哮喘联盟

   摘要
   背景：现有的关于肥胖和哮喘的前瞻性研究只用体重指数(BMI)作为肥胖指标；缺乏使用具体肥胖指标的研究，身体健康水平和久坐时间与肥胖和哮喘的关系尚不明确。
   目的：(1)比较多种肥胖指标与儿童哮喘的关系；(2)进一步描述中心性肥胖、身体健康水平、久坐时间和哮喘之间的相互关系。
   方法：共2758位4年级到6年级的在校生被纳入台湾儿童健康研究(TCHS)，每年收集以下方面的数据：身体健康，久坐时间，肥胖指标（包括体重、身高、腰臀比、皮肤皱褶厚度及身体成分），哮喘和肺功能检测。采用广义估计方程(GEE)分析3年重复测量数据以明确肥胖、久坐时间、身体健康水平和哮喘之间的相互作用；采用结构方程模型(SEM)探讨这些因素间的发病机理。对基线非哮喘儿童随访两年，分析中心性肥胖和非肥胖组的哮喘发生率。
   结果：中心性肥胖能最准确的预测哮喘发生。低身体健康水平和高久坐时间能增加中心性肥胖风险，导致哮喘发展。肥胖相关的肺功能降低是中心性肥胖向哮喘发展的一个可能机制。
   结论：中心性肥胖检测应该纳入儿童哮喘风险预测。应鼓励儿童增加身体健康水平，减少久坐时间，以预防中心性肥胖相关哮喘的发生。
 

（刘国梁 审校）
Am J Respir Crit Care Med. 2014 Mar 26. [Epub ahead of print]

 

Pathway From Central Obesity to Childhood Asthma: Physical Fitness and Sedentary Time Are Leading Factors.

Chen YC1, Tu YK, Huang KC, Chen PC, Chu DC, Lee YL.
 

ABSTRACT
RATIONALE: Available prospective studies of obesity and asthma have used only body mass index (BMI) as an indicator for adiposity; studies using detailed obesity measures are lacking, and the role of physical fitness level and sedentary time remains unexplored in the link between obesity and asthma.
OBJECTIVES: (1) Comparing various anthropometric measures of obesity in relation to childhood asthma, and (2) further characterising the interrelations amongst central obesity, physical fitness level, sedentary time, and asthma.
METHODS: The nationwide Taiwan Children Health Study (TCHS) followed 2758 schoolchildren from fourth to sixth grade, annually collecting data regarding physical fitness, sedentary time, obesity measures (comprising body weight and height, abdominal/hip circumference, skin fold thickness, and body composition), asthma, and pulmonary function tests. The generalized estimating equation (GEE) was used for three years of repeated measurements to analyse the interrelation amongst obesity, sedentary time, physical fitness level, and asthma; a structural equation model (SEM) was used to explore the pathogenesis amongst these factors. Asthma incidence was analysed during a 2-year follow-up amongst centrally obese and non-obese groups in baseline non-asthmatic children.
RESULTS: Central obesity most accurately predicts asthma. Low physical fitness levels and high screen time increase the risk of central obesity which leads to asthma development. Obesity-related reduction in pulmonary function is a possible mechanism in the pathway from central obesity to asthma.
CONCLUSIONS:Central obesity measurement should be incorporated in childhood asthma risk predictions. Children are encouraged to increase their physical fitness levels and reduce their sedentary time to prevent central-obesity-related asthma.
 

Am J Respir Crit Care Med. 2014 Mar 26. [Epub ahead of print]