哮喘联盟

   摘要
   背景：肥胖在哮喘患者中普遍存在。在普通人群中，短睡眠时间是肥胖的一个新危险因素。
   目的：本研究旨在评价睡眠时间与哮喘患者肥胖特征的相关性。
   方法：调查三级诊所成人的哮喘症状和习惯睡眠时间。根据病例记录评价哮喘严重程度(1-4级)，摘录身高和体重、目前的药物治疗和伴随疾病的诊断情况。BMI≥30 kg/m2定义为肥胖。习惯性睡眠分为<6小时 (极短), 6 到 <7小时 (短), 7-8小时 (正常), >8 to ≤9小时 (长) 和 >9小时 (极长)五类。吸入糖皮质激素剂量分为低、中和高。
   结果：611例受试者中(平均BMI 30±8)，249 例(41%)为肥胖者。校正协变量后，肥胖与短和极长的睡眠时间是相关的：与正常睡眠者相比，短睡眠者肥胖的几率平均高66%([95%CI: 1.07-2.57], p=0.02)，极长睡眠者肥胖的几率平均高124%(95%CI[1.08-1.65], p=0.03)。肥胖也与最严重的哮喘分级(1.87 [1.09-3.21], p=0.02)和精神病理学(1.64 [1.08-2.48], p=0.02)显著相关，同时发现肥胖与吸入高剂量糖皮质激素有相关趋势(1.82 [0.93-3.56], p=0.08)。
   结论：哮喘者肥胖与较短和极长睡眠时间、更重的哮喘分级、精神病理学和吸入高剂量糖皮质激素相关。虽然本横断面研究尚不能证明其因果关系，但将来的睡眠调查研究可能会提供新的方法，来减少日益增加的哮喘患者肥胖的发生率。
 

（刘国梁 审校）
J Asthma. 2013 Aug 8. [Epub ahead of print]

 

Sleep duration, asthma and obesity.
 

Teodorescu M, Polomis DA, Gangnon RE, Consens FB, Chervin RD, Teodorescu MC.
 

Abstract
Background: Obesity is more prevalent in asthmatics. Short sleep duration is a novel risk factor for obesity in general populations.
Objective: We tested the association of sleep duration and asthma characteristics with obesity.
Methods: Adults at tertiary clinics were surveyed on asthma symptoms and habitual sleep duration. Medical records were used to assess asthma severity step (1-4), extract height and weight, current medications and diagnosed comorbid conditions. BMI≥30 kg/m2 defined obesity. Habitual sleep was categorized as <6 (very short), 6 to <7h (short), 7-8h (normal), >8 to ≤9h (long) and >9h (very long). Inhaled corticosteroid doses were categorized as low, moderate and high.
Results: Among 611 participants (mean BMI 30±8), 249 (41%) were obese. After adjustment for covariates, obesity was associated with short and very long sleep: as compared to normal sleepers, the odds of being obese were on average 66% higher ([95% Confidence Interval: 1.07-2.57], p=0.02) among short and 124% higher ([1.08-1.65], p=0.03) among very long sleepers, and the association with very short sleep approached significance (1.74 [0.96-3.14], p=0.06). Obesity was also significantly related to highest asthma step (1.87 [1.09-3.21], p=0.02) and psychopathology (1.64 [1.08-2.48], p=0.02), and a trend was seen with high dose inhaled corticosteroids (1.82 [0.93-3.56], p=0.08).
Conclusions: Obesity in asthmatics is associated with shorter and very long sleep duration, worse asthma severity, psychopathology, and high dose inhaled corticosteroids. Although this cross-sectional study cannot prove causality, we speculate that further investigation of sleep may provide new opportunities to reduce the rising prevalence of obesity among asthmatics.
 

J Asthma. 2013 Aug 8. [Epub ahead of print]