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超重不是儿童哮喘的合并症因素:GrowthOb 研究。

Overweight is not a comorbidity factor during childhood asthma: the GrowthOb study.

机构信息

AP-HP, Hôpital Européen Georges-Pompidou, Service de Physiologie, Clinique de la Dyspnée, Paris, France.

出版信息

Eur Respir J. 2012 May;39(5):1120-6. doi: 10.1183/09031936.00103311. Epub 2011 Sep 1.

Abstract

While being overweight is a risk factor for subsequent asthma in children, the importance of body mass index (BMI) as a comorbidity factor remains debated. The aim of this study was to assess the relationships between being overweight and the characteristics of childhood asthma. The BMI, BMI z-scores and International Obesity Task Force (IOTF) grades were evaluated in asthmatic children according to atopic status, symptoms during the past 3 months, exercise breathlessness, treatment and lung function in 6-15-yr-old children with confirmed asthma. 491 asthmatic children (mean ± SD age 10.8 ± 2.6 yrs; 179 females) were prospectively enrolled. There were 78 (15.5%) overweight (IOTF grade 1) and eight (1.6%) obese (grade 2) children. The children's BMI z-scores did not differ according to atopy, exacerbation, symptom-free days or treatment. The BMI z-score correlated positively with forced vital capacity and forced expiratory volume in 1 s in females, which could be related to earlier puberty in overweight females (growth spurt with increased volumes). Compared with normal weight children, overweight and obese children had reduced lung volume ratios (functional residual capacity/total lung capacity (TLC) and residual volume/TLC), no evidence of airflow limitation and similar symptoms. In conclusion, the observed functional relationships with BMI are not specific to asthma and being overweight is not associated with significant clinical impacts on asthma during childhood.

摘要

虽然超重是儿童后续哮喘的一个风险因素,但体重指数(BMI)作为合并症因素的重要性仍存在争议。本研究旨在评估超重与儿童哮喘特征之间的关系。根据特应性状态、过去 3 个月的症状、运动时呼吸困难、治疗和肺功能,评估了哮喘儿童的 BMI、BMI z 评分和国际肥胖工作组(IOTF)分级,这些儿童为确诊哮喘的 6-15 岁儿童。前瞻性纳入 491 例哮喘儿童(平均年龄 ± 标准差 10.8 ± 2.6 岁;女性 179 例)。有 78 例(15.5%)超重(IOTF 分级 1)和 8 例(1.6%)肥胖(分级 2)儿童。儿童的 BMI z 评分与特应性、恶化、无症状天数或治疗无关。BMI z 评分与女性的用力肺活量和 1 秒用力呼气量呈正相关,这可能与超重女性青春期更早(生长突增导致容量增加)有关。与正常体重儿童相比,超重和肥胖儿童的肺容积比(功能残气量/总肺容量(TLC)和残气量/TLC)降低,没有气流受限的证据,且症状相似。总之,与 BMI 观察到的功能关系并非特定于哮喘,并且超重与儿童哮喘期间的显著临床影响无关。

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