抑郁症状在成人BMI与哮喘控制关系中的中介效应
2015/02/25
摘要
背景：肥胖与更差的哮喘控制相关。抑郁也在哮喘患者以及肥胖患者中呈不均衡流行。然而，尚无研究探索过抑郁在肥胖-哮喘之间关系中的中介作用。本研究探索成人样本中抑郁症状调节肥胖-哮喘关系的程度。
方法：招募共计798例在du Sacré-Coeur de Montréal医院就诊的被医生诊断为哮喘的门诊患者。患者提供人口学资料及病史信息，并且完成一连串的问卷，包括贝克抑郁自评问卷（BDI）-II和哮喘控制问卷（ACQ）。BMI根据患者自我报告的身高与体重来进行计算。
结果：在校正了年龄，性别，受教育年限，同居关系，以及吸入皮质激素的量之后，发现BMI与ACQ 之间 (β=0.017, P =.026)，BMI与BDI-II之间 ( β= 0.189, P = .002)，BDI-II与ACQ之间( β= 0.044, P <.001)均存在相关关系。然而，当BDI-II和BMI进入同一个模型，BDI-II仍然与ACQ有关(β= 0.044, P < .001)； 而BMI却与ACQ未发现相关性(β= 0.009, P = .226)。
结论：结果表明抑郁和较高的BMI均与更差的哮喘控制相关。但是，与我们之前的假设一致，BMI与更差的哮喘控制之间的关系是由抑郁症状起中介调节效应。未来研究需要探索抑郁症状在体重和哮喘控制中的精确作用。
Mediator Effect of Depressive Symptoms on the Association Between BMI and Asthma Control in Adults
Boudreau M; Bacon SL; Ouellet K; Jacob A; Lavoie KL.
ABSTRACT
BACKGROUND: Obesity has been associated with worse asthma control. Depression has also been shown to be disproportionally prevalent among patients with asthma and among patients with obesity. However, no studies have examined the mediating effect of depression on the obesity-asthma relationship. This study examined the extent to which depressive symptoms may mediate the obesity-asthma relationship in an adult sample.
METHODS: A total of 798 patients with physician-diagnosed asthma were recruited from the outpatient asthma clinic at Hopital du Sacré-Coeur de Montréal. Patients provided demographic and medical history information and completed a battery of questionnaires, including the Beck Depression Inventory (BDI)-II and the Asthma Control Questionnaire (ACQ). BMI was calculated from self-reported height and weight.
RESULTS: Analyses adjusted for age, sex, years of education, cohabitation, and inhaled corticosteroid dose revealed an association between BMI and ACQ (β= 0.017, P = .026), between BMI and BDI-II ( β= 0.189, P = .002), and between BDI-II and ACQ (β= 0.044, P < .001). However, when both BDI-II and BMI were entered into the same model, BDI-II (β= 0.044,P < .001) but not BMI (β = 0.009, P = .226) remained significantly associated with ACQ.
CONCLUSIONS: The results indicate that depression and a high BMI are both associated with worse asthma control. However, consistent with our hypotheses, the relationship between BMI and worse asthma control was mediated by depressive symptoms. Future studies should examine the precise role of depressive symptoms in both weight and asthma control.
CHEST；2014; 146(2):348-354.
背景：肥胖与更差的哮喘控制相关。抑郁也在哮喘患者以及肥胖患者中呈不均衡流行。然而，尚无研究探索过抑郁在肥胖-哮喘之间关系中的中介作用。本研究探索成人样本中抑郁症状调节肥胖-哮喘关系的程度。
方法：招募共计798例在du Sacré-Coeur de Montréal医院就诊的被医生诊断为哮喘的门诊患者。患者提供人口学资料及病史信息，并且完成一连串的问卷，包括贝克抑郁自评问卷（BDI）-II和哮喘控制问卷（ACQ）。BMI根据患者自我报告的身高与体重来进行计算。
结果：在校正了年龄，性别，受教育年限，同居关系，以及吸入皮质激素的量之后，发现BMI与ACQ 之间 (β=0.017, P =.026)，BMI与BDI-II之间 ( β= 0.189, P = .002)，BDI-II与ACQ之间( β= 0.044, P <.001)均存在相关关系。然而，当BDI-II和BMI进入同一个模型，BDI-II仍然与ACQ有关(β= 0.044, P < .001)； 而BMI却与ACQ未发现相关性(β= 0.009, P = .226)。
结论：结果表明抑郁和较高的BMI均与更差的哮喘控制相关。但是，与我们之前的假设一致，BMI与更差的哮喘控制之间的关系是由抑郁症状起中介调节效应。未来研究需要探索抑郁症状在体重和哮喘控制中的精确作用。
(郑洁1 张红萍1 王刚1 四川大学华西医院中西医结合科呼吸病组 610041 摘译)
（CHEST；2014; 146(2):348-354.)
（CHEST；2014; 146(2):348-354.)
Mediator Effect of Depressive Symptoms on the Association Between BMI and Asthma Control in Adults
Boudreau M; Bacon SL; Ouellet K; Jacob A; Lavoie KL.
ABSTRACT
BACKGROUND: Obesity has been associated with worse asthma control. Depression has also been shown to be disproportionally prevalent among patients with asthma and among patients with obesity. However, no studies have examined the mediating effect of depression on the obesity-asthma relationship. This study examined the extent to which depressive symptoms may mediate the obesity-asthma relationship in an adult sample.
METHODS: A total of 798 patients with physician-diagnosed asthma were recruited from the outpatient asthma clinic at Hopital du Sacré-Coeur de Montréal. Patients provided demographic and medical history information and completed a battery of questionnaires, including the Beck Depression Inventory (BDI)-II and the Asthma Control Questionnaire (ACQ). BMI was calculated from self-reported height and weight.
RESULTS: Analyses adjusted for age, sex, years of education, cohabitation, and inhaled corticosteroid dose revealed an association between BMI and ACQ (β= 0.017, P = .026), between BMI and BDI-II ( β= 0.189, P = .002), and between BDI-II and ACQ (β= 0.044, P < .001). However, when both BDI-II and BMI were entered into the same model, BDI-II (β= 0.044,P < .001) but not BMI (β = 0.009, P = .226) remained significantly associated with ACQ.
CONCLUSIONS: The results indicate that depression and a high BMI are both associated with worse asthma control. However, consistent with our hypotheses, the relationship between BMI and worse asthma control was mediated by depressive symptoms. Future studies should examine the precise role of depressive symptoms in both weight and asthma control.
CHEST；2014; 146(2):348-354.
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低收入家庭儿童中二手烟暴露及其与哮喘的相关性
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空气污染暴露与儿童哮喘患病率的多中心研究：ESCAPE项目
