哮喘联盟

   摘要
   背景：虽然目前有一些关于哮喘和血脂异常的研究，但两者之间是正相关、负相关还是没有相关性目前仍无定论。大多数研究都受限于它们的横断面设计和研究且受试者的大年龄跨度。一项对塞浦路斯地区儿童的队列研究分析了哮喘与他们16～18岁间血清中的高密度脂蛋白胆固醇浓度（随访调查）的关系，结合或不结合考虑他们11～12岁时的血清高密度脂蛋白胆固醇浓度（基线）。
   方法：我们按照病例对照实验设计方法将研究对象分为三组，第一组为活动性哮喘患者（AA; n = 68），第二组为目前只有气喘表现的患者（CWO; n = 123），第三组为正常对照（n = 660）。采用Logistic回归分析模型评估哮喘的发生与随访期间血清HDL-C水平及基线血清HDL-C水平的相关性。
   结果：在随访期间，活动性哮喘患者组及只有气喘表现的患者组的平均HDL-C水平显著低于正常对照组（47.9 和 49.7 vs. 53.4 mg/dl; p = 0.001 和 p = 0.011）。活动性哮喘患者与血清中低水平HDL-C浓度间存在显著相关性（<15th 百分位数; OR 2.32, 95% CI 1.16-4.47），在对患者基础血清HDL-C浓度进行校正后，此相关性仍然存在（OR 2.14, 95% CI 1.06-4.14）。将结果按基线血清HDL-C浓度进行分层后，只有高基线血清HDL-C浓度的患者的哮喘发生与HDL-C水平显著相关（OR 2.40, 95% CI 1.03-5.20）。将结果按IgE致敏作用进行分层后，只有在IgE致敏的患者的哮喘发生与HDL-C水平显著相关（OR 3.41, 95% CI 1.12-9.88）。
   结论：无论其儿童时期的血清HDL-C水平如何，青少年哮喘的发生与低水平的血清HDL-C水平显著相关。此外，对于那些青少年时期的血清HDL-C水平低于其儿童时期的患者以及IgE致敏的患者，其哮喘的发生与HDL-C水平的相关性更显著。
 

（苏楠 审校）
Int Arch Allergy Immunol. 2014 Nov 1;165(2):91-99. [Epub ahead of print]

 

Asthma: The Role of Low High-Density-Lipoprotein Cholesterol in Childhood and Adolescence.
 

Yiallouros PK1, Savva SC, Kolokotroni O, Dima K, Zerva A, Kouis P, Bousquet J, Middleton N.
 

ABSTRACT
BACKGROUND: Several studies have examined the relationship of asthma with serum dyslipidemia and reported positive, negative or no association. Most studies were limited by their cross-sectional design and the wide age range of the participants. In a cohort of children in Cyprus, we explored the association of asthma with serum high-density-lipoprotein cholesterol (HDL-C) at age 16-18 years (follow-up) independently of and in relation to HDL-C at age 11-12 years (baseline).
METHODS: In a case-control design, we recruited active asthmatics (AA; n = 68), current wheezers only (CWO; n = 123) and non-asthmatic controls (n = 660). Logistic regression models were used to evaluate associations of asthma with follow-up serum HDL-C and the role of baseline HDL-C.
RESULTS: At follow-up, mean HDL-C levels in AA and CWO patients were significantly lower than in the controls (47.9 and 49.7 vs. 53.4 mg/dl; p = 0.001 and p = 0.011). We observed significant associations of AA patients with low HDL-C (<15th percentile; OR 2.32, 95% CI 1.16-4.47) that remained significant after further adjustment for baseline HDL-C (OR 2.14, 95% CI 1.06-4.14). Stratification by baseline HDL-C indicated that the association was significant only in those with high baseline HDL-C (OR 2.40, 95% CI 1.03-5.20). Stratification by IgE sensitization showed that the association was pronounced only in subjects who were sensitized (OR 3.41, 95% CI 1.12-9.88).
CONCLUSIONS: Adolescent asthma is associated with low serum HDL-C independent of previous HDL-C levels in childhood. The association appears pronounced in those with a drop in HDL-C levels between childhood and adolescence and in those who have IgE sensitization.
 

Int Arch Allergy Immunol. 2014 Nov 1;165(2):91-99. [Epub ahead of print]