Blood Glucose Levels, Inflammation, and Mortality in Asthmatic Populations: A Prospective Cohort Study

Abstract Background Presently, the associations between blood glucose management, systemic inflammation, and prognosis in the asthmatic population are still uncertain. Method This investigation included 2719 people with asthma from the National Health and Nutrition Examination Survey (NHANES). The l...

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Main Authors: Jun Wen, Changfen Wang, Rongjuan Zhuang, Shuliang Guo, Jing Chi
Format: Article
Language:English
Published: Springer 2025-06-01
Series:Journal of Epidemiology and Global Health
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Online Access:https://doi.org/10.1007/s44197-025-00425-7
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author Jun Wen
Changfen Wang
Rongjuan Zhuang
Shuliang Guo
Jing Chi
author_facet Jun Wen
Changfen Wang
Rongjuan Zhuang
Shuliang Guo
Jing Chi
author_sort Jun Wen
collection DOAJ
description Abstract Background Presently, the associations between blood glucose management, systemic inflammation, and prognosis in the asthmatic population are still uncertain. Method This investigation included 2719 people with asthma from the National Health and Nutrition Examination Survey (NHANES). The linear regression, Cox proportional hazards regression, the Shapley Additive Explanations (SHAP) model, restricted cubic spline (RCS), survival area plot, and survival quantile plot were used to comprehensively evaluate the associations between fasting plasma glucose (FPG), hemoglobin A1c (HbAlc), the systemic inflammation, and the mortality in populations with asthma. Results The Cox regression model revealed a positive correlation between HbA1c (HR: 1.21, 95% CI: 1.04–1.42) and FPG (HR: 1.08, 95% CI: 1.02–1.15) and the risk of death in asthmatics, while diabetes (HR: 1.55, 95% CI: 1.07–2.23) also increased the death risk of asthma. The RCS, survival area plot, and survival quantile plot all corroborated the positive association between HbA1c, FPG, and the death risk in asthma patients. The SHAP model suggested that the top five key markers for predicting the mortality risk of asthmatic people were age, cardiovascular disease, cholesterol, systemic inflammatory index (SII), and FPG. This investigation also revealed a positive relationship between HbA1c and FPG as well as neutrophils, along with a positive association between FPG and the SII. Conclusions Higher blood glucose levels—reflected by both HbA1c and FPG—are independently associated with greater mortality risk in adults with asthma. And hyperglycemia is linked to systemic inflammation, optimizing blood glucose control may improve inflammatory status and long-term outcomes in this population.
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spelling doaj-art-8491aa3f9f024a64951b092bc63fa4022025-08-20T03:10:27ZengSpringerJournal of Epidemiology and Global Health2210-60142025-06-0115111010.1007/s44197-025-00425-7Blood Glucose Levels, Inflammation, and Mortality in Asthmatic Populations: A Prospective Cohort StudyJun Wen0Changfen Wang1Rongjuan Zhuang2Shuliang Guo3Jing Chi4Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing Medical UniversityDepartment of Cardiology, People’s Hospital of Qianxinan PrefectureDepartment of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing Medical UniversityDepartment of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing Medical UniversityDepartment of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing Medical UniversityAbstract Background Presently, the associations between blood glucose management, systemic inflammation, and prognosis in the asthmatic population are still uncertain. Method This investigation included 2719 people with asthma from the National Health and Nutrition Examination Survey (NHANES). The linear regression, Cox proportional hazards regression, the Shapley Additive Explanations (SHAP) model, restricted cubic spline (RCS), survival area plot, and survival quantile plot were used to comprehensively evaluate the associations between fasting plasma glucose (FPG), hemoglobin A1c (HbAlc), the systemic inflammation, and the mortality in populations with asthma. Results The Cox regression model revealed a positive correlation between HbA1c (HR: 1.21, 95% CI: 1.04–1.42) and FPG (HR: 1.08, 95% CI: 1.02–1.15) and the risk of death in asthmatics, while diabetes (HR: 1.55, 95% CI: 1.07–2.23) also increased the death risk of asthma. The RCS, survival area plot, and survival quantile plot all corroborated the positive association between HbA1c, FPG, and the death risk in asthma patients. The SHAP model suggested that the top five key markers for predicting the mortality risk of asthmatic people were age, cardiovascular disease, cholesterol, systemic inflammatory index (SII), and FPG. This investigation also revealed a positive relationship between HbA1c and FPG as well as neutrophils, along with a positive association between FPG and the SII. Conclusions Higher blood glucose levels—reflected by both HbA1c and FPG—are independently associated with greater mortality risk in adults with asthma. And hyperglycemia is linked to systemic inflammation, optimizing blood glucose control may improve inflammatory status and long-term outcomes in this population.https://doi.org/10.1007/s44197-025-00425-7Hemoglobin A1c (HbAlc)Fasting plasma glucose (FPG)Systemic inflammationMortalityAsthmaShapley Additive Explanations (SHAP)
spellingShingle Jun Wen
Changfen Wang
Rongjuan Zhuang
Shuliang Guo
Jing Chi
Blood Glucose Levels, Inflammation, and Mortality in Asthmatic Populations: A Prospective Cohort Study
Journal of Epidemiology and Global Health
Hemoglobin A1c (HbAlc)
Fasting plasma glucose (FPG)
Systemic inflammation
Mortality
Asthma
Shapley Additive Explanations (SHAP)
title Blood Glucose Levels, Inflammation, and Mortality in Asthmatic Populations: A Prospective Cohort Study
title_full Blood Glucose Levels, Inflammation, and Mortality in Asthmatic Populations: A Prospective Cohort Study
title_fullStr Blood Glucose Levels, Inflammation, and Mortality in Asthmatic Populations: A Prospective Cohort Study
title_full_unstemmed Blood Glucose Levels, Inflammation, and Mortality in Asthmatic Populations: A Prospective Cohort Study
title_short Blood Glucose Levels, Inflammation, and Mortality in Asthmatic Populations: A Prospective Cohort Study
title_sort blood glucose levels inflammation and mortality in asthmatic populations a prospective cohort study
topic Hemoglobin A1c (HbAlc)
Fasting plasma glucose (FPG)
Systemic inflammation
Mortality
Asthma
Shapley Additive Explanations (SHAP)
url https://doi.org/10.1007/s44197-025-00425-7
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