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Published on: August 7, 2017
Low Vitamin B12 Levels and Its Association With Insulin Resistance: A Potent Cardiovascular Risk Indicator in
Arulvijayavani Subramaniam1, Sathiya Ramasamy2, Soundararajan Palanisamy3
1Biochemistry, Jawaharlal Institute of Postgraduate Medical Education and Research Karaikal, Karaikal, IND.
Insights
Poorly controlled asthma in children is linked to lower vitamin B12 levels and higher insulin resistance. These factors, along with increased BMI, elevate cardiometabolic risk, necessitating clinical attention for better asthma management.
Area of Science:
- Pediatric Pulmonology
- Metabolic Health
- Nutritional Biochemistry
Background:
- Insulin resistance is associated with Body Mass Index (BMI), potentially worsening asthma severity in obese children.
- Low vitamin B12 (Vit B12) levels are linked to cardiovascular risks due to elevated homocysteine.
- Limited research exists on the interplay of serum B12, insulin resistance, and poorly controlled asthma in pediatric populations.
Purpose of the Study:
- To compare cardio-metabolic risk factors (BMI, waist-hip ratio, insulin resistance, Vit B12) between well-controlled and poorly-controlled pediatric asthma.
- To investigate the relationship between these cardio-metabolic parameters and asthma severity, assessed via Pulmonary Function Tests (PFTs).
Main Methods:
- Sixty pediatric asthma patients (ages 10-15) were categorized into well-controlled and poorly-controlled groups based on asthma control criteria.
- Anthropometric measurements (BMI, waist-hip ratio) and fasting blood samples (glucose, insulin, Vit B12) were collected.
- Insulin resistance was calculated using HOMA-IR; PFTs (FEV1, FVC, FEV1/FVC ratio) assessed lung function.
Main Results:
- Significant differences were observed in BMI, insulin resistance, Vit B12 levels, and PFTs between the poorly controlled and well-controlled asthma groups (p<0.01).
- Asthma severity (FEV1:FVC%) negatively correlated with BMI, WHR, glucose, insulin, and HOMA-IR, but positively with Vit B12.
- A significant negative correlation was found between Vit B12 and HOMA-IR (r=0.76).
Conclusions:
- Poorly controlled asthma in children is associated with decreased vitamin B12 and increased insulin resistance compared to well-controlled asthma.
- Elevated BMI, insulin resistance, and low Vit B12 in poorly controlled asthma may contribute to cardiometabolic risk.
- These findings highlight the need for monitoring and managing metabolic health in pediatric asthma patients.
Abstract:
Introduction As insulin resistance metabolically affects the body mass index (BMI), obese asthma children have more severe diseases than children with normal body mass index. A low level of vitamin B12 (Vit B12) is a known atherogenic factor by increasing the homocysteine level and therefore promotes cardiovascular morbidity and mortality. Limited studies have evaluated the role of serum B12 and insulin resistance among poorly controlled asthma in children. The purpose of the study was to compare the cardio-metabolic risk factor such as BMI, waist-hip ratio (WHR), insulin resistance, and vitamin B12 in well-controlled and poorly-controlled asthma patients and to determine the relationship between these parameters with the severity of asthma as assessed by Pulmonary Function Test. Methodology Based on the asthma control questionnaire and Global Initiative for Asthma (GINA) criteria, chronic asthma patients (n=60) of age 10-15 years were divided into two groups, namely well-controlled and poorly-controlled (30 each). Anthropometry was assessed by BMI and waist-hip ratio, and fasting blood samples were collected for the estimation of blood glucose, insulin, and serum vitamin B12 levels. Insulin resistance (HOMA-IR) was calculated using the formula- fasting glucose (mg/dL) x fasting insulin (µIU/mL)]/405. Forced expiratory volume (FEV1), forced vital capacity (FVC), and FEV1/FVC ratio were measured to assess the pulmonary function test. Results There were significant differences in the values of the BMI, insulin resistance, vitamin B12, and pulmonary function tests between poorly controlled and well-controlled asthma (p<0.01). The FEV1: FVC% was negatively correlated with BMI (r=0.53), WHR (r=0.50), glucose (r=0.68), insulin (r=0.68), Insulin resistance (r=0.80), and positive correlation with Vit B12 (0.73). In addition, Vit B12 and HOMA-IR correlate negatively (r=0.76). Conclusion This study concludes that the level of Vit B12 is decreased and insulin resistance is increased in poorly controlled asthmatic children in comparison to well-controlled asthma. These factors along with the increased BMI in poorly controlled asthma can predispose to cardiometabolic risk which needs attention.
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