哮喘联盟

   摘要
   背景：肥胖和哮喘的急剧增加是主要的公共健康问题。尽管哮喘-肥胖的相关性已得到广泛研究，但是体重减轻对哮喘严重程度（通过检测气道高反应性（AHR））的影响并没有引起足够的关注。我们的主要研究目的是确定体重减轻是否可以降低成年肥胖哮喘患者的哮喘严重程度。
   方法：在本项前瞻性、对照、平行研究中，我们随访了22例18～75岁的肥胖-哮喘患者，他们的体重指数（BMI）＞32.5kg/m2 ，存在气道高反应性（乙酰甲胆碱PC20<16mg/mL）。16例受试者进行为期3个月的行为减肥项目，6例受试者作为对照。首要研究终点是3个月后AHR的变化，次要研究终点是肺功能、哮喘控制和生活质量的改变。
   结果：在研究起始，受试者的平均年龄为44岁(SD±9), 其中95%为女性，这些女性的平均BMI是45.7kg/m2 (SD±9.2)。3个月后，干预组体重平均下降16.5kg (SD± 9.9) ，而对照组增加0.6kg (SD±2.6)。在干预组，乙酰甲胆碱PC20(p=0.009)、FEV1 (p=0.009)、FVC(p=0.010)、哮喘控制(p<0.001) 和哮喘生活质量(p=0.003)明显改善，而对照组的这些参数无改变。干预组的体力活动水平也明显增加，但对照组无变化。
   结论：对于肥胖-哮喘患者来说，减轻体重能改善哮喘严重程度、AHR、哮喘控制、肺功能和生活质量。这些发现表明肥胖-哮喘患者需要积极寻求健康的减重措施。
 

（杨冬 审校）
Chest. 2015 Mar 12. doi: 10.1378/chest.14-3105. [Epub ahead of print]
 

Effects of weight loss on airway responsiveness in obese asthmatics: Does weight loss lead to reversibility of asthma?
 

Pakhale S, Baron J, Dent R, Vandemheen K, Aaron SD.
 

ABSTRACT
BACKGROUND:Growing epidemics of obesity and asthma are major public health concerns. Despite that asthma-obesity links are widely studied, the effects of weight loss on asthma severity measured by airway hyper-responsiveness (AHR) have received limited attention. Our main study objective was to examine whether weight reduction reduces asthma severity in adult obese-asthmatics.
METHODS:In a prospective controlled parallel group study, we followed 22 obese-asthmatic subjects aged 18-75 years, with a body mass index (BMI) >32.5kg/m2 and airway hyper-responsiveness (PC20<16mg/mL of methacholine). Sixteen subjects followed a behavioural weight reduction program for 3 months and 6 subjects were controls. The primary outcome was change in AHR over 3 months. Changes in lung function, asthma control and quality of life were secondary outcomes.
RESULTS:At study entry, subjects' mean age was 44 years (SD±9), 95% were females with mean BMI of 45.7kg/m2 (SD±9.2). After 3 months, mean weight loss was 16.5kg (SD± 9.9) in the weight loss group but controls had a mean weight gain of 0.6kg (SD±2.6). There were significant improvements in PC20 to methacholine (p=0.009), FEV1 (p=0.009), FVC (p=0.010), asthma-control (p<0.001) and asthmaquality of life (p=0.003) in the intervention group whilst these parameters remained unchanged in the control group. Physical activity levels also increased significantly in the intervention group but not in the controls.
CONCLUSION:Weight loss in obese-asthmatics can improve asthma severity and result in improvements in AHR, asthma control, lung function, and quality of life. These findings support the need to actively pursue healthy weight loss measures in obese-asthmatics.
 

Chest. 2015 Mar 12. doi: 10.1378/chest.14-3105. [Epub ahead of print]