体重指数与哮喘严重程度的关系：美国全国哮喘调查
2008/06/06
肥胖与哮喘严重程度之间的关系一直存在争议。最近一项在美国进行的研究探讨了体重指数(BMI)与哮喘严重程度之间的相关性。这项研究共纳入3095个哮喘病人，根据BMI将哮喘患者分为理想体重组、超重组以及肥胖组。该项研究通过评价患者症状、就诊情况、平喘药物使用、误工天数及全球哮喘防治创议（GINA）哮喘严重程度分级等多项指标来评估哮喘的严重程度。
他们的研究发现，与理想体重的哮喘患者相比，肥胖的哮喘患者更容易出现症状持续、误工天数更长；具有更高的使用短效β2受体激动剂及吸入糖皮质激素的频率；而且肥胖的哮喘患者治疗反应也较差。他们认为肥胖与哮喘严重程度相关。
（毛辉 四川大学华西医院呼吸科 610041 摘译）
(Thorax. 2008 Jan;63(1):14-20. Links)
Body mass index and asthma severity in the National Asthma Survey.
Taylor B, Mannino D, Brown C, Crocker D, Twum-Baah N, Holguin F.
Emory University, Atlanta, Georgia, USA.
BACKGROUND: The association between obesity and asthma severity remains controversial and limited to small studies.
METHODS: We determined the association of body mass index (BMI) and asthma severity in the National Asthma Survey. We included adults (age > or = 18 years) who self-reported symptoms of asthma in the past 5 years. A total of 3095 patients were divided into the following BMI categories: 1080 (35%) non-overweight (BMI < 25), 993 (32%) overweight (BMI > or = 25 and < 30) and 1022 (33%) obese (BMI > or = 30). Asthma severity measures included respiratory symptoms, healthcare utilisation, medication use, missed work days and the Global Initiative for Asthma (GINA) severity classification. Models were adjusted for: gender, race, age, education, income, employment status, smoking status, family history of asthma, state of residence and residence in a metropolitan statistical area.
RESULTS: Compared with non-overweight subjects, obese subjects with asthma were more likely to report continuous symptoms (OR 1.66, 95% CI 1.09 to 2.54), miss more work days (OR 1.35, 95% CI 1.01 to 1.81), use short acting beta agonists (OR 1.36, 95% CI 1.06 to 1.75), use inhaled corticosteroids (OR 1.34, 95% CI 1.01 to 1.79) and use any controller medication according to GINA guidelines (OR 1.37, 95% CI 1.01 to 1.85). Also, obese respondents were less likely to be in asthma remission (OR 0.56, 95% CI 0.38 to 0.82) and were more likely to have severe persistent asthma (GINA IV) (OR 1.42, 95% CI 1.05 to 1.90).
CONCLUSIONS: In a large, diverse sample of adults with asthma, obesity was associated with measures of asthma severity after adjusting for potential confounders.
Thorax. 2008 Jan;63(1):14-20. Links
他们的研究发现，与理想体重的哮喘患者相比，肥胖的哮喘患者更容易出现症状持续、误工天数更长；具有更高的使用短效β2受体激动剂及吸入糖皮质激素的频率；而且肥胖的哮喘患者治疗反应也较差。他们认为肥胖与哮喘严重程度相关。
（毛辉 四川大学华西医院呼吸科 610041 摘译）
(Thorax. 2008 Jan;63(1):14-20. Links)
Body mass index and asthma severity in the National Asthma Survey.
Taylor B, Mannino D, Brown C, Crocker D, Twum-Baah N, Holguin F.
Emory University, Atlanta, Georgia, USA.
BACKGROUND: The association between obesity and asthma severity remains controversial and limited to small studies.
METHODS: We determined the association of body mass index (BMI) and asthma severity in the National Asthma Survey. We included adults (age > or = 18 years) who self-reported symptoms of asthma in the past 5 years. A total of 3095 patients were divided into the following BMI categories: 1080 (35%) non-overweight (BMI < 25), 993 (32%) overweight (BMI > or = 25 and < 30) and 1022 (33%) obese (BMI > or = 30). Asthma severity measures included respiratory symptoms, healthcare utilisation, medication use, missed work days and the Global Initiative for Asthma (GINA) severity classification. Models were adjusted for: gender, race, age, education, income, employment status, smoking status, family history of asthma, state of residence and residence in a metropolitan statistical area.
RESULTS: Compared with non-overweight subjects, obese subjects with asthma were more likely to report continuous symptoms (OR 1.66, 95% CI 1.09 to 2.54), miss more work days (OR 1.35, 95% CI 1.01 to 1.81), use short acting beta agonists (OR 1.36, 95% CI 1.06 to 1.75), use inhaled corticosteroids (OR 1.34, 95% CI 1.01 to 1.79) and use any controller medication according to GINA guidelines (OR 1.37, 95% CI 1.01 to 1.85). Also, obese respondents were less likely to be in asthma remission (OR 0.56, 95% CI 0.38 to 0.82) and were more likely to have severe persistent asthma (GINA IV) (OR 1.42, 95% CI 1.05 to 1.90).
CONCLUSIONS: In a large, diverse sample of adults with asthma, obesity was associated with measures of asthma severity after adjusting for potential confounders.
Thorax. 2008 Jan;63(1):14-20. Links
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