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JACI Highlights - October 2009
Novel relationship of serum cholesterol with asthma and wheeze in the United States
Michael B. Fessler, MD, Mark W. Massing, MD, PhD, Brian Spruell, BS, Renee Jaramillo, MStat, David W. Draper, PhD, Jennifer H. Madenspacher, MS, Samuel J. Arbes, DDS, PhD, MPH, Agustin Calatroni, MA, MS, and Darryl C. Zeldin, MD
Cholesterol has been shown to have a complex influence on inflammation. In cardiovascular disease (CVD), elevated lipid levels of LDL cholesterol are associated with inflammation and damage in the blood vessels. Asthma is an inflammatory disease of the airways and emerging research indicates that in the lung, cholesterol metabolism and inflammation are linked. It has also been observed that Mexican Americans living in the U.S. are distinguished by having an unexplained low prevalence of asthma and a relatively low incidence of CVD despite increased rates of lipid disease and inflammation. Given the high prevalence of asthma in the United States, studying these relationship variations may be of significant clinical importance. In a study in the Journal of Allergy and Clinical Immunology, found online now at www.jacionline.org, Fessler et al hypothesized that cholesterol would be directly associated with current asthma and wheeze and that these relationships would differ among racial/ethnic groups. The authors analyzed data from the National Health and Nutrition Examination Survey (NHANES) 2005-2006, which classified participants into 5 main racial/ethnic groups: non-Hispanic Whites, non-Hispanic Blacks, Mexican Americans, Other Hispanic, and Other/Multi-race. They found that cholesterol is inversely related to current asthma in the overall US population - serum total cholesterol and non-HDL cholesterol were lower in current asthmatics than in subjects without current asthma - as they were with wheeze requiring medical attention. This relationship was mainly reflective of Mexican Americans. The authors also found that the cholesterol-asthma relationship was not affected by body mass index or serum C-reactive protein levels (an indicator of systemic inflammation.) This study is the first to investigate a connection between cholesterol and asthma in a national survey and the first to identify a factor that may possibly contribute to the reduced prevalence and complications of asthma in Mexican Americans. These findings may have implications for the treatment of dyslipidemia (a disorder which elevates the “bad” cholesterol, LDL, and decreases the “good” cholesterol, HDL) in Mexican Americans. This study also offers new insights into basic disease mechanisms of asthma and treatment that may have applicability to other racial/ethnic groups.
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