哮喘联盟

   摘要
   在成人中，伴有肥胖的哮喘表现为气道和全身炎症变化，但尚未在儿童中进行全面研究。本试验旨在肥胖和非肥胖哮喘患儿和对照者中比较气道炎症和全身炎症。本试验为一项横断面研究，年龄8-17岁的儿童入选研究，并分为4个组：肥胖哮喘（OA, n=74）组、非肥胖哮喘（NOA, n=249）组、肥胖对照（OC, n=9）组和非肥胖对照组（NOC, n=29）。检测肺功能、痰液和全身炎症生物标志物。OA女性非嗜酸性粒细胞性哮喘（60.0%）较OA男性更常见（30.8%）。然而，OA和NOA组之间在嗜酸性粒细胞百分数和中性粒细胞百分数方面无显著差异。与NOA组和NOC组相比，OC组（非OA组）的瘦素水平较高，而与NOC组相比，OA组的脂肪细胞因子下降。与NOC组相比，OA组的补呼气量下降。与OA组相比，OC组残气量（RV）下降；与OA组和NOA组相比，OC组RV/总肺容积下降。对于有和无哮喘的儿童，肥胖与明显的肺功能受限相关。在哮喘患儿中，肥胖与气道和全身炎症变化无关。然而，肥胖的女性哮喘患儿，非嗜酸性粒细胞性哮喘发生率较男性更高，但需进一步研究进行证实。

（刘国梁 审校）
Eur Respir J. 2013 Jan 24. [Epub ahead of print]

 

Airway and systemic inflammation in obese children with asthma.

Jensen ME, Gibson PG, Collins CE, Wood LG.

Source
Hunter Medical Research Institute, Newcastle, NSW 2310, Australia.

Abstract 
Obese asthma presents via altered airway and systemic inflammation in adults. This has not been comprehensively described in children. To compare airway and systemic inflammation in obese and non-obese asthmatic children and controls. In a cross-sectional study, children aged 8-17 yr were assigned to one of four groups: obese asthma (OA, n=74); non-obeseasthma (NOA, n=249); obese control (OC, n=9); non-obese control (NOC, n=29). Lung function, and both sputum and systemic inflammatory biomarkers were measured.Non-eosinophilic asthma was more prevalent among OA females (60.0%) versus OA males (30.8%). However, there were no differences in %eosinophils or %neutrophils between OA and NOA. Leptin was higher in OC, but not OA, versus NOA and NOC, while adiponectin was reduced in OA versus NOC only. Expiratory reserve volume was reduced in OA, versus NOC. Residual volume (RV) and RV/total lung capacity were reduced in OC versus OA, and OC versus OA and NOA, respectively.Obesity was associated with significant lung restriction in children with and without asthma. Obesity was not associated with significantly altered airway or systemic inflammation in asthmatic children. However, the higher prevalence of non-eosinophilic asthma in female obese asthmatics, compared to males, warrants further investigation.
 

Eur Respir J. 2013 Jan 24. [Epub ahead of print]