哮喘联盟

   摘要
   目的：本研究旨在评估城市持续性哮喘儿童中超重/肥胖与正常体重对哮喘症状、活动受限、医疗资源占用的不同影响。
   方法：数据来源于以学校为基础的哮喘治疗试验(the School Based Asthma Therapy trial)。2006-2009年共纳入530例3-10岁的持续性哮喘儿童（有效率：74%）。通过家访的形式评估儿童哮喘症状和医疗资源占用情况。根据在学校护士办公室测定的儿童身高和体重，来确定BMI百分位数，并对正常体重儿童与超重/肥胖(BMI>P85)儿童进行比较。运用双变量与多变量分析进行评估。
   结果：共收集了472例(89%)儿童的BMI数据；其中，49%的儿童超重/肥胖。对儿童民族、种族、干预组别、照料者年龄、筛选时间进行校正后，超重/肥胖儿童伴有哮喘症状的天数多于正常体重儿童（4.25 vs. 3.42/2周，p = 0.035），且活动受限更明显（3.43 vs. 2.55/2周， p = 0.013）。超重/肥胖儿童比正常体重儿童更容易因各种原因急诊就诊或住院治疗（47% vs. 36%，OR = 1.5， 95% CI：1.01 - 2.19），且存在超重/肥胖儿童过去一年因哮喘急性发作就诊更多的趋势(1.68 vs. 1.31, p = 0.090)。超重/肥胖儿童日常并不预防性服用吸入性糖皮质激素(OR = 1.0, 95% CI: 0.68 - 1.56)。
   结论：对持续性哮喘儿童，与正常体重者相比，超重/肥胖的儿童哮喘症状更多、活动受限更明显、医疗资源占用也更多，而吸入性糖皮质激素的应用并没有增加。因此，有必要做出更多努力来进一步提高超重/肥胖儿童的健康状况。
 

（杨冬 审校）
J Asthma. 2016 Jan 20:1-7. [Epub ahead of print]

 

Asthma and overweight/obese: double trouble for urban children.
 

Wiesenthal EN1, Fagnano M1, Cook S1, Halterman JS1.
 

Abstract
OBJECTIVE:To evaluate the effects of overweight/obese versus normal weight on symptoms, activity limitation and health care utilization among a group of urban children with persistent asthma.
METHODS:Data were obtained from the School Based Asthma Therapy trial. We enrolled 530 children ages 3-10 with persistent asthma from 2006 to 2009 (response rate: 74%). We conducted in-home interviews to assess symptoms and health care utilization. We measured height and weight in school nurse offices to determine BMI percentile, and compared normal weight children to overweight/obese (BMI >85th percentile) children. Bivariate and multivariate analyses were used.
RESULTS:We collected BMI data from 472 children (89%); 49% were overweight/obese. When controlling for child race, child ethnicity, intervention group, caregiver age and screen time, overweight/obese children had more days with asthma symptoms (4.25 versus 3.42/2 weeks, p = 0.035) and more activity limitation (3.43 versus 2.55/2 weeks, p = 0.013) compared to normal weight children. Overweight/obese children were more likely to have had an ED visit or hospitalization for any reason (47% versus 36%, OR 1.5, 95% CI 1.01, 2.19), and there was a trend for overweight/obese children to have more acute asthma visits in the past year (1.68 versus 1.31, p = 0.090). Overweight/obese children were not more likely to be taking a daily preventive inhaled corticosteroid (OR 1.0, 95% CI 0.68, 1.56).
CONCLUSIONS:Overweight/obese children with persistent asthma experience more asthma symptoms, activity limitation and health care utilization compared to normal weight children, with no increased use of inhaled corticosteroids. Further efforts are needed to improve the health of these children.
 

J Asthma. 2016 Jan 20:1-7. [Epub ahead of print]