肥胖对哮喘儿童呼出气一氧化氮水平的影响
2013/10/11
摘要
背景：已有研究证明了哮喘与肥胖的联系。然而，作为哮喘患者气道炎症的一个标记物，呼出气一氧化氮(FeNO)与肥胖关系的研究结果一直是矛盾的。本研究旨在评价哮喘和非哮喘儿童中肥胖者FeNO与肥胖相关代谢并发症的关系。
方法：本研究纳入了6～17岁的儿童并将其分为4组：肥胖哮喘儿童组(n = 52)，正常体重哮喘儿童组(n = 49)，肥胖非哮喘儿童组(n = 51)和正常体重非哮喘儿童组(n = 42)。所有患儿均接受FeNO测量和肺功能测定。测量血脂，血糖和胰岛素水平用于评估代谢并发症。采用内环境稳态模型，即抗胰岛素性稳态模式评估法(HOMA-IR)来评估胰岛素抵抗情况，。评估所有受试者是否存在代谢综合征（MS）。
结果：本研究纳入的194例受试者的平均年龄为11.6 ± 2.5岁。存在代谢综合征的哮喘患者与无代谢综合征的哮喘患者相比FeNO水平并无差异(14.5 ± 8.0 和 16.7 ± 8.7， p = 0.449)。在非哮喘患儿组，有代谢综合征的受试者FeNO水平要高于与无代谢综合征受试者(12.5 ± 5.1 和 17.3 ± 8.3, p = 0.014)。Spearman's等级相关系数显示非哮喘患儿组FeNO与体重指数(BMI)呈正相关关系(p = 0.049, r2: 0.204)，多元回归分析显示，BMI仍然是FeNO的一个独立危险因素。
结论：本研究显示在非哮喘儿童中，BMI与FeNO水平呈正相关，提示肥胖与气道炎症反应增加存在关联。
（刘国梁 审校）
Int Arch Allergy Immunol. 2013 Jul 31;162(2):58-64. [Epub ahead of print]
The Effect of Obesity on the Level of Fractional Exhaled Nitric Oxide in Children with Asthma.
Erkoçoğlu M, Kaya A, Ozcan C, Akan A, Vezir E, Azkur D, Kara O, Demirel F, Ginis T, Civelek E, Kocabaş CN.
Abstract
Background: Several studies have demonstrated a relationship between asthma and obesity. However, the results have been conflicting with regard to the relationship between fractional exhaled nitric oxide (FeNO), used as a marker of airway inflammation in asthmatic patients, and obesity. We aimed to evaluate the association of FeNO with obesity and obesity-related metabolic complications in asthmatic and nonasthmatic children.
Methods: The study population included children aged between 6 and 17 years and consisted of 4 groups: obese asthmatics (n = 52), normal-weight asthmatics (n = 49), obese nonasthmatics (n = 51) and normal-weight nonasthmatics (n = 42). FeNO measurement and spirometry were performed for all patients. To evaluate the metabolic complications, serum lipids, glucose and insulin levels were measured. Insulin resistance (IR) was estimated by the homeostasis model assessment, HOMA-IR. All participants were evaluated for the presence of metabolic syndrome (MS).
Results: The mean age for the 194 subjects participating in the study was 11.6 ± 2.5 years. The FeNO level of asthma patients with MS was not different from those without MS (14.5 ± 8.0 and 16.7 ± 8.7, respectively, p = 0.449). In the nonasthmatic group, subjects with MS had a higher FeNO level than subjects without MS (12.5 ± 5.1 and 17.3 ± 8.3, respectively, p = 0.014). Spearman's rank correlation coefficients revealed a positive correlation between FeNO and body mass index (BMI; p = 0.049, r2: 0.204) in the nonasthmatic group and after multivariate regression analysis, BMI still persisted as an independent risk factor for FeNO.
Conclusion: We found a positive correlation between BMI and FeNO level which suggests a link between obesity and increased airway inflammation in nonasthmatic children.
Int Arch Allergy Immunol. 2013 Jul 31;162(2):58-64. [Epub ahead of print]
