Metabolic Syndrome and Pulmonary Dysfunction in Socioeconomically Disadvantaged Asthmatic Children During COVID-19 Pandemic

초록

Rationale School-closure due to COVID-19 pandemic may reduce physical activity and increased obesity and metabolic syndrome(MS) in children. We hypothesized that obesity and MS due to decreased physical activity are associated with pulmonary dysfunction in children with asthma. Methods Asthmatic subjects who attended the allergy clinic of Korea University Anam Hospital, Seoul, from January to December 2021 were participated in this study. Data of 61 asthmatic subjects who completed blood test, spirometry and methacholine challenge test and were evaluated. Results Among the 61 asthmatic subjects 21(34.4%) met the diagnostic criteria of MS. Height, weight, waist circumference(WC) and BMI were significantly increased in the MS asthmatics than non-MS asthmatics. The mean levels of FEV1(90.7±14.3%pred vs 82.6±11.7%pred, p <0.001) and FVC(103.1±19.0%pred vs 87.2±14.8%pred, p <0.001) were significantly higher in the MS asthmatics than non-MS asthmatics, in contrary FEV1/FVC(79.7±9.01%pred vs 84.6±7.67%pred, p =0.030) shows opposite result. The mean triglyceride(168.8±124.8 vs 106.5±56.2 mg/dL, p =0.019) and LDL-C(106.6±22.3 vs 94.8±22.1 mg/dL, p =0.047) levels were significantly higher in the MS asthmatics than in the non-MS asthmatics. Multivariable linear regression results after adjustment for age, sex and height demonstrated that low FEV1/FVC significantly associated with WC (β=-0.246, p =0.045), serum total cholesterol(β=-0.319, p =0.020) and LDL-C(β=-0.317, p =0.032) but not with BMI(β=-0.146, p =0.256) and triglyceride(β=-0.066, p =0.134). Conclusions This cross-sectional study highlights the significant effects of obesity on lung function in asthmatic children during COVID-19 pandemic. These results have important implications for public health and indicate that more emphasis should be placed on the development of prevention strategies for obesity and MS in asthmatic children.