对加利福尼亚州教师体重、腰围以及哮喘患病率的研究
2010/01/07
肥胖是哮喘的危险因素之一，尤其在妇女中更显著。我们已知内脏脂肪可以影响全身炎症反应，但目前几乎没有研究能够指出腹型肥胖可以反应内脏脂肪的代谢水平。J Von Behren等人针对女教师这一群体进行大样本量的调查，测其腹部脂肪相关参数、BMI与哮喘患病率之间的关系，对年龄、吸烟史、种族等因素进行分析。
研究入组的88304名女性中，13% (n = 11 500)是肥胖人群(BMI 30 kg/m2)，1334人为重度肥胖(BMI 40 kg/m2)。与正常体重人群对比，超重人群与哮喘患病率之间的关联度为1。4 (95% CI 1.31 to 1.49)，而重度肥胖人群为3。3 (95% CI 2.85 to 3.82)。腰围粗(>88 cm)的女性，哪怕BMI正常，其哮喘患病率仍高(OR 1.37, 95% CI 1.18 to 1.59)。肥胖妇女以腹部脂肪堆积为主（即中心性肥胖）者与哮喘患病率之间的关联度较腰围88 cm的人群高(2.36 vs 1.57)。通过比较急诊就诊情况以及住院情况，肥胖和超重妇女重症哮喘发生的危险性较大。
J Von Behren的研究证实了超重与哮喘严重程度以及哮喘患病率之间的相关性，并且得出腰围粗、哪怕BMI正常的妇女，哮喘患病率高的结论。
（于娜 中国医科大学附属第一医院呼吸内科 110001 摘译）
（Thorax2009;64:889-893）
Obesity, waist size and prevalence of current asthma in the California Teachers Study cohort
J Von Behren1, M Lipsett2, P L Horn-Ross1,3, R J Delfino4, F Gilliland5, R McConnell5, L Bernstein6, C A Clarke1,3, P Reynolds1,3
1 Northern California Cancer Center, Berkeley and Fremont, California, USA 2 Environmental Health Investigations Branch, California Department of Public Health, Richmond, California, USA
3 Department of Health Research and Policy, Stanford University School of Medicine, Stanford, California, USA
4 Department of Epidemiology, School of Medicine, University of California, Irvine, California, USA
5 Keck School of Medicine, University of Southern California, Los Angeles, California, USA
6 Department of Cancer Etiology, City of Hope National Medical Center, Duarte, California, USA
Correspondence to Ms J Von Behren, Northern California Cancer Center, 2001 Center Street, Suite 700, Berkeley, CA 94704, USA; jvonbehren@nccc.org
Background: 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. A study was undertaken to examine the relationship between the prevalence of asthma and measures of abdominal obesity and adult weight gain in addition to body mass index (BMI) in a large cohort of female teachers.
Methods: Prevalence odds ratios (ORs) for current asthma were calculated using multivariable linear modelling, adjusting for age, smoking and race/ethnicity.
Results: Of the 88 304 women in the analyses, 13% (n = 11 500) were obese (BMI 30 kg/m2) at baseline; 1334 were extremely obese (BMI 40 kg/m2). Compared with those of normal weight, the adjusted OR for adult-onset asthma increased from 1.40 (95% confidence interval (CI) 1.31 to 1.49) for overweight women to 3.30 (95% CI 2.85 to 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 to 1.59). Among obese women the OR for asthma was greater in those who were also abdominally obese than in 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 hospital admissions.
Conclusions: 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.
Published Online First: 25 August 2009. doi:10.1136/thx.2009.114579
Thorax 2009;64:889-893
Copyright © 2009 BMJ Publishing Group Ltd & British Thoracic Society.
研究入组的88304名女性中，13% (n = 11 500)是肥胖人群(BMI 30 kg/m2)，1334人为重度肥胖(BMI 40 kg/m2)。与正常体重人群对比，超重人群与哮喘患病率之间的关联度为1。4 (95% CI 1.31 to 1.49)，而重度肥胖人群为3。3 (95% CI 2.85 to 3.82)。腰围粗(>88 cm)的女性，哪怕BMI正常，其哮喘患病率仍高(OR 1.37, 95% CI 1.18 to 1.59)。肥胖妇女以腹部脂肪堆积为主（即中心性肥胖）者与哮喘患病率之间的关联度较腰围88 cm的人群高(2.36 vs 1.57)。通过比较急诊就诊情况以及住院情况，肥胖和超重妇女重症哮喘发生的危险性较大。
J Von Behren的研究证实了超重与哮喘严重程度以及哮喘患病率之间的相关性，并且得出腰围粗、哪怕BMI正常的妇女，哮喘患病率高的结论。
（于娜 中国医科大学附属第一医院呼吸内科 110001 摘译）
（Thorax2009;64:889-893）
Obesity, waist size and prevalence of current asthma in the California Teachers Study cohort
J Von Behren1, M Lipsett2, P L Horn-Ross1,3, R J Delfino4, F Gilliland5, R McConnell5, L Bernstein6, C A Clarke1,3, P Reynolds1,3
1 Northern California Cancer Center, Berkeley and Fremont, California, USA 2 Environmental Health Investigations Branch, California Department of Public Health, Richmond, California, USA
3 Department of Health Research and Policy, Stanford University School of Medicine, Stanford, California, USA
4 Department of Epidemiology, School of Medicine, University of California, Irvine, California, USA
5 Keck School of Medicine, University of Southern California, Los Angeles, California, USA
6 Department of Cancer Etiology, City of Hope National Medical Center, Duarte, California, USA
Correspondence to Ms J Von Behren, Northern California Cancer Center, 2001 Center Street, Suite 700, Berkeley, CA 94704, USA; jvonbehren@nccc.org
Background: 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. A study was undertaken to examine the relationship between the prevalence of asthma and measures of abdominal obesity and adult weight gain in addition to body mass index (BMI) in a large cohort of female teachers.
Methods: Prevalence odds ratios (ORs) for current asthma were calculated using multivariable linear modelling, adjusting for age, smoking and race/ethnicity.
Results: Of the 88 304 women in the analyses, 13% (n = 11 500) were obese (BMI 30 kg/m2) at baseline; 1334 were extremely obese (BMI 40 kg/m2). Compared with those of normal weight, the adjusted OR for adult-onset asthma increased from 1.40 (95% confidence interval (CI) 1.31 to 1.49) for overweight women to 3.30 (95% CI 2.85 to 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 to 1.59). Among obese women the OR for asthma was greater in those who were also abdominally obese than in 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 hospital admissions.
Conclusions: 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.
Published Online First: 25 August 2009. doi:10.1136/thx.2009.114579
Thorax 2009;64:889-893
Copyright © 2009 BMJ Publishing Group Ltd & British Thoracic Society.
