肥胖、腰围及哮喘患病率趋势－加利福尼亚教师队列研究
2009/10/15
肥胖是哮喘的危险因素，尤其在女性中。内脏脂肪被认为能影响全身炎症反应，作为反应内脏脂肪代谢差异的腹部肥胖，较少有队列研究对其进行评价。本试验在女性教师中进行大样本的队列研究，探寻哮喘患病率与腹部肥胖、成人体重增加及体块指数（BMI）之间的关系。
采用多变量线性模型，计算当前哮喘的流行率优势比（ORs），并校正年龄、吸烟和种族差异。共纳入88,304名妇女。基线时有13% (11,500)的女性诊断为肥胖（BMI >/= 30 kg/m2），1,334名诊断为过度肥胖（BMI≥40）。
与正常体重人群相比，成人期发生哮喘的校正OR值从肥胖妇女中的1.40（95% CI: 1.31, 1.49）增至过度肥胖妇女中的3.30（95% CI: 2.85, 3.82）。即使是正常BMI的妇女，大腰围（> 88 cm）与哮喘患病率增加相关（OR = 1.37, 95% CI: 1.18, 1.59）。而在肥胖妇女中，腹部肥胖者患哮喘的风险较腰围≤88 cm的女性大，OR分别为2.36和57。肥胖和超重的女性经急诊及住院治疗评价的严重哮喘发作风险更大。
本研究证实了超重与哮喘严重程度和患病率之间的关系，显示即使在拥有正常体重的女性中，大腰围也与哮喘患病率增加相关。
（林江涛 审校）
Von Behren J, et al. Thorax. 2009 Aug 25. [Epub ahead of print]
Obesity, Waist Size, and Prevalence of Current Asthma in the California Teachers Study Cohort.
Von Behren J, Lipsett M, Horn-Ross PL, Delfino RJ, Gillilan F, McConnell R, Bernstein L, Clarke CA, Reynolds P.
Northern California Cancer Center, United States.
Obesity is a risk factor for asthma, particularly in women, but few cohort studies have evaluated abdominal obesity, which reflects metabolic differences in visceral fat known to influence systemic inflammation. We examined the relationships of asthma prevalence with measures of abdominal obesity and adult weight gain, in addition to body mass index (BMI), in a large cohort of female teachers. We calculated prevalence odds ratios (ORs) for current asthma using multivariable linear modeling, adjusting for age, smoking, and race/ethnicity. Of the 88,304 women in the analyses, 13% (11,500) were obese (BMI >/= 30 kg/m2) at baseline; 1,334 were extremely obese (BMI >/= 40). Compared to those of normal weight, the adjusted OR for adult-onset asthma increased from 1.40 (95% confidence interval (CI): 1.31, 1.49) for overweight women to 3.30 (95% CI: 2.85, 3.82) for extremely obese women. Large waist circumference (> 88 cm) was associated with increased asthma prevalence even among women with a normal BMI (OR = 1.37, 95% CI: 1.18, 1.59). Among obese women, the OR for asthma was greater among those who were also abdominally obese compared to women whose waist was </=88 cm (2.36 vs. 1.57). Obese and overweight women were at greater risk of severe asthma episodes, measured by urgent medical visits and hospitalizations. This study confirms the association between excess weight and asthma severity and prevalence, and showed that a large waist was associated with increased asthma prevalence even among women considered to have normal body weight.
上一篇：
成人期哮喘发作的危险因素：一项为期14年的纵向研究
下一篇：
体重超重妇女与哮喘的控制
