Taylor B, Mannino D, Brown C, Crocker D, Twum-Baah N, Holguin F
Emory University, Atlanta, Georgia, USA.
Thorax. 2008 Jan;63(1):14-20. doi: 10.1136/thx.2007.082784.
The association between obesity and asthma severity remains controversial and limited to small studies.
We determined the association of body mass index (BMI) and asthma severity in the National Asthma Survey. We included adults (age > or = 18 years) who self-reported symptoms of asthma in the past 5 years. A total of 3095 patients were divided into the following BMI categories: 1080 (35%) non-overweight (BMI < 25), 993 (32%) overweight (BMI > or = 25 and < 30) and 1022 (33%) obese (BMI > or = 30). Asthma severity measures included respiratory symptoms, healthcare utilisation, medication use, missed work days and the Global Initiative for Asthma (GINA) severity classification. Models were adjusted for: gender, race, age, education, income, employment status, smoking status, family history of asthma, state of residence and residence in a metropolitan statistical area.
Compared with non-overweight subjects, obese subjects with asthma were more likely to report continuous symptoms (OR 1.66, 95% CI 1.09 to 2.54), miss more work days (OR 1.35, 95% CI 1.01 to 1.81), use short acting beta agonists (OR 1.36, 95% CI 1.06 to 1.75), use inhaled corticosteroids (OR 1.34, 95% CI 1.01 to 1.79) and use any controller medication according to GINA guidelines (OR 1.37, 95% CI 1.01 to 1.85). Also, obese respondents were less likely to be in asthma remission (OR 0.56, 95% CI 0.38 to 0.82) and were more likely to have severe persistent asthma (GINA IV) (OR 1.42, 95% CI 1.05 to 1.90).
In a large, diverse sample of adults with asthma, obesity was associated with measures of asthma severity after adjusting for potential confounders.
肥胖与哮喘严重程度之间的关联仍存在争议，且仅限于小型研究。
我们在全国哮喘调查中确定了体重指数（BMI）与哮喘严重程度之间的关联。我们纳入了在过去5年中自我报告有哮喘症状的成年人（年龄≥18岁）。总共3095名患者被分为以下BMI类别：1080名（35%）非超重（BMI<25），993名（32%）超重（BMI≥25且<30），1022名（33%）肥胖（BMI≥30）。哮喘严重程度的衡量指标包括呼吸道症状、医疗保健利用情况、药物使用、误工天数以及全球哮喘防治创议（GINA）严重程度分类。模型针对以下因素进行了调整：性别、种族、年龄、教育程度、收入、就业状况、吸烟状况、哮喘家族史、居住州以及是否居住在大都市统计区。
与非超重受试者相比，肥胖的哮喘受试者更有可能报告持续症状（比值比[OR]1.66，95%置信区间[CI]1.09至2.54），误工天数更多（OR 1.35，95%CI 1.01至1.81），使用短效β受体激动剂（OR 1.36，95%CI 1.06至1.75），使用吸入性糖皮质激素（OR 1.34，95%CI 1.01至1.79），并根据GINA指南使用任何控制药物（OR 1.37，95%CI 1.01至1.85）。此外，肥胖的受访者哮喘缓解的可能性较小（OR 0.56，95%CI 0.38至0.82），且更有可能患有重度持续性哮喘（GINA IV级）（OR 1.42，95%CI 1.05至1.90）。
在一个大型、多样化的成年哮喘患者样本中，在调整潜在混杂因素后，肥胖与哮喘严重程度的衡量指标相关。
