身体质量指数、吸烟、喝酒、固体燃料的使用对患哮喘风险的影响：来自51个国家代表性调查的涉及175 000人的个体参与者数
2016/06/20
摘要
背景：我们评估身体质量指数（BMI）、吸烟、饮酒和使用固体燃料（SFU）之间的关系，以及这些因素对喘息症状（WS）和诊断的哮喘（DA）的单独影响和联合效益。
方法：我们分析了来自51个国家代表性调查的175 000个人，采用喘息症状和哮喘诊断的自我报告作为评价哮喘的程度。评价哮喘与低体重（BMI<18.5 kg/m（2））、肥胖（BMI≥30 kg/m（2）、吸烟、饮酒和使用固体燃料之间的合并OR值的固定效应和随机效应。
结果：所有个体危险因素的加合风险与喘息和哮喘显著相关（当前正在抽烟的女性哮喘患者和使用固体燃料的两性哮喘患者除外）。对女性吸烟者，吸烟量和持续时间显现了更强的剂量关系，体重指数表现出更强的二次关系。加合的风险通常在女性中更大，尤其是低体重（OR=2.73）和肥胖（OR=2.00）吸烟者他们患喘息的风险更高（OR=2.13, 患哮喘的OR=1.58）。低/高的身体质量指数、吸烟、饮酒的加合效应对女性患喘息和哮喘的影响一致高于男性。过瘦吸烟者中使用固体燃料与患喘息（男性和女性）和哮喘（女性）也呈正相关。
结论：身体质量指数、吸烟、饮酒和使用固体燃料，这些因素组合起来，发展为哮喘的风险增加了两倍或三倍。这些危险因素可能有助于解释不同国家的哮喘负担为什么存在广泛差异。
（杨冬 审校）
BMJ Open Respir Res. 2016 Apr 4;3(1):e000121. doi: 10.1136/bmjresp-2015-000121. eCollection 2016.
Effects of body mass index, tobacco smoking, alcohol drinking and solid fuel use on the risk of asthma: Individual Participant Data (IPD) meta-analysis of 175 000 individuals from 51 nationally representative surveys.
Patra J1, Maher YI2, Mishra S2, Bhatia M2, Alam D2, Malini DS3, Gupta PC4, Jha P1.
Author information
Abstract
BACKGROUND:We assessed the relationship of body mass index (BMI), smoking, drinking and solid fuel use (r; SFU), and the individual and combined effects of these factors on wheezing symptoms (WS) and on diagnosed asthma (DA).
METHODS:We analysed 175 000 individuals from 51 nationally representative surveys, using self-reports of WS and DA as the measures of asthma. The fixed-effects and random-effects estimates of the pooled ORs between asthma and underweight (BMI <18.5 kg/m(2)), obesity (BMI ≥30 kg/m(2)), smoking, drinking and SFU were reported.
RESULTS:The pooled risks of all individual risk factors were significantly associated with WS and DA (with the exception of current smoking with DA in women and SFU with DA in both genders). Stronger dose-response relationships were seen in women for smoking amounts and duration; BMI showed stronger quadratic relationships. The combined risks were generally larger in women than in men, with significant risks for underweight (OR=2.73) as well as obese (OR=2.00) smokers for WS (OR=2.13 and OR=1.58 for DA, respectively). The magnitude of the combined effects from low/high BMI, smoking and drinking were also consistently higher among women than among men in WS and DA. SFU among underweight smokers also had positive association with WS (men and women) and DA (women).
CONCLUSIONS:BMI, smoking, drinking and SFU-in combination-are associated with double or triple the risk of development of asthma. These risk factors might help explain the wide variation in asthma burden across countries.
KEYWORDS:Asthma; Asthma Epidemiology; Tobacco and the lung
BMJ Open Respir Res. 2016 Apr 4;3(1):e000121. doi: 10.1136/bmjresp-2015-000121. eCollection 2016.
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