The association between asthma and obesity is well known, with several underlying mechanisms. The aim of the study was to evaluate whether metabolic syndrome may be other underlying mechanism related to this association. The study included 112 children (73 boys and 39 girls, mean age 11.1 ± 2.4); out of them 41were overweight, 38 had asthma and a normal body mass index (BMI), and 33 were overweight asthmatics. Serum leptin, adiponectin, glycemia, insulinemia, lipid profile levels (cholesterol and triglycerides) and the homeostasis model assessment (HOMA) index were analyzed as parameters of metabolic syndrome. BMI, waist circumferences (WC), and waist to hips ratio (WHR) were measured as parameters of obesity. Levels of BMI, WC, WHR, HOMA-IR (insulin resistance), and HOMA-AD (adiponectin) were significantly higher in overweight group (p<0.001) and overweight with asthma group compared to asthma (p<0.05). Asthma group had significantly lower level of leptin (p=0.00001) and significantly higher level of glycemia (p=0.0001) compared to overweight group and also compared to overweight with asthma group (p=0.00001 and p=0.001, respectively). A strong positive correlation was observed between leptin, BMI and WC in all three groups as well as between insulinemia and BMI in overweight (r=0.384) and asthma group (r=0.603). A significant strong correlation was also found between HOMA-IR and HOMA-AD with BMI in asthma group for consequently r=620 and r=531.Undoubtedly, there is an association with some parameters of the metabolic syndrome in childhood asthma. However, obesity has been shown to be a major driver of metabolic changes.

Leptin, as a major adipokine, positively correlates with the body’s fat, while atopy is an important feature in the development of childhood asthma. We aimed to evaluate the relationship between leptin, parameters of obesity, and atopy in children with asthma. The study included 112 children (73 boys, 39 girls, mean age 11.1±2.4). 41 were overweight, 38 had asthma and a normal body mass index (BMI), and 33 were overweight asthmatics. Serum leptin levels, BMI, waist circumference (WC), and waist to hips ratio (WHR) were measured. Skin prick test (SPT)/CAP, total serum IgE, fractional exhaled nitric oxide (FeNO), and pulmonary function tests were performed. In asthmatic children, serum leptin median level was 9.2±16.2 ng/ml, in overweight children was 30.6±21.6 ng/ml, and in overweight asthmatics was 31.1±20.3 ng/ml with a significant difference between the groups (p=0.0374), yet with a significantly lower median level in the group of children with asthma compared to the overweight children: with asthma (p=0.00001) and without asthma (p=0.00001). In the three groups of patients, BMI and WC displayed a significant positive correlation with leptin (for BMI r=0.652 vs. r=0.530 vs. r=0.563, respectively and for WC r=0.508 vs. r=0.426 vs. r=0.527, respectively). No significant correlations of leptin within atopy parameters (Eo, IgE, SPT/CAP, FeNO) in all three analyzed groups (p>0.05) was detected. Conclusion: Atopy was not confirmed as an underlying mechanism of the association between asthma and being overweight. Leptin had a significant linear correlation as a parameter of central obesity with BMI and WC in all three groups, but not with WHR.