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We investigated effect modification in adults using the National Health and Nutrition Examination Survey 2003\u20132012, a large, nationally representative database.<\/jats:p><jats:p>Insulin resistance and a history of physician-diagnosed current asthma were obtained from 12\u200a421 adults, ages 18\u201385\u2005years. We used logistic regression to determine associations between obesity and current asthma, adjusting for age, sex, race\/ethnicity, poverty income ratio and smoking status. An interaction term evaluated effect modification by insulin resistance of the obesity\u2013asthma association.<\/jats:p><jats:p>As expected, obesity was positively associated with current asthma. Insulin resistance modified this association, with obesity measured as body mass index, waist circumference or waist-to-height ratio. The relationship between obesity and current asthma was stronger with increasing insulin resistance tertiles (OR 2.05, 95% CI 2.76\u20133.00; p-value for interaction 0.03). This association was robust to adjustments for other components of the metabolic syndrome (hypertriglyceridaemia, hypertension, hyperglycaemia and systemic inflammation). None of these components were themselves effect modifiers of the obesity\u2013asthma association.<\/jats:p><jats:p>In this large, nationally representative sample, insulin resistance modified the association between obesity and current asthma in adults. Targeting insulin resistance may represent a novel therapeutic strategy for obese patients with asthma.<\/jats:p>","DOI":"10.1183\/13993003.00246-2016","type":"journal-article","created":{"date-parts":[[2016,4,22]],"date-time":"2016-04-22T00:35:01Z","timestamp":1461285301000},"page":"403-410","update-policy":"https:\/\/doi.org\/10.1183\/ers-crossmark-policy","source":"Crossref","is-referenced-by-count":128,"title":["Insulin resistance modifies the association between obesity and current asthma in adults"],"prefix":"10.1183","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9731-4828","authenticated-orcid":false,"given":"Juan Carlos","family":"Cardet","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel","family":"Ash","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tope","family":"Kusa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr","given":"Carlos A.","family":"Camargo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elliot","family":"Israel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"81","published-online":{"date-parts":[[2016,4,21]]},"reference":[{"key":"2024102100003454000_48.2.403.1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2014.732"},{"key":"2024102100003454000_48.2.403.2","first-page":"84","article-title":"Current asthma prevalence \u2013 United States, 2006\u20132008","volume":"60","author":"Moorman","year":"2011","journal-title":"MMWR Surveill Summ"},{"key":"2024102100003454000_48.2.403.3","first-page":"93","article-title":"Asthma attacks among persons with current asthma \u2013 United States, 2001\u20132010","volume":"62","author":"Moorman","year":"2013","journal-title":"MMWR Surveill Summ"},{"key":"2024102100003454000_48.2.403.4","doi-asserted-by":"publisher","DOI":"10.1378\/chest.12-0872"},{"key":"2024102100003454000_48.2.403.5","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0036631"},{"key":"2024102100003454000_48.2.403.6","doi-asserted-by":"publisher","DOI":"10.1111\/j.1398-9995.2012.02855.x"},{"key":"2024102100003454000_48.2.403.7","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200801-076OC"},{"key":"2024102100003454000_48.2.403.8","doi-asserted-by":"publisher","DOI":"10.1378\/chest.07-0936"},{"key":"2024102100003454000_48.2.403.9","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.06.00077205"},{"key":"2024102100003454000_48.2.403.10","doi-asserted-by":"publisher","DOI":"10.3109\/02770900903338494"},{"key":"2024102100003454000_48.2.403.11","doi-asserted-by":"publisher","DOI":"10.1016\/j.rmed.2007.06.031"},{"key":"2024102100003454000_48.2.403.12","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201203-0573OC"},{"key":"2024102100003454000_48.2.403.13","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2006.10.029"},{"key":"2024102100003454000_48.2.403.14","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201401-0178OC"},{"key":"2024102100003454000_48.2.403.15","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200906-0896OC"},{"key":"2024102100003454000_48.2.403.16","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2013.281501"},{"key":"2024102100003454000_48.2.403.17","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.109.192644"},{"key":"2024102100003454000_48.2.403.18","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00046013"},{"key":"2024102100003454000_48.2.403.19","doi-asserted-by":"publisher","DOI":"10.1080\/02770900600567056"},{"key":"2024102100003454000_48.2.403.20","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2015.01.010"},{"key":"2024102100003454000_48.2.403.21","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2015.12.034"},{"key":"2024102100003454000_48.2.403.22","doi-asserted-by":"publisher","DOI":"10.1111\/j.1398-9995.2010.02402.x"},{"key":"2024102100003454000_48.2.403.23","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2222.2008.03197.x"},{"key":"2024102100003454000_48.2.403.24","unstructured":"National Health and Nutrition Examination Survey. 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