哮喘联盟

   摘要
   背景：肥胖增加哮喘的风险与哮喘严重程度, 并且肥胖是儿童和青少年中胰岛素抵抗和代谢综合征(metabolic syndrome: MS)的一个公认的危险因素。
   目的：我们旨在探索美国哮喘和非哮喘青少年中肥胖，胰岛素抵抗，代谢综合征与肺功能之间的关系。
   方法：我们对2007-2010年国家健康和营养调查中的1429名12-17周岁的青少年进行了一个横断面研究。评价哮喘和非哮喘儿童肥胖，胰岛素敏感性/抵抗，代谢综合征与肺功能之间的关系采用校正过的回归分析。
   结果：在哮喘与非哮喘青少年中胰岛素抵抗与FEV1及用力肺活量（FVC）呈负相关，然而MS与更低的FEV1/FVC比例相关，并且在哮喘患者中下降更显著，这些相关性由超重/肥胖青少年驱动。在伴随胰岛素抵抗的青少年中更高的体重指数与FEV1/FVC比例下降相关。与健康受试者比较，伴随MS的青少年其FEV1/FVC比例下降约2%，伴随哮喘的青少年下降约6%，同时伴随MS和哮喘的青少年FEV1/FVC比例下降约10%（P< .05）。
   结论：在超重/肥胖青少年中胰岛素抵抗和MS均与更差的肺功能相关。和肥胖与胰岛素抵抗一样，哮喘与代谢综合征协同地降低肺功能。这些因素可能有利于了解肥胖患者哮喘严重程度的发病机制，并且为进一步研究提供了根据。
 

(刘影 张红萍 王刚  四川大学华西医院中西医结合科呼吸病组 610041 摘译)
（J Allergy Clin Immunol 2015 Mar 3. pii: S0091-6749(15)00099-8）
 

Insulin resistance, metabolic syndrome, and lung function in US adolescents with and without asthma
 

Erick F, Yueh-Ying H, Radhika H. M, and Juan C. C
J Allergy Clin Immunol 2015 Mar 3. pii: S0091-6749(15)00099-8

ABSTRACT
BACKGROUND:Obesity increases both the risk of asthma and asthma severity and is a well-known risk factor for insulin resistance and the metabolic syndrome (MS) in children and adolescents.
OBJECTIVE:We aimed to examine the association among obesity, insulin sensitivity, MS, and lung function in US adolescents with and without asthma.
METHODS:We performed a cross-sectional study of 1429 adolescents aged 12 to 17 years in the 2007-2010 National Health and Nutrition Examination Survey. Adjusted regression was used to assess the relationships among obesity, insulin sensitivity/resistance, MS, and lung function in children with and without asthma.
RESULTS:Insulin resistance was negatively associated with FEV1 and forced vital capacity (FVC) in adolescents with and without asthma, whereas MS was associated with lower FEV1/FVC ratios, with a more pronounced decrease found among asthmatic patients; these associations were driven by overweight/obese adolescents. Higher body mass index was associated with a decrease in FEV1/FVC ratios among adolescents with insulin resistance. Compared with healthy participants, adolescents with MS had an approximately 2% decrease in FEV1/FVC ratios, adolescents with asthma had an approximately 6% decrease, and those with MS and asthma had approximately 10% decreased FEV1/FVC ratios (P < .05).
CONCLUSION:Insulin resistance and MS are associated with worsened lung function in overweight/obese adolescents. Asthma and MS synergistically decrease lung function, as do obesity and insulin resistance. These factors might contribute to the pathogenesis of asthma severity in obese patients and warrant further investigation.