哮喘联盟

   摘要
   哮喘是儿童最常见的慢性疾病，然而肥胖与哮喘风险的相关性以及肥胖对哮喘临床结果的影响尚未十分明确。本研究是一项以人群为基础的纵向研究，人口统计学和临床数据来自于2007～2010年加利福尼亚州南部凯萨医疗机构的健康计划中所纳入的623,358例6～19岁患者的住院和电子病历。哮喘的粗发生率范围为16.9/1000人-年（正常体重青少年）～22.3/1000人-年（极度肥胖青少年）。相对于正常体重青少年，超重、中度肥胖和极度肥胖青少年校正后的哮喘风险分别为1.16 (95% 置信区间: 1.13, 1.20)、 1.23 (95% 置信区间: 1.19, 1.28)、和 1.37 (95% 置信区间: 1.32, 1.42)(P趋势 < 0.0001)。与其他组相比，肥胖和哮喘风险的相关性在亚洲/太平洋岛民组和最年轻的(6～10岁)女孩组最显著。在已患有哮喘的青少年中，伴有中度或重度肥胖者发生需急诊治和/或口服糖皮质激素治疗的哮喘急性发作更为频繁。结论，肥胖青少年不仅仅更容易患哮喘，而且更可能发展为严重的哮喘，从而导致更多的医疗使用和激进的哮喘治疗需求。
 

（苏楠 审校）
Am J Epidemiol. 2013 Aug 6. [Epub ahead of print]

 

Increased Asthma Risk and Asthma-Related Health Care Complications Associated with Childhood Obesity.

Black MH, Zhou H, Takayanagi M, Jacobsen SJ, Koebnick C.

Abstract
Asthma is the most common chronic condition of childhood, yet the relationship between obesity and asthma risk and the impact of obesity on clinical asthma outcomes are not well understood. For this population-based, longitudinal study, demographic and clinical data were extracted from administrative and electronic health records of 623,358 patients aged 6-19 years who were enrolled in the Kaiser Permanente Southern California health plan in 2007-2011. Crude asthma incidence ranged from 16.9 per 1,000 person-years among normal-weight youth to 22.3 per 1,000 person-years among extremely obese youth. The adjusted risks of asthma for overweight, moderately obese, and extremely obese youth relative to those of normal weight youth were 1.16 (95% confidence interval: 1.13, 1.20), 1.23 (95% confidence interval: 1.19, 1.28), and 1.37 (95% confidence interval: 1.32, 1.42), respectively (Ptrend < 0.0001). The relationship between obesity and asthma risk was strongest in Asian/Pacific Islanders and in the youngest girls (aged 6-10 years), compared with other groups. Among youth who developed asthma, those who were moderately or extremely obese had more frequent asthma exacerbations requiring emergency department services and/or treatment with oral corticosteroids. In conclusion, obese youth are not only more likely to develop asthma, but they may be more likely to have severe asthma, resulting in a greater need for health care utilization and aggressive asthma treatment.
 

Am J Epidemiol. 2013 Aug 6. [Epub ahead of print]