0.05, P < 0.0001, and P < 0.0001, respectively). Multiple logistic regression analysis showed that VFA and the HOMA index were significantly associated with asthma in patients with type 2 diabetes (odds ratio, 1.78; 95% confidence interval, 1.31–3.89; P = 0.0115 and odds ratio, 3.65; 95% confidence interval, 1.37–7.85; P = 0.0078, respectively). Conclusions Our data suggest that VFA and insulin resistance are associated with the development of asthma in patients with type 2 diabetes.
Highlights
The number of patients with type 2 diabetes has increased in Japan [1], and type 2 diabetes has attracted attention as a risk factor for asthma [2]
We hypothesized that the presence of asthma would be associated with visceral fat accumulation (VFA) and insulin resistance in patients with type 2 diabetes
Measurement of metabolic parameters revealed that the serum high-density lipoprotein cholesterol (HDL-C) level was lower while the homeostasis model assessment (HOMA) index and the degree of VFA were higher in patients with asthma than those without asthma
Summary
The number of patients with type 2 diabetes has increased in Japan [1], and type 2 diabetes has attracted attention as a risk factor for asthma [2]. The risk factors for the development of asthma in patients with type 2 diabetes have not been determined. Both asthma and obesity are common clinical problems that often coexist in the same patient, and epidemiologic studies have consistently demonstrated that obesity is a risk factor for asthma [3, 4]. Many previous studies have shown that the strongest associations were present between asthma and measures of abdominal or visceral obesity [5, 7]. Abdominal obesity is known to be a strong predictor of poor lung function [8]
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