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按照日本肥胖定义界定的肥胖对日本哮喘患者控制情况的影响。

Influence of obesity on control in asthmatic Japanese patients defined by the Japanese definition of obesity.

作者信息

Youkou Akira, Hasegawa Takashi, Suzuki Kazuo, Koya Toshiyuki, Sakagami Takuro, Toyabe Shinichi, Arakawa Masaaki, Gejyo Fumitake, Narita Ichiei, Suzuki Eiichi

机构信息

Division of Respiratory Medicine, Niigata University Graduate School of Medical and Dental Sciences, Japan.

出版信息

Intern Med. 2011;50(18):1911-6. doi: 10.2169/internalmedicine.50.5474. Epub 2011 Sep 15.

Abstract

BACKGROUND Despite the use of inhaled corticosteroid (ICS) becoming increasingly widespread, many problems related to asthma management still need to be addressed. One of them, obesity, has been reported to exert a harmful influence on asthma control. However, there have been few reports focusing not only on both obesity and its influence on Japanese asthma patients but also on the Japanese definition of obesity, as defined by the Japan Society for the Study of Obesity (JASSO). AIMS & METHODS The aim of this study was to confirm the influence of obesity, as defined by the JASSO, on asthma management in Japanese asthmatic patients. Using data from the Niigata Asthma Treatment Study Group 2008 questionnaire survey, differences between the "normal" group (18.5 kg/m(2) ≤ BMI <25 kg/m(2)) and the "obese" group (25 kg/m(2) ≤ BMI) were analyzed. RESULTS There was a significantly lower step 1 rate (19.4% v.s. 26.8%) and a higher proportion of patients using inhaled salmeterol (43.6% v.s. 35.8%) and leukotriene receptor antagonist (49.8% v.s. 40.8%) in the obese group relative to the normal group, although there were no significant differences in indicators of asthma control, including asthma control test scores. CONCLUSION This study investigated influences of JASSO-defined obesity on asthma severity and management in a clinical setting in Japan. It is possible that there are strong interactions between asthma and obesity, such as obesity causing decreased ICS therapy efficacy and leukotriene (LT)-related inflammation, although further investigation is necessary.

摘要

背景 尽管吸入性糖皮质激素(ICS)的使用越来越广泛,但哮喘管理方面的许多问题仍需解决。其中之一,肥胖,据报道对哮喘控制有有害影响。然而,很少有报告不仅关注肥胖及其对日本哮喘患者的影响,还关注日本肥胖学会(JASSO)定义的肥胖的日本定义。目的与方法 本研究的目的是确认JASSO定义的肥胖对日本哮喘患者哮喘管理的影响。使用新潟哮喘治疗研究组2008年问卷调查的数据,分析了“正常”组(18.5kg/m²≤BMI<25kg/m²)和“肥胖”组(25kg/m²≤BMI)之间的差异。结果 肥胖组的第1步治疗率显著低于正常组(19.4%对26.8%),使用吸入性沙美特罗(43.6%对35.8%)和白三烯受体拮抗剂(49.8%对40.8%)的患者比例高于正常组,尽管在包括哮喘控制测试分数在内的哮喘控制指标方面没有显著差异。结论 本研究在日本的临床环境中调查了JASSO定义的肥胖对哮喘严重程度和管理的影响。哮喘和肥胖之间可能存在强烈的相互作用,例如肥胖导致ICS治疗效果下降和白三烯(LT)相关炎症,尽管还需要进一步研究。

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