哮喘联盟

   摘要
   目的：基于美国国家代表性数据库，研究体重指数（BMI）、腰围（WC）以及腰围-身高比（WHtR）与特应性和非特应性哮喘的关系。
   方法：采用受试者工作特征曲线下面积（AUC）和多变量logistic回归模型，对国家健康和营养研究调查2005-2006的数据进行分析。
   结果：在各测量指标和哮喘转归上，女性AUC(0.59-0.64)均大于男性(0.50-0.58)。对社会人口统计学特征和吸烟状态进行校正后，仅WHtR与男女患者的特应性哮喘呈正相关（每1 SD的优势比[95%可信区间]：男性：1.018 [1.004, 1.032], p=.01; 女性：1.018 [1.006, 1.030], p=0.003），同时该相关性在进一步对BMI校正后仍然存在。仅在女性患者中，非特应性哮喘与BMI（优势比[95%CI]：1.018 [1.006, 1.030], p=0.003）、WC (1.018 [1.006, 1.030], p=0.004)和WHtR (1.016 [1.004, 1.028], p=0.008)每增加1 SD呈显著相关。
   结论：基于美国国家数据，本研究为可能存在的两个不同哮喘分型提供了证据：（1）肥胖男性和女性特应性哮喘；（2）肥胖女性非特应性哮喘。本研究结果的具体机制以及其在哮喘治疗中的作用尚需进一步研究。
 

（苏楠 审校）
J Asthma. 2013 Jan 25. [Epub ahead of print]
 

Association of general and central obesity and atopic and nonatopic asthma in US adults.
 
Ma J, Xiao L.

Source
Department of Health Services Research, Palo Alto Medical Foundation Research Institute , Palo Alto , California.

Abstract 
OBJECTIVE: To examine the association of body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR) with asthma prevalence by atopic status and sex using U.S. nationally representative data.
METHODS: The National Health and Nutrition Examination Survey 2005-2006 data were analyzed using areas under the receiver operating characteristic curves (AUCs) and multivariate logistic regression models.
RESULTS: Women had higher AUCs (0.59-0.64) than men (0.50-0.58) across anthropometric indices and asthma outcomes. After controlling for sociodemographic characteristics and smoking status, only WHtR was positively associated with atopic asthma in both sexes (odds ratio per 1 SD [95% confidence interval]: men, 1.018 [1.004, 1.032], p=.01; women, 1.018 [1.006, 1.030], p=.003), and the associations persisted after further adjustment of BMI. Only in women was nonatopic asthma significantly associated with every 1 SD increase of BMI (odds ratio [95% confidence interval]: 1.018 [1.006, 1.030], p=.003), WC (1.018 [1.006, 1.030], p=.004), and WHtR (1.016 [1.004, 1.028], p=.008).
CONCLUSIONS: Using U.S. national data, this study adds to the emerging evidence suggesting two possible distinct phenotypes: (1) obese men and women with atopic asthma and (2) obese women with nonatopic asthma. The mechanistic and therapeutic implications of these findings warrant further investigation.

J Asthma. 2013 Jan 25. [Epub ahead of print]