哮喘联盟

   摘要
   目的:本研究旨在描述巴西哮喘儿童青少年的体质指数，胰岛素抵抗，脂肪因子和炎性标记物水平，以及研究其与哮喘严重程度和控制情况的可能关联。
   方法:横断面研究(n=92;年龄:3-18岁)。
   评估数据：体重和身高，用于计算体质指数(BMIZ) 和年龄别身高(HAZ)。
   实验室测量: 血脂; 血糖和胰岛素的内稳态模型评估(HOMA); 脂肪因子; 肿瘤坏死因子-α(TNF-α), C反应蛋白(CRP) 和单核细胞趋化蛋白-1 (MCP-1); 总免疫球蛋白E (IgE) 和针对气源性致敏源的特异性IgE。
   结果:中位数年龄为 9.6岁(3.0-16.6);大多数参与者为男性(n=52, 56.5%), 青春期前(n=54, 58.6%) 以及过敏性哮喘 (n=85, 92.4%)。超重/肥胖 (38%)显示与年龄呈负相关 (调整的OR值[OR]=0.781; 95% 置信区间[CI] 0.66-0.92) 和与瘦素水平呈正相关(调整的OR=1.13; 95%CI 1.04-1.22). 胰岛素浓度与中度持续性哮喘独立相关 (调整的 OR=1.31; 95% CI 1.09-1.52). HOMA显示与瘦素 (β=0.475; 95%CI 0.117-0.268)和总IgE (β=0.197; 95% CI 0.002-0.096)呈正相关，与TNF-α呈负相关(β=-0.255; 95% CI; -0.366-0.055).
   结论:哮喘与胰岛素抵抗以及由脂肪因子介导的系统性炎症反应相关，在超重受试者中伴有瘦素水平显著突出。
 

（杨冬 审校）
J Asthma. 2015 Nov 2:1-24. [Epub ahead of print]

 

Body mass index, adipokines and insulin resistance in asthmatic children and adolescents.
 

Morishita R1, Franco MD2, Souza FI1, Solé D1, Puccini RF1, Strufaldi MW1.
 

Abstract
OBJECTIVE:The present study aimed to describe the body mass index, insulin resistance, levels of adipokines and inflammatory markers in Brazilian asthmatic children and adolescents and to investigate their possible association with the severity and control of asthma.
METHODS:Cross-sectional study (n=92; age: 3-18 years).
ASSESSED DATA: Body weight and height, used to calculate the body mass index (BMIZ) and height-for-age (HAZ).
LABORATORY MEASUREMENTS: Lipid profile; glycaemia and insulin for homeostasis model assessment (HOMA); adipokines; tumour necrosis factor alpha (TNF-α), C-reactive protein (CRP) and monocyte chemoattractant protein-1 (MCP-1); total immunoglobulin E (IgE) and specific IgE against aeroallergens.
RESULTS:The median age was 9.6 years (3.0-16.6); most participants were male (n=52, 56.5%), prepubertal (n=54, 58.6%) and had atopic asthma (n=85, 92.4%). Overweight/obesity (38%) showed an inverse correlation with age (adjusted odds ratio [OR]=0.781; 95% confidence interval [CI] 0.66-0.92) and a direct correlation with the leptin concentration (adjusted OR=1.13; 95%CI 1.04-1.22). Insulin concentration was independently associated with moderated persistent asthma (adjusted OR=1.31; 95% CI 1.09-1.52). HOMA showed a direct correlation with the leptin (β=0.475; 95%CI 0.117-0.268) and total IgE (β=0.197; 95% CI 0.002-0.096) levels and an inverse correlation with the TNF-α levels (β=-0.255; 95% CI; -0.366-0.055).
CONCLUSIONS:Asthma was associated with insulin resistance and a systemic inflammatory response possibly mediated by adipokines, with leptin levels standing out among the participants with excess weight.
 

J Asthma. 2015 Nov 2:1-24. [Epub ahead of print]