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Mid-childhood fat mass and airflow limitation at 15 years: The mediating role of insulin resistance and C-reactive protein

Title: Mid-childhood fat mass and airflow limitation at 15 years: The mediating role of insulin resistance and C-reactive protein
Authors: Peralta, GP; Granell, R; Bedard, A; Carsin, A-E; Fuertes, E; Howe, LD; Marquez, S; Jarvis, DL; Garcia-Aymerich, J
Publisher Information: Wiley
Publication Year: 2022
Collection: Imperial College London: Spiral
Description: Background: We previously reported an association of high fat mass levels from age 9 to 15 years with lower forced expiratory flow in 1 s (FEV1)/forced vital capacity (FVC) ratio (i.e., increased risk of airflow limitation) at 15 years. Here, we aimed to assess whether insulin resistance and C-reactive protein (CRP) at 15 years partially mediate this association. Methods: We included 2263 children from the UK Avon Longitudinal Study of Parents and Children population-based cohort (ALSPAC). Four fat mass index (FMI) trajectories (“low,” “medium-low,” “medium-high,” “high”) from 9 to 15 years were previously identified using Group-Based Trajectory Modeling. Data on CRP, glucose, insulin, and post-bronchodilator FEV1/FVC were available at 15 years. We defined insulin resistance by the homeostasis model assessment-estimated insulin resistance index (HOMA-IR). We used adjusted linear regression models and a causal mediation analysis to assess the mediating role of HOMA-IR and CRP. Results: Compared to children in the “low” FMI trajectory, children in the “medium-high” and “high” FMI trajectories had lower FEV1/FVC at 15 years. The percentage of the total effect explained by HOMA-IR was 19.8% [−114.1 to 170.0] and 20.4% [1.6 to 69.0] for the “medium-high” and “high” trajectories, respectively. In contrast, there was little evidence for a mediating role of CRP. Conclusion: The association between mid-childhood fat mass and FEV1/FVC ratio at 15 years may be partially mediated by insulin resistance.
Document Type: article in journal/newspaper
Language: English
Relation: Pediatric Allergy and Immunology; http://hdl.handle.net/10044/1/101891
DOI: 10.1111/pai.13894
Availability: http://hdl.handle.net/10044/1/101891; https://doi.org/10.1111/pai.13894
Rights: © 2022 The Authors. Pediatric Allergy and Immunology published by European Academy of Allergy and Clinical Immunology and John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made. ; https://creativecommons.org/licenses/by-nc-nd/4.0/
Accession Number: edsbas.9692F5C9
Database: BASE