突尼斯妇女肥胖引起的支气管肺高反应性。

Clinical Laboratory of Physiology, Physiology and Functionnal Testing Department 99/UR 08-67, Medical School of Sousse, Sousse, Tunisia.

Int J Obes (Lond). 2010 Jun;34(6):1078-85. doi: 10.1038/ijo.2010.22. Epub 2010 Mar 16.

OBJECTIVE

The specific objective of this investigation was to determine whether bronchopulmonary responsiveness (BPR) to methacholine (MCH) was associated with the body mass index (BMI) of Tunisian women.

SUBJECTS

In all, 160 healthy nonsmoker women (52 lean, 45 overweight and 63 obese) were recruited and examined in the Clinical Laboratory of Physiology located in the Medical School of Sousse. The average ages (+/-s.e.) of the three categories of lean, overweight and obese subjects were 27.7+/-1.1, 33.2+/-1.7 and 37.5+/-1.3 years, respectively. Their corresponding mean BMIs (+/-s.e.) were 21.9+/-0.3, 27.7+/-0.2 and 36.5+/-0.8 kg m(-2), respectively.

MEASUREMENTS

Before their inclusion into the study, subjects were screened for their lung status by measuring their pulmonary function testing parameters using a whole body plethysmograph. BPR was assessed, using a cumulative concentration response curve technique, by measuring with a spirometer the decrease in forced expiratory volume in 1 s (FEV(1)) in response to a cumulative dose of MCH.

RESULTS

After adjusting for age, significant differences in both FEV(1) and forced vital capacity (VC) were found between the obese and lean groups (P<0.01), as well as between the obese and overweight groups (P<0.01). In addition, forced expiratory flow between 25 and 75% of VC was significantly different between the obese and lean groups (P<0.001), as well as between the lean and overweight groups (P=0.015). The mean maximum fall of FEV(1) in response to MCH challenge was significantly higher for the obese group (12.0%) than for the overweight (9.8%) or the lean (6.6%) group (P<0.01). Furthermore, the efficacy of the MCH agonist promoting the maximal response (E(max)) and its potency or effective dose producing 50% of the maximal response (ED(50)) were both associated with BMI (the higher the BMI, the higher the E(max) and the lower the ED(50)).

CONCLUSION

Our data clearly show that obesity affects pulmonary function performance in Tunisian women by potentially promoting their bronchial hyperreactivity as suggested by the significant correlation between their BMI and the efficacy of the MCH, as well as its potency.

目的

本研究的具体目的是确定对乙酰甲胆碱（MCH）的支气管肺反应性（BPR）是否与突尼斯女性的体重指数（BMI）有关。

对象

共招募了 160 名健康的不吸烟女性（52 名消瘦者、45 名超重者和 63 名肥胖者），并在位于苏塞医学院的临床生理学实验室进行了检查。三类消瘦者、超重者和肥胖者的平均年龄（±标准差）分别为 27.7±1.1、33.2±1.7 和 37.5±1.3 岁。相应的平均 BMI（±标准差）分别为 21.9±0.3、27.7±0.2 和 36.5±0.8kg/m2。

测量

在将受试者纳入研究之前，通过使用全身体积描记法测量其肺功能测试参数来筛查其肺部状况。通过使用肺活量计测量乙酰甲胆碱累积剂量引起的用力呼气量 1 秒（FEV1）的下降，使用累积浓度反应曲线技术评估 BPR。

结果

在调整年龄后，肥胖组和消瘦组（P<0.01）以及肥胖组和超重组（P<0.01）之间的 FEV1 和用力肺活量（VC）均存在显著差异。此外，肥胖组和消瘦组之间（P<0.001）以及消瘦组和超重组之间（P=0.015）用力呼气量在 25%至 75%之间的流速存在显著差异。肥胖组（12.0%）对乙酰甲胆碱激发的最大 FEV1 下降平均值明显高于超重组（9.8%）或消瘦组（6.6%）（P<0.01）。此外，乙酰甲胆碱激动剂促进最大反应的功效（E(max)）及其产生最大反应的 50%有效剂量（ED50）均与 BMI 相关（BMI 越高，E(max)越高，ED50 越低）。