终身体质指数轨迹对成人哮喘发病率和持续性的影响
2022/03/17
摘要
背景：从童年到成年的高体质指数轨迹与一些慢性病的发展有关，但这种轨迹是否影响成年哮喘至今尚未调查。
目的：本研究的目的是调查儿童到中年（5-43岁）的体质指数轨迹与43-53岁的哮喘发病率、持续性和复发之间的关系。
方法：在塔斯马尼亚纵向健康研究中（n=4194），记录了5-43岁参与者8个时间点的体重和身高。使用基于群体的轨迹模型来开发体质指数轨迹。使用多元逻辑和线性回归建立了体质指数轨迹与43-53岁的哮喘发病率、持续性和复发的相关性，以及其与50岁的支气管高反应性和53岁的支气管扩张剂反应性之间的关联性。
结果：确定了五种不同的体质指数轨迹：平均轨迹、低轨迹、高轨迹、儿童高递减型轨迹和儿童平均递增型轨迹。与平均轨迹相比，儿童平均递增型轨迹和高轨迹与发生哮喘（分别为OR=2.6；95%CI 1.1，6.6和OR=4.4；95%CI 1.7，11.4）和中年支气管高反应性（分别为OR=2.9；1.1，7.5和OR=3.5；95%CI 1.1，11.4）的风险增加相关。没有观察到与哮喘持续性或复发的关联。
结论：对于5-43岁的参与者，当其体质指数轨迹表现为儿童平均递增型和高轨迹型时，其发生成人哮喘的风险较高。因此，鼓励个人在生活中保持正常的体质指数可能有助于减少成人哮喘的负担。
Impact of lifetime body mass index trajectories on the incidence and persistence of adult asthma.
Gulshan Bano Ali, Adrian J Lowe, Jennifer L Perret, E. Haydn Walters, Caroline J. Lodge, David Johns, Alan James, Bircan Erbas, Garun S Hamilton, Gayan Bowatte, Richard Wood-Baker, Michael J. Abramson, Dinh S Bui, Shyamali C Dharmage
Abstract
BACKGROUND:High body mass index trajectories from childhood to adulthood are associated with development of some chronic diseases, but whether such trajectories influence adult asthma has not been investigated to date.
OBJECTIVE:We investigated associations between body mass index trajectories from childhood to middle age (5–43 years) and incidence, persistence, and relapse of asthma from ages 43 to 53 years.
METHODS:In the Tasmanian Longitudinal Health Study (n= 4194), weight and height were recorded at 8-time points between 5 and 43 years. body mass index trajectories were developed using group-based trajectory modelling. Associations between body mass index trajectories and asthma incidence, persistence, and relapse from 43 to 53 years; bronchial hyper-responsiveness at 50 years; and bronchodilator responsiveness at 53 years were modelled using multiple logistic and linear regression.
RESULTS:Five distinct body mass index trajectories were identified: average, low, high, child high-decreasing, and child average-increasing. Compared to the average trajectory, child average-increasing and high trajectories were associated with increased risk of incident asthma (OR=2.6; 95%CI 1.1, 6.6 and OR=4.4; 1.7, 11.4, respectively) and bronchial hyper-responsiveness in middle age (OR= 2.9; 1.1, 7.5 and OR= 3.5;1.1, 11.4, respectively). No associations were observed for asthma persistence or relapse.
CONCLUSIONS:Participants with child average-increasing and high body mass index trajectories from childhood to middle age were at higher risk of incident adult asthma. Thus, encouraging individuals to maintain normal body mass index over the life course may help reduce the burden of adult asthma.
背景：从童年到成年的高体质指数轨迹与一些慢性病的发展有关，但这种轨迹是否影响成年哮喘至今尚未调查。
目的：本研究的目的是调查儿童到中年（5-43岁）的体质指数轨迹与43-53岁的哮喘发病率、持续性和复发之间的关系。
方法：在塔斯马尼亚纵向健康研究中（n=4194），记录了5-43岁参与者8个时间点的体重和身高。使用基于群体的轨迹模型来开发体质指数轨迹。使用多元逻辑和线性回归建立了体质指数轨迹与43-53岁的哮喘发病率、持续性和复发的相关性，以及其与50岁的支气管高反应性和53岁的支气管扩张剂反应性之间的关联性。
结果：确定了五种不同的体质指数轨迹：平均轨迹、低轨迹、高轨迹、儿童高递减型轨迹和儿童平均递增型轨迹。与平均轨迹相比，儿童平均递增型轨迹和高轨迹与发生哮喘（分别为OR=2.6；95%CI 1.1，6.6和OR=4.4；95%CI 1.7，11.4）和中年支气管高反应性（分别为OR=2.9；1.1，7.5和OR=3.5；95%CI 1.1，11.4）的风险增加相关。没有观察到与哮喘持续性或复发的关联。
结论：对于5-43岁的参与者，当其体质指数轨迹表现为儿童平均递增型和高轨迹型时，其发生成人哮喘的风险较高。因此，鼓励个人在生活中保持正常的体质指数可能有助于减少成人哮喘的负担。
(中日友好医院呼吸与危重症医学科 沈焜路 摘译 林江涛 审校)
(Eur Respir J. 2022 Feb 24:2102286. doi: 10.1183/13993003.02286-2021.)
(Eur Respir J. 2022 Feb 24:2102286. doi: 10.1183/13993003.02286-2021.)
Impact of lifetime body mass index trajectories on the incidence and persistence of adult asthma.
Gulshan Bano Ali, Adrian J Lowe, Jennifer L Perret, E. Haydn Walters, Caroline J. Lodge, David Johns, Alan James, Bircan Erbas, Garun S Hamilton, Gayan Bowatte, Richard Wood-Baker, Michael J. Abramson, Dinh S Bui, Shyamali C Dharmage
Abstract
BACKGROUND:High body mass index trajectories from childhood to adulthood are associated with development of some chronic diseases, but whether such trajectories influence adult asthma has not been investigated to date.
OBJECTIVE:We investigated associations between body mass index trajectories from childhood to middle age (5–43 years) and incidence, persistence, and relapse of asthma from ages 43 to 53 years.
METHODS:In the Tasmanian Longitudinal Health Study (n= 4194), weight and height were recorded at 8-time points between 5 and 43 years. body mass index trajectories were developed using group-based trajectory modelling. Associations between body mass index trajectories and asthma incidence, persistence, and relapse from 43 to 53 years; bronchial hyper-responsiveness at 50 years; and bronchodilator responsiveness at 53 years were modelled using multiple logistic and linear regression.
RESULTS:Five distinct body mass index trajectories were identified: average, low, high, child high-decreasing, and child average-increasing. Compared to the average trajectory, child average-increasing and high trajectories were associated with increased risk of incident asthma (OR=2.6; 95%CI 1.1, 6.6 and OR=4.4; 1.7, 11.4, respectively) and bronchial hyper-responsiveness in middle age (OR= 2.9; 1.1, 7.5 and OR= 3.5;1.1, 11.4, respectively). No associations were observed for asthma persistence or relapse.
CONCLUSIONS:Participants with child average-increasing and high body mass index trajectories from childhood to middle age were at higher risk of incident adult asthma. Thus, encouraging individuals to maintain normal body mass index over the life course may help reduce the burden of adult asthma.
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对中至重度哮喘患者自主性的了解
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过敏性哮喘的预防与过敏原避免措施和暴露的作用
