哮喘联盟

   摘要
   背景：在生长发育的关键时期营养不良可能对肺生理与功能产生永久性的影响。
   目的：调查儿童时期或成年早期急性营养不良是否会增加日后因阻塞性气道疾病、慢性阻塞性肺疾病(COPD)或哮喘导致的住院风险。
   方法：本研究所纳入的7841例女性来自前瞻性-EPIC研究，她们在0～21岁时经历了1944～1945年的荷兰饥荒。通过入院登记来判断肺部检查结果，295例亚组女性受试者进行了盲法计算机断层扫描（CT）。使用Cox比例风险回归分析饥荒对阻塞性气道疾病、COPD和哮喘住院风险的影响。Logistic回归分析饥荒对发生肺部疾病（经CT证实）风险的影响。
   结果：在暴露于中度饥荒后，因阻塞性气道疾病、COPD和哮喘导致的住院风险增加；在暴露于重度饥荒后显著增加：危害比分别为阻塞性气道疾病1.31(95% CI: 0.97 -1.77)和哮喘1.57 (95% CI: 1.10-2.23)。与不吸烟者比较，既往吸烟者的饥荒暴露与COPD住院治疗具有更强相关性。
   结论：儿童期或成年早期急性营养不良可增加日后COPD和哮喘住院风险，可能是通过增加了对烟草烟雾的敏感性。

（林江涛 审校）
PLoS One. 2013 Dec 23;8(12):e82636. doi: 10.1371/journal.pone.0082636.
 

Famine in the Young and Risk of Later Hospitalization for COPD and Asthma.
 

van Abeelen AF1, Elias SG2, de Jong PA3, Grobbee DE2, Bossuyt PM4, van der Schouw YT2, Roseboom TJ5, Uiterwaal CS2.
 

ABSTRACT
BACKGROUND: Undernutrition during critical periods of growth and development may permanently affect lung physiology and function.
OBJECTIVES: To investigate whether acute undernutrition in childhood or young adulthood increases the risk of later hospitalization for obstructive airways disease, chronic obstructive pulmonary disease (COPD), or asthma.
METHODS: We studied 7,841 women from Prospect-EPIC who experienced the 1944-45 Dutch famine between ages 0 and 21. Pulmonary outcomes were measured by registered hospital admissions and exposure-blinded computed tomography (CT) in a subgroup of 295 women. With Cox proportional hazard regression we explored effects of famine exposure on risk of hospitalization for obstructive airways disease, COPD, and asthma. With logistic regression we explored effects of famine on risk of CT evidence of pulmonary disease.
RESULTS: risks of hospitalization for obstructive airways disease, copd, and asthma were increased after moderate famine exposure, and significantly increased after severe famine exposure: hazard ratios for obstructive airways disease were 1.31 (95% CI: 0.97 to 1.77) and 1.57 (95% CI: 1.10 to 2.23) respectively. Associations between famine exposure and hospitalization for COPD were stronger in ever-smokers than in never-smokers.
CONCLUSIONS: Acute undernutrition in childhood or young adulthood is associated with an increased risk of later COPD and asthma hospitalization, possibly through increased sensitivity for tobacco smoke.
 

PLoS One. 2013 Dec 23;8(12):e82636. doi: 10.1371/journal.pone.0082636