哮喘联盟

    背景：哮喘的发生随着肥胖的增加而增加，但是两者之间的联系尚不清楚。本试验旨在研究三个不同生命时段中肥胖与哮喘的关系，以及免疫调节性脂肪因子，瘦素和脂联素是否与超重相关的哮喘有关。
    方法：对以下年龄段患者的肥胖与哮喘相关性进行前瞻性队列研究：3～18岁（平均10±5岁，n = 3582，1980年），9～24岁（平均16±5岁，n = 2764, 1986年），24～39岁（平均32±5岁，n = 2620, 2001年），并进一步研究血清瘦素和脂联素水平与哮喘的关系。同时分析过敏状态、吸烟及其他实验室数据（血清胰岛素、血浆C反应蛋白和血脂）。
    结果：变应反应和父母哮喘史与各年龄段上人群的哮喘显著相关。24～39岁，而非更早年龄段的人群中，体重指数（BMI）（OR 1.05; P = 0.019）和女性（OR 1.56; P = 0.031）与哮喘独立相关。同时，BMI增加与成年期哮喘发生有关（OR 1.08; P = 0.030）。瘦素、脂联素水平及其他肥胖相关的生物标记物均与哮喘无独立相关性。
    结论：成年人中，哮喘与肥胖相关，但这项结果并不支持瘦素、脂联素及其他肥胖相关的生物标记物与哮喘有关。需寻找其他相关因素来更地了解肥胖与哮喘之间的关系。

（刘国梁 审校）
Jartti T, et al. Allergy. 2009 Feb 10. [Epub ahead of print]

Obesity, adipokines and asthma.

Background: The prevalence of asthma and obesity is increasing concomitantly, but many aspects of this link are unclear. Our objective was to examine whether obesity is associated with asthma in three time points of life, and whether immunomodulatory adipokines, leptin and adiponectin are linked to overweight-associated asthma.
Methods: We studied the association between obesity and asthma at ages 3-18 years [mean (SD), 10 years (5), n = 3582, year 1980], 9-24 years [16 years (5), n = 2764, 1986] and 24-39 years [32 years (5), n = 2620, 2001] in a prospective cohort study and further tested for associations with serum leptin and adiponectin concentrations. Data on allergy status, smoking and other laboratory values (serum insulin, plasma C-reactive protein and serum lipid values) were also analyzed.
Results: Allergy and parental asthma were significantly associated with asthma at all ages. At ages 24-39 years, but not earlier, body mass index (BMI) (odds ratio, OR 1.05; P = 0.019) and female gender (OR 1.56; P = 0.031) were independently associated with asthma. Increase in BMI was also associated with incident asthma during adulthood (OR 1.08; P = 0.030). Levels of leptin, adiponectin or any other obesity-related biomarker were not independently associated with asthma.
Conclusions: Asthma is linked with obesity in adults, but our results do not support a significant role for leptin, adiponectin or any other obesity-related biomarker studied in this association. Other factors should be sought for better understanding the connection between obesity and asthma.