儿童肥胖与过敏性和非过敏性哮喘间的关系：来自国家健康与营养调查的结果（1999～2006）
2011/01/27
摘要
背景：在过去的几十年里，儿童肥胖和哮喘的发病率显著上升，研究结果也显示，肥胖与哮喘相关。虽然并不是所有，但一些研究显示，肥胖对哮喘的影响在非过敏性人群中大于过敏性人群，其中全身性炎症可能是一个重要因素。
目的：在美国儿童中研究肥胖与过敏性哮喘和非过敏性哮喘的关系，以及评价C反应蛋白在其中的作用。
设计：对来自于国家健康与营养调查的有代表性的数据进行分析，采用Logistic回归分析研究体重与当前哮喘的关系。超重定义为BMI超过该年龄BMI的第85百分位数，肥胖定义为BMI超过该年龄BMI的第95百分位数。2005～2006年数据（n = 3387），基于过敏状态，采用出现至少一个过敏原特异性免疫球蛋白（IgE）阳性对相关性进行分层。
参与机构和参与者：分层、多阶段概率抽样用于选择调查人群。本研究包括来自于NHANES（1999-2006）的年龄为2～19岁的儿童（n=16074），有BMI及当前哮喘记录。
主要检测结果：自我主诉的由医生诊断的当前哮喘。
结果：儿童和青少年中，肥胖与当前哮喘显著相关（OR：1.68, 95%CI：1.33, 2.12）。在非过敏性儿童中该相关性（OR: 2.46, 95% CI: 1.21, 5.02）强于过敏性儿童（OR: 1.34, 95% CI: 0.70, 2.57）（交互P=0.09）。非过敏性儿童中，C反应蛋白水平与当前哮喘相关，但经BMI校正后未见该相关性。
结论：儿童体重超重与高哮喘患病率相关，特别是那些不伴有过敏性疾病的患者。
（苏楠 审校）
J Asthma. 2010 Aug 16. [Epub ahead of print]
Association of Childhood Obesity With Atopic and Nonatopic Asthma: Results From the National Health and Nutrition Examination Survey 1999-2006.
Visness CM, London SJ, Daniels JL, Kaufman JS, Yeatts KB, Siega-Riz AM, Calatroni A, Zeldin DC.
Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, U.S.A.
Abstract
Background. Obesity and asthma prevalence have both risen among children over the last several decades, and research efforts increasingly suggest that obesity is associated with asthma. Some, but not all, studies have shown that the effect of obesity on asthma is stronger among nonatopic individuals than among those with atopy. Systemic inflammation may be a factor in this relationship.
Objective. To examine the association of obesity with atopic and nonatopic asthma among U.S. children and to assess the role of C-reactive protein.
Design. Nationally representative data from the National Health and Nutrition Examination Survey (NHANES) were used to examine the relationship of weight to current asthma using logistic regression. Overweight was defined as >/=85th percentile of body mass index (BMI)-for-age and obesity was defined as >/=95th percentile of BMI-for-age. The presence of at least one positive allergen-specific immunoglobulin E (IgE) was used to stratify the relationship by atopic status in 2005-2006 data (n = 3387).
Setting and Participants. Stratified, multistage probability sampling was used to identify survey participants. This analysis includes children ages 2-19 (n = 16,074) from the 1999-2006 NHANES who have information on BMI and current asthma.
Main Outcome Measure. Self-report of doctor-diagnosed current asthma.
Results. Obesity was significantly related to current asthma among children and adolescents (odds ratio [OR]: 1.68, 95% confidence interval [CI]: 1.33, 2.12). The association was stronger in nonatopic children (OR: 2.46, 95% CI: 1.21, 5.02) than in atopic children (OR: 1.34, 95% CI: 0.70, 2.57) (interaction p value = .09). C-reactive protein levels were associated with current asthma in nonatopic children, but not after adjusting for BMI.
Conclusion. Excess weight in children is associated with higher rates of asthma, especially asthma that is not accompanied by allergic disease.
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肥胖对哮喘表型的影响依赖于哮喘严重程度
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根据遗传学背景预测哮喘病程？
