Dept of Medicine, University of New Mexico, School of Medicine, Albuquerque, NM 87131, USA.
Eur Respir J. 2011 Jan;37(1):65-71. doi: 10.1183/09031936.00193709. Epub 2010 Jun 4.
The obesity phenotype associated with asthma is not known. Our objective was to define the relative contribution of various distributions of fat and lean mass to asthma prevalence. Data were obtained from 2,525 participants (including 1,422 females) who underwent dual-energy X-ray absorptiometry (DEXA) at the year 20 examination in the Coronary Artery Risk Development in Young Adults (CARDIA) cohort. Total, truncal, arm and leg distributions of fat and lean mass were adjusted to the person's height. Self-reported asthma was the outcome. Asthma among females was associated with greater total fat mass, arm fat mass, total lean mass, truncal lean mass and arm lean mass. Among males, none of these mass measures were significantly associated with asthma. Among females, the association with asthma was stronger for total lean mass than for total fat mass. Further, among various regional distributions of lean and fat mass in females, truncal lean mass was the strongest predictor. Total lean mass is more strongly associated with asthma than total fat mass among females. These findings are contrary to the popular perception that excess physiological fat drives the obesity-asthma association. Rather, we hypothesise that ectopic fat within the "lean" tissues drives this association among females.
与哮喘相关的肥胖表型尚不清楚。我们的目的是确定脂肪和瘦体重的各种分布对哮喘患病率的相对贡献。本研究数据来自于冠状动脉风险发展中的年轻人（CARDIA）队列研究中 2525 名参与者（包括 1422 名女性），他们在第 20 年检查时接受了双能 X 线吸收法（DEXA）检查。将脂肪和瘦体重的总分布、躯干分布、手臂分布和腿部分布调整到个人身高。以自我报告的哮喘为结局。女性哮喘与总脂肪量、手臂脂肪量、总瘦体重、躯干瘦体重和手臂瘦体重增加有关。在男性中，这些体重指标均与哮喘无明显相关性。在女性中，与哮喘的相关性与总瘦体重相比，与总脂肪量更强。此外，在女性的瘦体重和脂肪的各种区域性分布中，躯干瘦体重是最强的预测因子。与哮喘相关的总瘦体重比总脂肪量在女性中更为强烈。这些发现与普遍的看法相悖，即生理性脂肪过多会导致肥胖与哮喘之间的关联。相反，我们假设女性体内“瘦”组织中的异位脂肪会导致这种关联。
