# Insulin Resistance, Pre-Diabetes, and Diabetes in Obesity-Associated Asthma

> **NIH NIH K23** · BAYLOR COLLEGE OF MEDICINE · 2021 · $206,899

## Abstract

PROJECT SUMMARY AND ABSTRACT
 Asthma and obesity are prevalent conditions in the United States. Obese individuals with asthma are at
risk for obesity-associated asthma, a distinct phenotype that is more severe and exacerbation prone. Insulin
resistance, pre-diabetes, and diabetes, a spectrum of disorders in glucose metabolism that is enriched in
obesity, have been implicated as contributing to the excess morbidity observed in obesity-associated asthma.
In general populations, these conditions have been associated with diminished lung function and respiratory
symptoms, supporting a pathologic role in pulmonary health. However, there are significant limitations in
literature, and its relevancy to asthma control and severity in humans, and among individuals with obesity, is
uncertain. In this application, we propose to examine the association of insulin resistance, pre-diabetes, and
diabetes with asthma exacerbations, asthma control, and lung function, as well as effect modification of this
association by obesity. We will perform this analysis in two complementary aims, (1) a “big data” applied
epidemiology project leveraging the electronic health record of two major health systems in the United States,
combining cohort analyses with pharmaco-epidemiologic techniques to investigate the hypothesized pathway,
and (2) a prospectively enrolled cohort study of obese participants with asthma who undergo bariatric surgery,
with repeated measurements of insulin resistance, lung function, and patient-reported asthma outcomes. The
results of these analyses will build evidence for a deleterious role of insulin resistance, pre-diabetes, and
diabetes within obesity-associated asthma. This is especially important, as this common asthma phenotype
has few specific treatment options. This project proposal will provide mentored training for the applicant to
develop skills in the conduct of a patient-oriented clinical study, pharmacoepidemiology, EHR analytic
techniques, and biostatistics. These skills will be pivotal toward the applicant's goal of becoming an
independent physician-scientist and clinical epidemiologist with expertise in asthma and obesity-associated
asthma. He is overseen by a mentorship team comprised of experts in asthma, patient-oriented research, EHR
epidemiology, and biostatistics. The career development plan is a natural continuation of research activities in
fellowship and serves to establish an expertise distinct from his principal mentor. The research strategy and
career development plan will be operationalized within the Division of Pulmonary and Critical Care Medicine at
the Johns Hopkins University, leveraging a collaborative and productive research environment with a strong
history of successful development of junior faculty.

## Key facts

- **NIH application ID:** 10126325
- **Project number:** 1K23HL151669-01A1
- **Recipient organization:** BAYLOR COLLEGE OF MEDICINE
- **Principal Investigator:** Tianshi David Wu
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $206,899
- **Award type:** 1
- **Project period:** 2021-05-15 → 2026-04-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10126325

## Citation

> US National Institutes of Health, RePORTER application 10126325, Insulin Resistance, Pre-Diabetes, and Diabetes in Obesity-Associated Asthma (1K23HL151669-01A1). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10126325. Licensed CC0.

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