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Prevalence of asthmatic symptoms in Lebanese patients with type 1 diabetes and their unaffected siblings compared to age-matched controls

Acta Diabetologica volume 47, pages 13–18 (2010)Cite this article

Abstract

Patients with type 1 diabetes (a TH1 disease) have been reported to be at a lower risk of developing asthma (a TH2 disease). Both diseases are affected by environmental and genetic factors. Our objective is to examine this relationship in Lebanon, a Middle-Eastern country, where no previous similar studies are available. This is a cross-sectional observational study conducted at the Chronic Care Center, a referral medical center for type 1 diabetics. Patients with type 1 diabetes aged 6–39 years old, their unaffected siblings and age-matched control completed the International Primary Care Airways Group asthma screening questionnaire. The prevalence of asthma symptoms was compared among the three groups and separately within a subgroup of diabetics in relation to their carrier state of previously collected genetic data. Among 305 diabetics, 776 siblings and 187 controls, diabetics were at lower risk of having any asthma symptoms than controls; OR 0.48 (95% CI 0.32–0.72, p < 0.001) and siblings were at lower risk than diabetics and controls; OR 0.64 (95% CI 0.45–0.91, p = 0.01) and 0.28 (95% CI 0.19–0.42, p < 0.001), respectively. Among 66 diabetics, carriers of the HLA-DQB1*0201 allele were at lower risk of having any asthma symptoms than non-carriers (25.5 vs. 53.3%, p = 0.04). Only a statistically non-significant trend of higher risk was observed in carriers of HLA-DQB1*0301 and G allele at the 49 (A/G) nucleotide of CTLA-4 gene. The TH1–TH2 paradigm might partially explain these findings, since siblings were the least to report asthma symptoms. Future research is needed with diagnostic tests for asthma and extensive genetic testing.

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Fig. 1

Abbreviations

Th1:

T helper type 1

Th2:

T helper type 1

T1DM:

Type 1 diabetes mellitus

IPAG:

International Primary Care Airways Group

CCC:

Chronic Care Center

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Acknowledgments

The valuable assistance of Mrs. Claude Sadek, Colette Bitar and Pascal Nawfal in the collection of questionnaires at the Chronic Care Center is highly appreciated.

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Authors and Affiliations

  1. Division of Endocrinology and Metabolism, Department of Internal Medicine, American University of Beirut Medical Center, 3 Dag Hammarskjold Plaza, 8th Floor, New York, NY, 10017 2324, USA

    Nadine Taleb, Mira S. Zantout & Sami T. Azar

  2. Division of Pulmonary and Critical Care, American University of Beirut Medical Center, New York, NY, 10017 2324, USA

    Pierre Bou Khalil

  3. School of Medicine, The Lebanese American University, Harvard School of Public Health, Boston, MA, 02215, USA

    Pierre Zalloua

Authors
  1. Nadine Taleb
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  2. Pierre Bou Khalil
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  3. Mira S. Zantout
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  4. Pierre Zalloua
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  5. Sami T. Azar
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Corresponding author

Correspondence to Sami T. Azar.

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N. Taleb and P. Bou Khalil have contributed equally to this work.

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Taleb, N., Bou Khalil, P., Zantout, M.S. et al. Prevalence of asthmatic symptoms in Lebanese patients with type 1 diabetes and their unaffected siblings compared to age-matched controls. Acta Diabetol 47 (Suppl 1), 13–18 (2010). https://doi.org/10.1007/s00592-009-0108-5

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