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Does HbA1c affect lung function and hospitalizations in asthmatic adults?

Published online: June 20, 2020

In 2016, asthma affected 9.3% of people and caused ~93,000 hospitalizations in the United Kingdom (U.K.).  Asthma hospitalizations result from severe or poorly controlled disease and account for a high proportion of asthma-related healthcare costs. Whereas insulin resistance and glucose dysregulation have been associated with asthma and asthma severity, the role of an elevated glycated hemoglobin A1c (HbA1c) on asthma control or severity is less clear.

In a study published in a recent issue of The Journal of Allergy and Clinical Immunology: In Practice, Yang and colleagues hypothesized that chronic hyperglycemia would lead to worse lung function and asthma hospitalizations among adults with asthma but no physician-diagnosed diabetes mellitus. Using data from the UK Biobank (UKB), the authors examined the relation between HbA1c level and hospitalizations for asthma and lung function measures in a cohort of 47,606 British adults with self-reported physician-diagnosed asthma but no diagnosis of diabetes. The researchers found that an elevated HbA1c level was significantly associated with increased risk of at least one hospitalization for asthma, as well as small decrements in forced expiratory volume in the first second (FEV1) and forced vital capacity (FV) - but not in FEV1/FVC.

In summary, this study suggests that an elevated HbA1c level is linked to increased risk of asthma hospitalizations and lower FEV1 and FVC among British adults with asthma but no physician-diagnosed diabetes. Longitudinal studies are needed to determine whether improved glycemic control reduces the risk of asthma hospitalizations.

The Journal of Allergy and Clinical Immunology: In Practice is an official journal of the AAAAI, focusing on practical information for the practicing clinician.

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