哮喘联盟

   摘要
   背景：近年来，幼儿哮喘和肥胖的患病率在增加，这提示它们之间存在潜在的关联。然而，所有关联的方向不明且潜在的因果关联仍未知
   方法：评估超重/肥胖（年龄> 18岁评估体重指数(BMI)）与BMI评估后至少1年医生诊断的哮喘之间的关联。我们试图通过性别研究潜在的效应修正因子。在PubMed 和 Embase数据库中使用关键词、年龄限定（0～18岁）但不限定日期和语言进行检索。在每一项研究中确认：作者、出版日期、地点、超重/肥胖的定义、哮喘的定义、纳入人数、持续时间、队列研究的描述、随访时间,校正后的效应估计(95% CI)和亚组分析的评估
   结果：六项前瞻性队列研究主要集中在符合纳入标准的年龄> 18岁的儿童。超重患者的联合风险比（RR）与哮喘相关（RR = 1.35; 95% CI = 1.15, 1.58）。在男童患者中，超重患者的联合风险比与哮喘显著相关(RR = 1.41; 95% CI = 1.05, 1.88)。女童患者中，当BMI由z值来定义时，超重患者的联合风险比(RR)也与哮喘显著相关(RR = 1.19; 95% CI = 1.06, 1.34)。男童和女童患者中，肥胖患者的联合风险比与哮喘相关(RR = 1.50; 95% CI = 1.22, 1.83)，其中男童患者 (RR = 1.40; 95% CI = 1.01, 1.93)，女童患者 (RR = 1.53; 95% CI = 1.09, 2.14)
   结论：与正常体重的幼儿相比，肥胖患者特别是超重患者今后医生诊断的哮喘风险增加。除性别外，没有研究报道任何其他潜在的效应修正因子。但观察到性别的效应因子前后矛盾。
 

（林江涛 审校）
BMC Pediatr. 2013 Aug 13;13(1):121. [Epub ahead of print]

 

Childhood body mass index and subsequent physician-diagnosed asthma: a systematic review and meta-analysis of prospective cohort studies.
 

Egan KB, Ettinger AS, Bracken MB.
 

Abstract
 

BACKGROUND: Childhood asthma and obesity prevalence have increased in recent years suggesting a potential association. However, the direction of any association is poorly understood and the potential causal-relationship is unknown.
METHODS: We examined the association between overweight/obesity, defined by body mass index (BMI) >18 years of age, and subsequent physician-diagnosed incident asthma at least one year after BMI assessment. We sought to explore potential effect modification by sex. PubMed and Embase were searched using keywords and restricted to subjects aged 0--18 years. There were no date or language restrictions. From each study we extracted: authors, publication date, location, overweight/obesity definitions, asthma definitions, number of participants, recruitment duration, description of cohort, follow-up time, adjusted effect estimates (with 95% CI) and estimates of subgroup analysis.
RESULTS: Six prospective cohort studies which focused on children >18 years of age met criteria for inclusion. The combined risk ratio (RR) of overweight was associated with asthma (RR = 1.35; 95% CI = 1.15, 1.58). In boys, the combined RR of overweight on asthma was significant (RR = 1.41; 95% CI = 1.05, 1.88). For girls, when BMI was defined by Z-score, the combined RR of overweight on asthma was also significant (RR = 1.19; 95% CI = 1.06, 1.34). The combined risk ratio (RR) of obesity was associated with asthma in both boys and girls (RR = 1.50; 95% CI = 1.22, 1.83), in boys only (RR = 1.40; 95% CI = 1.01, 1.93) and in girls only (RR = 1.53; 95% CI = 1.09, 2.14).
CONCLUSIONS: Overweight and, especially, obese children are at increased risk of subsequent physician diagnosed asthma in comparison to normal weight children. Except for sex, no studies reported any other potential effect modifiers. The observed sex effects were inconsistent.
 

BMC Pediatr. 2013 Aug 13;13(1):121. [Epub ahead of print]