Quiz: Asthma, Lipids, and Left Ventricular Mass

The following questions are based on recent studies reported in the respiratory disease literature, reviews of which have appeared on Patient Care this year. See what you remember from your reading; links to articles/studies are provided on the last page. 

A recent study compared the risk of a serious asthma–related event in children age 4 to 11 years who were given either fluticasone propionate alone or a fixed-dose combination of fluticasone propionate and salmeterol. The children all required daily asthma medications and had a history of asthma exacerbations in the previous year. 

1. The risk of a serious asthma-related event was:

A. Greater in the fluticasone-alone group

B. Greater in the fixed-dose fluticasone-salmeterol

C. Similar in both groups

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Answer: C. The risk of a serious asthma-related event was similar in both treatment groups

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A history of childhood asthma was found to be associated with an increased risk for elevated left ventricular mass index among apparently healthy adults.

2. The result was independent of which of the following major cardiovascular risk factors:

A. Age, sex, race

B. Smoking status

C. Antihypertensive medication

D. Heart rate, BMI, systolic blood pressure 

E. A and B

F. C and D

G. All of the above

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Answer: E. All of the above (the result was independent of all risk factors listed)

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A study in 165 patients with clinically stable, atopic asthma assessed whether serum lipids and lipoproteins correlated with blood eosinophil counts or serum periostin levels.

3. In those with atopic asthma, blood eosinophils positively correlated with serum HDL-cholesterol and total HDL particles. In contrast, blood eosinophil counts negatively correlated with serum triglyceride levels, independent of age, sex, race, body mass index, and serum C-reactive protein levels.

A. True

B. False

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Answer: B. False.  The converse is actually true: In those with atopic asthma, blood eosinophils negatively correlated with serum HDL-cholesterol and total HDL particles. In contrast, blood eosinophil counts positively correlated with serum triglyceride levels, independent of age, sex, race, body mass index, and serum C-reactive protein levels.

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4.  What percentage of patients with asthma also have clinically significant insomnia?A. ~10%

B. ~20%

C. ~30%

D. ~50
 

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Answer: C. ~30% (33% or one-third)

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5. Which of the following statements, based on results of a recent systematic review, is not true regarding administering an oral vitamin D supplement to patients with mild-to-moderate asthma?

A. Reduced the rate of exacerbations that required systemic corticosteroids.

B. Decreased the risk of having at least 1 exacerbation that required an emergency department visit or hospitalization or both.

C. Reduced the risk of severe asthma attacks requiring hospital admission or emergency department attendance.

D. Improved lung function and day-to-day asthma symptoms.

Please click below for answer and links to additional information.

Answer: D. Improved lung function and day-to-day asthma symptoms (vitamin D did not improve these measures).

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For additional information on questions and answers, please see articles below.

1. Beta-Agonists Plus Glucocorticoids Safe for Asthma2. Asthma History Linked to Left Ventricular Disease

3. Lipid Levels Linked to Inflammation in Atopic Asthma4. Insomnia Common with Asthma5.Ease Severe Asthma Attacks with Vitamin D