普通人群中肥胖个体慢性咳嗽的风险和影响
2022/03/17
摘要
背景：肥胖个体可能具有较高的慢性咳嗽风险。肥胖者患慢性咳嗽的风险更高。我们调查了普通人群中肥胖个体慢性咳嗽的风险和影响因素。
方法：我们记录了来自哥本哈根普通人群研究中的44 554名成年人的慢性咳嗽、体重指数（BMI）和其他相关临床状况。哮喘和/或慢性阻塞性肺病患者被排除在外（n=10977）。BMI分为：体重不足（BMI<18.5 kg / m2），正常体重（18.5-24.9 kg / m2），超重（25.0-29.9 kg / m2），肥胖（30.0-34.9 kg / m2）和严重肥胖（≥35.0 kg / m2）。
结果：在33577名普通人群中，非肥胖者27829人（83%），肥胖5748人（17%）。与体重正常的个体相比，超重个体中慢性咳嗽多变量校正风险的ORs为1.4（95%CI 1.2至1.6），在肥胖个体中为1.9（95%CI 1.7至2.2），在严重肥胖个体中为2.6（95%CI 2.1至3.2）。分析显示，23%的肥胖者的慢性咳嗽是由胃食管反流病（GERD）所致。其他诱导因素包括蔬菜摄入量低（10%）和职业暴露（8%）。在肥胖人群中，与没有慢性咳嗽的人相比，有慢性咳嗽的人伴有更严重的呼吸道症状，更常见的是合并症包括胃食管反流病和糖尿病，更多的医疗保健利用率，肺功能下降和更高的血液炎症（所有p<0.05）。
结论：BMI与慢性咳嗽之间存在剂量反应关系，肥胖人群比普通人群发生慢性咳嗽风险高两倍至三倍。这种风险的增加部分是由GERD，低蔬菜摄入量和职业暴露所致的，通过改善这些因素可能使伴有慢性咳嗽的肥胖患者获益。
Risk and impact of chronic cough in obese individuals from the general population.
Landt EM, Çolak Y.
Abstract
BACKGROUND:Obese individuals may be at higher risk of chronic cough. We investigated the risk and impact of chronic cough in obese individuals from the general population.
METHODS:We recorded chronic cough, body mass index (BMI) and other related clinical conditions in 44 554 adults from the Copenhagen General Population Study. Individuals with asthma and/or chronic obstructive pulmonary disease were excluded (n=10 977). BMI was divided into: underweight (BMI <18.5 kg/m), normal weight (18.5-24.9 kg/m), overweight (25.0-29.9 kg/m), obese (30.0-34.9 kg/m) and severely obese (≥35.0 kg/m).
RESULTS:Among 33 577 adults from the general population, 27 829 (83%) were non-obese and 5748 (17%) were obese. Compared with individuals with normal weight, multivariable adjusted ORs for chronic cough risk were 1.4 (95% CI 1.2 to 1.6) in overweight, 1.9 (95% CI 1.7 to 2.2) in obese and 2.6 (95% CI 2.1 to 3.2) in severely obese individuals. Mediation analyses showed that chronic cough due to obesity was up to 23% mediated by gastro-oesophageal reflux disease (GERD). Other mediators included low vegetable intake with 10% and occupational exposure with 8%. Among obese individuals, those with versus without chronic cough had worse accompanying respiratory symptoms, more often comorbidities including GERD and diabetes, greater healthcare utilisations, lower lung function and higher blood inflammation (all p<0.05).
CONCLUSION:There is dose-response relationship between BMI and chronic cough, and chronic cough risk is twofold to threefold higher in obese individuals from the general population. This increased risk was partly mediated by GERD, low vegetable intake and occupational exposure, supporting that there may be benefit to gain by ameliorating some of these factors in obese individuals with chronic cough.
背景：肥胖个体可能具有较高的慢性咳嗽风险。肥胖者患慢性咳嗽的风险更高。我们调查了普通人群中肥胖个体慢性咳嗽的风险和影响因素。
方法：我们记录了来自哥本哈根普通人群研究中的44 554名成年人的慢性咳嗽、体重指数（BMI）和其他相关临床状况。哮喘和/或慢性阻塞性肺病患者被排除在外（n=10977）。BMI分为：体重不足（BMI<18.5 kg / m2），正常体重（18.5-24.9 kg / m2），超重（25.0-29.9 kg / m2），肥胖（30.0-34.9 kg / m2）和严重肥胖（≥35.0 kg / m2）。
结果：在33577名普通人群中，非肥胖者27829人（83%），肥胖5748人（17%）。与体重正常的个体相比，超重个体中慢性咳嗽多变量校正风险的ORs为1.4（95%CI 1.2至1.6），在肥胖个体中为1.9（95%CI 1.7至2.2），在严重肥胖个体中为2.6（95%CI 2.1至3.2）。分析显示，23%的肥胖者的慢性咳嗽是由胃食管反流病（GERD）所致。其他诱导因素包括蔬菜摄入量低（10%）和职业暴露（8%）。在肥胖人群中，与没有慢性咳嗽的人相比，有慢性咳嗽的人伴有更严重的呼吸道症状，更常见的是合并症包括胃食管反流病和糖尿病，更多的医疗保健利用率，肺功能下降和更高的血液炎症（所有p<0.05）。
结论：BMI与慢性咳嗽之间存在剂量反应关系，肥胖人群比普通人群发生慢性咳嗽风险高两倍至三倍。这种风险的增加部分是由GERD，低蔬菜摄入量和职业暴露所致的，通过改善这些因素可能使伴有慢性咳嗽的肥胖患者获益。
(中日友好医院呼吸与危重症医学科 万静萱 摘译 林江涛 审校)
(Thorax. 2022 Mar;77(3):223-230. doi: 10.1136/thoraxjnl-2020-216351.)
(Thorax. 2022 Mar;77(3):223-230. doi: 10.1136/thoraxjnl-2020-216351.)
Risk and impact of chronic cough in obese individuals from the general population.
Landt EM, Çolak Y.
Abstract
BACKGROUND:Obese individuals may be at higher risk of chronic cough. We investigated the risk and impact of chronic cough in obese individuals from the general population.
METHODS:We recorded chronic cough, body mass index (BMI) and other related clinical conditions in 44 554 adults from the Copenhagen General Population Study. Individuals with asthma and/or chronic obstructive pulmonary disease were excluded (n=10 977). BMI was divided into: underweight (BMI <18.5 kg/m), normal weight (18.5-24.9 kg/m), overweight (25.0-29.9 kg/m), obese (30.0-34.9 kg/m) and severely obese (≥35.0 kg/m).
RESULTS:Among 33 577 adults from the general population, 27 829 (83%) were non-obese and 5748 (17%) were obese. Compared with individuals with normal weight, multivariable adjusted ORs for chronic cough risk were 1.4 (95% CI 1.2 to 1.6) in overweight, 1.9 (95% CI 1.7 to 2.2) in obese and 2.6 (95% CI 2.1 to 3.2) in severely obese individuals. Mediation analyses showed that chronic cough due to obesity was up to 23% mediated by gastro-oesophageal reflux disease (GERD). Other mediators included low vegetable intake with 10% and occupational exposure with 8%. Among obese individuals, those with versus without chronic cough had worse accompanying respiratory symptoms, more often comorbidities including GERD and diabetes, greater healthcare utilisations, lower lung function and higher blood inflammation (all p<0.05).
CONCLUSION:There is dose-response relationship between BMI and chronic cough, and chronic cough risk is twofold to threefold higher in obese individuals from the general population. This increased risk was partly mediated by GERD, low vegetable intake and occupational exposure, supporting that there may be benefit to gain by ameliorating some of these factors in obese individuals with chronic cough.
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P2X3受体拮抗剂吉法匹生治疗难治性慢性咳嗽及不明原因慢性咳嗽的有效性与安全性评价（COUGH-1、COUGH-2）：两
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Gefapixant（一种P2X3拮抗剂）对咳嗽反射敏感性的作用：一项随机安慰剂对照研究
