哮喘联盟

   摘要
   背景和目的：流行病学数据确定肥胖增加是易发哮喘的危险因素。但是，肥胖和哮喘联系的潜在机制尚不清楚。在本文中，我们回顾了目前观察到的肥胖和哮喘关联的可能调节机制的相关知识。
   方法：系统性文献回顾。
   结果：肥胖和哮喘存在一些共同的病因因素，例如一个共同的遗传易感性和子宫环境影响，还可以有一些其他的共同易感因素，如体力活动和饮食。肥胖导致呼吸系统机械性能的重要变化可能解释了哮喘的出现。但是，也存在一些肥胖导致或加重哮喘的可信的生物学机制。这些包括胃-食管反流等共存病、睡眠障碍性呼吸的并发症、低肺容量呼吸、慢性系统性炎症以及内分泌因子（包括脂肪因子和生殖激素）。肥胖相关性哮喘总体来说与嗜酸性气道炎症无关联，脂肪因子可能在肥胖患者哮喘炎性发病机制中起重要作用。
   结论：肥胖和哮喘之间的联系并非直接性的，并且需要进一步阐明，因为理解潜在机制可能为这类哮喘高危人群的带来新的治疗选择。
 

（刘国梁 审校）
Respir Med. 2013 Sep;107(9):1287-300. doi: 10.1016/j.rmed.2013.03.019. Epub 2013 May 1.


 

Obesity and asthma: A coincidence or a causal relationship? A systematic review.
 

Ali Z, Ulrik CS.
 

ABSTRACT
BACKGROUND AND AIM: Epidemiological data has established increasing adiposity as a risk factor for incident asthma. However, the mechanisms underlying the association between obesity and asthma are incompletely understood. In the present paper, we review current knowledge of possible mechanisms mediating the observed association between obesity and asthma.
METHODS: Systematic literature review.
RESULTS: Obesity and asthma share some etiological factors, such as a common genetic predisposition and effects of in utero conditions, and may also have common predisposing factors such as physical activity and diet. Obesity results in important changes in the mechanical properties of the respiratory system which could explain the occurrence of asthma. However, there are also plausible biological mechanisms whereby obesity could be expected to either cause or worsen asthma. These include co-morbidities such as gastro-oesophageal reflux, complications from sleep-disordered breathing, breathing at low lung volumes, chronic systemic inflammation, and endocrine factors, including adipokines and reproductive hormones. Obesity related asthma is in general not associated with eosinophilic airway inflammation, and adipokines are likely to play important roles in the inflammatory pathogenesis of asthma in obese individuals.
CONCLUSION: The association between obesity and asthma is not straightforward, and further knowledge is clearly needed, as understanding the underlying mechanisms may lead to new therapeutic options for this high-risk part of the asthma population.
 

Respir Med. 2013 Sep;107(9):1287-300. doi: 10.1016/j.rmed.2013.03.019. Epub 2013 May 1.