哮喘联盟

   摘要
   背景：变态反应性气道炎症是否可介导超重或肥胖与儿童哮喘间的相关性尚不明确。本研究旨在评估美国儿童中肥胖症、哮喘与呼出气一氧化氮(FeNO)的相关性。
   方法：本研究为横断面研究，纳入2007～2010年全国健康和营养调查(NHANES)中2681例年龄为6～17岁儿童，评估哮喘、肥胖或肥胖症、FeNO(一种嗜酸性气道炎症的生物标记物) 指标。肥胖评估包括体重指数(BMI)、体脂百分比(PBF)和腰围(WC)。
   结果：在低FeNO水平儿童中，BMI、PBF和WC与哮喘相关(比值比 [OR]= 1.54 - 1.68, p<0.01)，但在高FeNO水平儿童中并无此相关性。在非哮喘儿童中，BMI、PBF和WC与更高的FEV1和FVC、更低的FEV1/FVC相关。在高FeNO水平的哮喘儿童中，所有肥胖指标均与FEV1/FVC下降相关，与FEV1或FVC无关(= -1.5% — -1.7% /Z评分)。在高FeNO而非低FeNO水平的哮喘儿童中，较高的BMI或PBF与较严重哮喘或哮喘控制不佳相关。以FeNO水平分层的超重或肥胖(定义为BMI≥85%)和哮喘或哮喘严重程度/控制情况指标的二次多因素分析得出了同样的结果。
   结论：在低FeNO水平儿童中，肥胖指标与哮喘相关。在高FeNO水平的哮喘儿童中，肥胖指标与较严重哮喘或哮喘控制不佳相关。
 

（林江涛 审校）
Am J Respir Crit Care Med. 2014 Jun 12. [Epub ahead of print]


 

Adiposity, FeNO, and Asthma in U.S. Children.
 

Han YY1, Forno E, Celedón JC.
 

ABSTRACT
BACKGROUND:Whether allergic airway inflammation mediates the association between overweight or obesity and childhood asthma is unknown. We examined adiposity, asthma, and fractional exhaled nitric oxide (FeNO) in U.S. children.
METHODS: Cross-sectional study of indicators of adiposity or obesity, FeNO (a biomarker of eosinophilic airway inflammation) and asthma in 2,681 children aged 6-17 years in the 2007-2010 National Health and Nutrition Examination Survey (NHANES). Adiposity measures included body mass index (BMI), percent body fat (PBF) and waist circumference (WC).
RESULTS: BMI, PBF, and WC were associated with asthma among children with low FeNO (odds ratio [OR]= 1.54 to 1.68, p<0.01), but not among children with an increased FeNO. Among children without asthma, BMI, PBF and WC were associated with higher FEV1 and FVC, and lower FEV1/FVC. Among children with asthma and a high FeNO, all adiposity indicators were associated with decreased FEV1/FVC (= -1.5% to -1.7% per z-score) but not with FEV1 or FVC. Higher BMI or PBF was associated with worse asthma severity or control in children with asthma and an increased FeNO, but not in children with asthma but a low FeNO. Similar results were obtained in a secondary multivariate analysis of overweight or obesity (defined as a BMI ≥85th percentile) and asthma or indicators of asthma severity/control, stratified by FeNO level.
CONCLUSIONS:Adiposity indicators are associated with asthma in children with low FeNO. Among children with asthma, adiposity indicators are associated with worse asthma severity or control in those with high FeNO.
 

Am J Respir Crit Care Med. 2014 Jun 12. [Epub ahead of print]