肥胖成年哮喘患者减重对哮喘的影响 —— 一项系统综述与荟萃分析
2025/11/28
摘要
背景：鉴于肥胖对哮喘的重大影响，它被视为哮喘管理中一种可治疗的特质。本系统综述与荟萃分析旨在评估减重干预对肥胖成年哮喘患者哮喘控制的效果。
方法：我们检索了截至2025年2月的英文随机对照试验，评估减重对肥胖成年哮喘患者的哮喘控制、生活质量或肺功能的影响。共纳入6项研究，涉及522名受试者。效应量以均数差或标准化均数差进行合并。
结果：在12至24周的减重期间，哮喘控制问卷评分显著改善（-0.75，95% CI [-0.91, -0.59]，I² = 0.0%），生活质量也显著提高（1.05，95% CI [0.17, 1.93]，I² = 86.4%）。肺功能同样得到改善，平均第一秒用力呼气容积（FEV₁）增加了4.65%（95% CI [2.96, 6.33]，I² = 0.0%）。然而，在52周随访时，这些获益未能持续，哮喘控制（-0.67，95% CI [-1.48, 0.14]，I² = 5.2%）和生活质量（0.05，95% CI [-0.15, 0.26]，I² = 0.8%）均未出现显著变化。亚组分析显示，体重减少≥10%的参与者其哮喘控制得到显著改善（-1.37，95% CI [-1.55, -1.20]，I² = 0.0%）。
结论：为期12至24周的减重可显著改善哮喘控制、生活质量和肺功能，其中体重减少达到基线体重10%及以上的个体获益尤为明显。然而，这些效果在52周时未能维持，表明需要持续进行体重管理以保持长期效益。尽管如此，现有数据仍较有限，因为研究结果主要反映短期结局，且基于的患者数量较少。
Effect of weight loss on asthma in obese adult patients with asthma - a systematic review and meta-analysis
Rybka-Fraczek A, Orzolek I, Dabrowska M
Abstract
BACKGROUND:Given its substantial impact on asthma, obesity is regarded as a treatable trait in asthma management. This systematic review and meta-analyses aim to assess weight loss intervention effects on asthma control in obese adults with asthma.
METHODS:We searched databases until February 2025 for English-language randomized controlled trials assessing weight loss influence on asthma control, quality of life, or lung function in obese adults. Six studies with 522 participants were included. Effect sizes were pooled as mean or standardized mean difference.
RESULTS:Weight reduction during 12-24 weeks significantly improved asthma control questionnaire score (-0.75 95% CI [-0.91, - 0.59], I2 = 0.0%) and quality of life (1.05 95% CI [0.17, 1.93], I2 = 86.4%). Lung function also improved, with mean FEV1 increase of (4.65% 95% CI [2.96, 6.33], I2 = 0.0%). However, benefits were not sustained at the 52-week follow-up, showing no significant changes in asthma control (-0.67, 95% CI [-1.48, 0.14], I2 = 5.2%) or quality of life (0.05, 95% CI [-0.15, 0.26], I2 = 0.8%). Subgroup analysis revealed that participants achieving ≥10% reduction experienced marked asthma control improvements (-1.37, 95% CI [-1.55, -1.20], I2 = 0.0%).
CONCLUSION:Weight reduction over 12-24 weeks significantly improves asthma control, quality of life, and lung function, with pronounced benefits in individuals losing ≥10% baseline weight. Effects were not maintained at 52 weeks, indicating sustained weight management necessity for preserve long-term benefits. Nevertheless, available data remain limited, as findings primarily address short-term outcomes and were based on limited number of patients.
背景：鉴于肥胖对哮喘的重大影响，它被视为哮喘管理中一种可治疗的特质。本系统综述与荟萃分析旨在评估减重干预对肥胖成年哮喘患者哮喘控制的效果。
方法：我们检索了截至2025年2月的英文随机对照试验，评估减重对肥胖成年哮喘患者的哮喘控制、生活质量或肺功能的影响。共纳入6项研究，涉及522名受试者。效应量以均数差或标准化均数差进行合并。
结果：在12至24周的减重期间，哮喘控制问卷评分显著改善（-0.75，95% CI [-0.91, -0.59]，I² = 0.0%），生活质量也显著提高（1.05，95% CI [0.17, 1.93]，I² = 86.4%）。肺功能同样得到改善，平均第一秒用力呼气容积（FEV₁）增加了4.65%（95% CI [2.96, 6.33]，I² = 0.0%）。然而，在52周随访时，这些获益未能持续，哮喘控制（-0.67，95% CI [-1.48, 0.14]，I² = 5.2%）和生活质量（0.05，95% CI [-0.15, 0.26]，I² = 0.8%）均未出现显著变化。亚组分析显示，体重减少≥10%的参与者其哮喘控制得到显著改善（-1.37，95% CI [-1.55, -1.20]，I² = 0.0%）。
结论：为期12至24周的减重可显著改善哮喘控制、生活质量和肺功能，其中体重减少达到基线体重10%及以上的个体获益尤为明显。然而，这些效果在52周时未能维持，表明需要持续进行体重管理以保持长期效益。尽管如此，现有数据仍较有限，因为研究结果主要反映短期结局，且基于的患者数量较少。
(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)
（J Allergy Clin Immunol Pract. 2025 Nov 14; DOI: 10.1016/j.jaip.2025.10.014）
Effect of weight loss on asthma in obese adult patients with asthma - a systematic review and meta-analysis
Rybka-Fraczek A, Orzolek I, Dabrowska M
Abstract
BACKGROUND:Given its substantial impact on asthma, obesity is regarded as a treatable trait in asthma management. This systematic review and meta-analyses aim to assess weight loss intervention effects on asthma control in obese adults with asthma.
METHODS:We searched databases until February 2025 for English-language randomized controlled trials assessing weight loss influence on asthma control, quality of life, or lung function in obese adults. Six studies with 522 participants were included. Effect sizes were pooled as mean or standardized mean difference.
RESULTS:Weight reduction during 12-24 weeks significantly improved asthma control questionnaire score (-0.75 95% CI [-0.91, - 0.59], I2 = 0.0%) and quality of life (1.05 95% CI [0.17, 1.93], I2 = 86.4%). Lung function also improved, with mean FEV1 increase of (4.65% 95% CI [2.96, 6.33], I2 = 0.0%). However, benefits were not sustained at the 52-week follow-up, showing no significant changes in asthma control (-0.67, 95% CI [-1.48, 0.14], I2 = 5.2%) or quality of life (0.05, 95% CI [-0.15, 0.26], I2 = 0.8%). Subgroup analysis revealed that participants achieving ≥10% reduction experienced marked asthma control improvements (-1.37, 95% CI [-1.55, -1.20], I2 = 0.0%).
CONCLUSION:Weight reduction over 12-24 weeks significantly improves asthma control, quality of life, and lung function, with pronounced benefits in individuals losing ≥10% baseline weight. Effects were not maintained at 52 weeks, indicating sustained weight management necessity for preserve long-term benefits. Nevertheless, available data remain limited, as findings primarily address short-term outcomes and were based on limited number of patients.
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