Jang An-Soo, Park Jong-Sook, Park Sung-Woo, Kim Do-Jin, Uh Soo-Taek, Seo Ki-Hyun, Kim Yong Hoon, Park Hae-Sim, Park Choon-Sik
Division of Allergy and Respiratory Diseases, Asthma and Allergy Research Group, Soonchunhyang University, Bucheon, Korea.
Respirology. 2008 Nov;13(7):1034-8. doi: 10.1111/j.1440-1843.2008.01358.x. Epub 2008 Aug 10.
Obesity is an important factor in the development of asthma. Aspirin hypersensitivity affects 5-10% of asthmatics. The association between obesity and aspirin hypersensitivity in asthma is unclear. This study evaluated the association of BMI and asthma in patients with aspirin-tolerant asthma (ATA) and aspirin-intolerant asthma (AIA).
Aspirin provocation tests were performed in 667 asthmatic patients and changes in FEV(1) were used to categorize patients as ATA or AIA. The BMI of asthmatics was graded using the percentile BMI of 406 normal controls.
Aspirin-induced changes in FEV(1)% ranged from 15% to 68%. Compared with the controls, the ATA group had a higher BMI (24.5 +/- 0.1 vs 23.8 +/- 0.2 kg/m(2), P = 0.001). The AIA group had a lower BMI. The aspirin-induced percentage fall in FEV(1) was inversely correlated with BMI in asthmatic patients (r = -0.094, P = 0.016). BMI was correlated with age and PC20, but not with FEV(1) in asthmatic patients. In a logistic regression adjusted for age, gender, and smoking status, FEV(1) and PC20 were associated with AIA with odds ratios of 0.986 and 0.586, respectively. BMI was associated with AIA with an odds ratio of 0.916.
Aspirin intolerance in asthmatics explains the lesser association with obesity. Obesity is not a risk factor in the development of asthma in patients with AIA.
肥胖是哮喘发病的一个重要因素。阿司匹林超敏反应影响5% - 10%的哮喘患者。肥胖与哮喘患者阿司匹林超敏反应之间的关联尚不清楚。本研究评估了体重指数（BMI）与阿司匹林耐受型哮喘（ATA）和阿司匹林不耐受型哮喘（AIA）患者哮喘之间的关联。
对667例哮喘患者进行阿司匹林激发试验，并使用第一秒用力呼气容积（FEV₁）的变化将患者分为ATA或AIA。哮喘患者的BMI根据406名正常对照者的BMI百分位数进行分级。
阿司匹林引起的FEV₁%变化范围为15%至68%。与对照组相比，ATA组的BMI更高（24.5±0.1 vs 23.8±0.2 kg/m²，P = 0.001）。AIA组的BMI较低。哮喘患者中，阿司匹林引起的FEV₁下降百分比与BMI呈负相关（r = -0.094，P = 0.016）。哮喘患者的BMI与年龄和激发试验浓度为20mg/ml时组胺累积量（PC20）相关，但与FEV₁无关。在对年龄、性别和吸烟状况进行校正的逻辑回归分析中，FEV₁和PC20与AIA相关，比值比分别为0.986和0.586。BMI与AIA相关，比值比为0.916。
哮喘患者的阿司匹林不耐受解释了其与肥胖关联较小的原因。肥胖不是AIA患者哮喘发病的危险因素。
