Novel relationship of serum cholesterol with asthma and wheeze in the United States

J Allergy Clin Immunol. 2009 Nov;124(5):967-74.e1-15. doi: 10.1016/j.jaci.2009.08.005. Epub 2009 Oct 3.

Abstract

Background: Cholesterol exerts complex effects on inflammation. There has been little investigation of whether serum cholesterol is associated with asthma, an inflammatory airways disease with great public health impact.

Objective: To determine relationships between levels of 3 serum cholesterol measures (total cholesterol [TC], high-density lipoprotein cholesterol [HDL-C], and non-HDL-C) and asthma/wheeze in a sample representative of the US population.

Methods: Cross-sectional study of 7005 participants age >or=6 years from the 2005 to 2006 National Health and Nutrition Examination Survey.

Results: Serum TC and non-HDL-C were lower in patients with current asthma than in subjects without current asthma in the overall population (TC, 188.5 vs 192.2 mg/dL; non-HDL-C, 133.9 vs 137.7 mg/dL; P < .05 for both), whereas HDL-C was not different. Adjusted odds ratios (ORs) from multivariate logistic regression per 1-SD increase of TC and non-HDL-C for current asthma were 0.92 (95% CI, 0.86-0.98) and 0.91 (95% CI, 0.85-0.98), respectively. On racial/ethnic stratification, these relationships reflect marked reductions unique to Mexican Americans (MAs; TC, 171.4 vs 189.3 mg/dL; P < .001; OR, 0.62; 95% CI, 0.48-0.80; non-HDL-C, 119.8 vs 137.9 mg/dL; P < .001; OR, 0.62; 95% CI, 0.48-0.79). Among MAs, the adjusted OR for wheeze requiring medical attention was 0.57 (95% CI, 0.43-0.75) for TC and 0.53 (95% CI, 0.33-0.85) for non-HDL-C. Relationships between cholesterol and asthma/wheeze were independent of body mass index and serum C-reactive protein, and similar between atopic and nonatopic participants.

Conclusion: Serum TC and non-HDL-C are inversely related to asthma in the US population, chiefly reflecting a relationship among MAs.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Asthma / blood
  • Asthma / epidemiology*
  • Body Mass Index
  • C-Reactive Protein / analysis
  • Cholesterol / blood*
  • Cross-Sectional Studies
  • Female
  • Humans
  • Logistic Models
  • Male
  • Multivariate Analysis
  • Respiratory Sounds*
  • United States / epidemiology

Substances

  • C-Reactive Protein
  • Cholesterol