肥胖和TNFA变异性对哮喘的联合作用：两个国际队列研究
2010/01/07
关键词：哮喘；特应性；遗传多态性；肥胖；肿瘤坏死因子-
肥胖是哮喘的危险因素之一。肥胖组织表达促炎症因子——肿瘤坏死因子(tumour necrosis factor, TNF)，而TNF水平与TNF- (TNFA)基因的多态性有关。那么肥胖和TNFA变异性间的关系如何，是否对哮喘发生具有联合作用？为了阐明肥胖和TNFA变异性对哮喘的作用，Castro-Giner等对欧洲的两个人口研究（欧洲社区呼吸健康调查和瑞士空气污染和成人心肺疾病调查）进行联合资料分析（这两个研究的步骤、问卷以及肺功能和特应性的测定方法近似）。
(TNFA)基因的多态性有关。那么肥胖和TNFA变异性间的关系如何，是否对哮喘发生具有联合作用？为了阐明肥胖和TNFA变异性对哮喘的作用，Castro-Giner等对欧洲的两个人口研究（欧洲社区呼吸健康调查和瑞士空气污染和成人心肺疾病调查）进行联合资料分析（这两个研究的步骤、问卷以及肺功能和特应性的测定方法近似）。 对9,167例研究对象的DNA样本进行TNFA -308 基因型分析和淋巴细胞毒素（lymphotoxin）- (LTA) +252 的基因变异分析。
(LTA) +252 的基因变异分析。 研究发现，肥胖和TNFA均与哮喘有关（肥胖OR：2.4, 95% CI：1.7–3.2; TNFA-308OR：1.3, 95% CI：1.1–1.6)。相对常见的G/GTNFA -308 基因型携带者，G/A 和A/ATNFA -308 基因型携带者中肥胖与哮喘更为密切相关，尤其是非特应性哮喘(G/A 和A/A基因型的OR: 6.1, 95% CI 2.5–14.4; 而G/G 基因型的OR: 1.7, 95% CI 0.8–3.3)。
本研究首次证实了肥胖、促炎遗传因子和哮喘的复杂关系模式，对于哮喘的群体防治具有重要的指导意义。
（韩伟 青岛市市立医院东院呼吸科 266071 摘译）
Eur Respir J 2009; 33:1003-1009
Joint effect of obesity and TNFA variability on asthma: two international cohort studies
F. Castro-Giner, M. Kogevinas, M. Imboden, R. de Cid, D. Jarvis, M. Mächler, W. Berger, P. Burney, K. A. Franklin, J. R. Gonzalez, J. Heinrich, C. Janson, E. Omenaas, I. Pin, T. Rochat, J. Sunyer, M. Wjst, J-M. Antó, X. Estivill and N. M. Probst-Hensch
Keywords: Asthma, atopy, genetic polymorphism, obesity, tumour necrosis factor-
Obesity is a risk factor for asthma. Adipose tissue expresses pro-inflammatory molecules including tumour necrosis factor (TNF), and levels of TNF are also related to polymorphisms in the TNF- (TNFA) gene. The current authors examined the joint effect of obesity and TNFA variability on asthma in adults by combining two population-based studies.
(TNFA) gene. The current authors examined the joint effect of obesity and TNFA variability on asthma in adults by combining two population-based studies. The European Community Respiratory Health Survey and the Swiss Cohort Study on Air Pollution and Lung and Heart Disease in Adults used comparable protocols, questionnaires and measures of lung function and atopy. DNA samples from 9,167 participants were genotyped for TNFA -308 and lymphotoxin- (LTA) +252 gene variants.
(LTA) +252 gene variants. Obesity and TNFA were associated with asthma when mutually adjusting for their independent effects (odds ratio (OR) for obesity 2.4, 95% confidence interval (CI) 1.7–3.2; OR for TNFA -308 polymorphism 1.3, 95% CI 1.1–1.6).
The association of obesity with asthma was stronger for subjects carrying the G/A and A/A TNFA -308 genotypes compared with the more common G/G genotype, particularly among nonatopics (OR for G/A and A/A genotypes 6.1, 95% CI 2.5–14.4; OR for G/G genotype 1.7, 95% CI 0.8–3.3).
The present findings provide, for the first time, evidence for a complex pattern of interaction between obesity, a pro-inflammatory genetic factor and asthma.
Eur Respir J 2009; 33:1003-1009
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人乳喂养对哮喘、肺功能和支气管高反应性的作用
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体力活动与哮喘发作的相关性：一项针对老年女性哮喘患者的前瞻性研究
