体育活动和久坐行为作为可治疗性特征对中重度哮喘的临床控制的影响
2024/03/26
摘要
背景：体育活动和久坐行为作为可治疗的特征可能以不同方式影响哮喘控制，但这种影响仍然知之甚少。
目的：评估体育活动和久坐行为对中重度哮喘患者临床控制的影响。
方法：这项横断面多中心研究纳入了426名中重度哮喘患者。评估包括体育活动和久坐时间（行为测量仪）、临床哮喘控制（哮喘控制问卷[ACQ]）、生活质量（哮喘生活质量问卷[AQLQ]）、焦虑和抑郁症状（医院焦虑和抑郁量表[HADS]）、人体测量数据和肺功能。参与者根据体育活动水平和久坐行为分组。
结果：与每天行走步数<7,500步的参与者相比，每天行走≥7,500步的参与者的ACQ评分更好（p<0.05），独立于久坐状态。有控制的哮喘患者百分比在积极/久坐（43.9%）和积极/非久坐（43.8%）组中高于不积极/久坐（25.4%）和不积极/非久坐（23.9%）组（p<0.02）。根据可治疗特征的体育活动不足（比值比[95% CI]：2.36 [1.55-3.59]）、更高的焦虑（2.26 [1.49-3.42]）和抑郁症状（1.95 [1.28-2.95]）存在不受控制的哮喘的可能性显著（p≤0.002）。肥胖和久坐时间与哮喘控制无关。
结论：我们的结果表明，每天行走≥7,500步与中重度哮喘成人的更好哮喘控制有关，与久坐时间无关。体育活动不足、焦虑和抑郁症状与哮喘不受控的可能性更高。这些结果表明，干预措施应主要集中在增加体育活动而不是减少久坐时间上。
Physical activity and sedentary behavior as treatable traits for clinical control in moderate-to-severe asthma
Fabiano F de Lima, Juliana M B Dos Santos, Adriana C Lunardi, Joice M de Oliveira, Patrícia D Freitas, Fabiana S Kim, Rosana Câmara Agondi, Regina M Carvalho-Pinto, Karina C Furlanetto, Celso R F Carvalho
Abstract
Background: Physical activity and sedentary behavior are treatable traits that may impact asthma control in distinct manners, but this impact remains poorly understood.
Objective: To evaluate the influence of physical activity and sedentary behavior on clinical control in adults with moderate-to-severe asthma.
Methods: This cross-sectional multicentric study included 426 individuals with moderate-to-severe asthma. Assessments included physical activity and sedentary time (actigraphy), clinical asthma control (Asthma Control Questionnaire [ACQ]), quality of life (Asthma Quality of Life Questionnaire [AQLQ]), anxiety and depression symptoms (Hospital Anxiety and Depression Scale [HADS]), anthropometric data, and lung function. Participants were grouped according to physical activity levels and sedentary behavior.
Results: Participants who walked ≥7,500 steps/day presented better ACQ scores than those who walked <7,500 steps/day (p<0.05), independent of sedentary status. The percentage of patients with controlled asthma was higher in the active/sedentary (43.9%) and active/nonsedentary (43.8%) groups than in the inactive/sedentary (25.4%) and inactive/nonsedentary (23.9%) groups (p<0.02). The likelihood of having uncontrolled asthma according to the treatable traits of physical inactivity (odds ratio [95% CI]: 2.36 [1.55-3.59]), higher anxiety (2.26 [1.49-3.42]), and depression symptoms (1.95 [1.28-2.95]) was significant (p≤0.002). Obesity and sedentary time were not associated with asthma control.
Conclusion: Our results show that ≥7,500 steps/day is associated with better asthma control independent of sedentary time in adults with moderate-to-severe asthma. Physical inactivity, anxiety, and depression symptoms are associated with higher odds of uncontrolled asthma. These results suggest that interventions should mainly focus on increasing physical activity rather than reducing sedentary time.
背景：体育活动和久坐行为作为可治疗的特征可能以不同方式影响哮喘控制，但这种影响仍然知之甚少。
目的：评估体育活动和久坐行为对中重度哮喘患者临床控制的影响。
方法：这项横断面多中心研究纳入了426名中重度哮喘患者。评估包括体育活动和久坐时间（行为测量仪）、临床哮喘控制（哮喘控制问卷[ACQ]）、生活质量（哮喘生活质量问卷[AQLQ]）、焦虑和抑郁症状（医院焦虑和抑郁量表[HADS]）、人体测量数据和肺功能。参与者根据体育活动水平和久坐行为分组。
结果：与每天行走步数<7,500步的参与者相比，每天行走≥7,500步的参与者的ACQ评分更好（p<0.05），独立于久坐状态。有控制的哮喘患者百分比在积极/久坐（43.9%）和积极/非久坐（43.8%）组中高于不积极/久坐（25.4%）和不积极/非久坐（23.9%）组（p<0.02）。根据可治疗特征的体育活动不足（比值比[95% CI]：2.36 [1.55-3.59]）、更高的焦虑（2.26 [1.49-3.42]）和抑郁症状（1.95 [1.28-2.95]）存在不受控制的哮喘的可能性显著（p≤0.002）。肥胖和久坐时间与哮喘控制无关。
结论：我们的结果表明，每天行走≥7,500步与中重度哮喘成人的更好哮喘控制有关，与久坐时间无关。体育活动不足、焦虑和抑郁症状与哮喘不受控的可能性更高。这些结果表明，干预措施应主要集中在增加体育活动而不是减少久坐时间上。
(中日友好医院呼吸与危重症医学科 顾宪民 摘译 林江涛 审校)
(J Allergy Clin Immunol Pract. 2024 Mar 14:S2213-2198(24)00274-5. doi: 10.1016/j.jaip.2024.03.012.)
(J Allergy Clin Immunol Pract. 2024 Mar 14:S2213-2198(24)00274-5. doi: 10.1016/j.jaip.2024.03.012.)
Physical activity and sedentary behavior as treatable traits for clinical control in moderate-to-severe asthma
Fabiano F de Lima, Juliana M B Dos Santos, Adriana C Lunardi, Joice M de Oliveira, Patrícia D Freitas, Fabiana S Kim, Rosana Câmara Agondi, Regina M Carvalho-Pinto, Karina C Furlanetto, Celso R F Carvalho
Abstract
Background: Physical activity and sedentary behavior are treatable traits that may impact asthma control in distinct manners, but this impact remains poorly understood.
Objective: To evaluate the influence of physical activity and sedentary behavior on clinical control in adults with moderate-to-severe asthma.
Methods: This cross-sectional multicentric study included 426 individuals with moderate-to-severe asthma. Assessments included physical activity and sedentary time (actigraphy), clinical asthma control (Asthma Control Questionnaire [ACQ]), quality of life (Asthma Quality of Life Questionnaire [AQLQ]), anxiety and depression symptoms (Hospital Anxiety and Depression Scale [HADS]), anthropometric data, and lung function. Participants were grouped according to physical activity levels and sedentary behavior.
Results: Participants who walked ≥7,500 steps/day presented better ACQ scores than those who walked <7,500 steps/day (p<0.05), independent of sedentary status. The percentage of patients with controlled asthma was higher in the active/sedentary (43.9%) and active/nonsedentary (43.8%) groups than in the inactive/sedentary (25.4%) and inactive/nonsedentary (23.9%) groups (p<0.02). The likelihood of having uncontrolled asthma according to the treatable traits of physical inactivity (odds ratio [95% CI]: 2.36 [1.55-3.59]), higher anxiety (2.26 [1.49-3.42]), and depression symptoms (1.95 [1.28-2.95]) was significant (p≤0.002). Obesity and sedentary time were not associated with asthma control.
Conclusion: Our results show that ≥7,500 steps/day is associated with better asthma control independent of sedentary time in adults with moderate-to-severe asthma. Physical inactivity, anxiety, and depression symptoms are associated with higher odds of uncontrolled asthma. These results suggest that interventions should mainly focus on increasing physical activity rather than reducing sedentary time.
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C-反应蛋白与哮喘之间的因果关系：两样本孟德尔随机化分析
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空气中花粉对中国北京不同年龄段变应性鼻炎和哮喘的影响
