Researchers at Johns Hopkins University have uncovered a significant relationship between hemoglobin A1c (HbA1c) levels and asthma control in children. The study, “Association Between Hemoglobin A1c and Pediatric Asthma Control,” was published in the Journal of Asthma and Allergy. The research was part of the AIRWEIGHS clinical trial, which is designed to explore how metabolic dysfunction, indicated by HbA1c levels, impacts asthma outcomes in an urban cohort of children.
The study involved 164 children, predominantly Black, who have asthma and live in Baltimore. During clinic visits, researchers assessed their HbA1c levels and asthma outcomes at baseline and three months. HbA1c levels were analyzed as a continuous measure and categorized as normal (less than 5.7%) or consistent with pre-diabetes (greater than or equal to 5.7%).
Key findings from the study include:
- Higher HbA1c levels linked to worse asthma control: Children with elevated HbA1c levels showed worse asthma control, as indicated by higher scores on the Asthma Therapy Assessment Questionnaire (ATAQ), spirometry and fractional exhaled nitric oxide (FeNO). Generalized Estimating Equation (GEE) regression models were used to analyze the association between HbA1c and asthma outcomes. Each percentage point increase in HbA1c was associated with a 0.74 increase in ATAQ score, reflecting poorer asthma management.
- BMI impacts asthma outcomes: The study found that the association between HbA1c and asthma morbidity was more pronounced among children with lower BMI percentiles. This suggests that metabolic dysfunction may have a stronger influence on asthma symptoms and exacerbation risk in non-obese children.
- Predominantly low-income and publicly insured participants: The cohort consisted primarily of children from households with an income below $34,999 who were publicly insured, highlighting socioeconomic factors that may contribute to asthma severity.
The study sheds light on the complex relationship between metabolic health and asthma, suggesting that addressing glycemic control could be crucial in managing asthma in pediatric populations. Researchers emphasized the need for future studies to investigate metabolic pathways in asthma, particularly among nonobese children with underlying metabolic dysfunction.
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