INSERM U700, Faculté de Médecine Xavier Bichat, Paris, France.
Obesity (Silver Spring). 2012 Mar;20(3):628-35. doi: 10.1038/oby.2011.308. Epub 2011 Oct 20.
Whereas global obesity assessed by BMI has been related to asthma risk, little is known as to the potential implication of abdominal adiposity in this relationship. In the elderly, in whom asthma remains poorly studied, abdominal adiposity tends to increase at the expense of muscle mass. The purpose of this study was to investigate the association between abdominal adiposity, assessed by waist circumference (WC), and prevalence and incidence of asthma in a large elderly cohort. Cross-sectional analysis was based on 7,643 participants aged ≥65 years including 592 (7.7%) with lifetime physician-diagnosed asthma. Longitudinal analysis involved 6,267 baseline nonasthmatics followed-up for a period of 4 years, 67 of whom exhibited incident asthma. Baseline WC was categorized according to sex-specific criteria (men/women): <94/80 cm (reference), [94-102[/[80-88[ (abdominal overweight), and ≥102/88 (abdominal obesity). Logistic and Cox regression models estimated asthma risk associated with WC after adjustment for age, sex, educational level, smoking status, BMI, physical ability, dyspnea, chronic bronchitis symptoms and history of cardiovascular disease. At baseline, asthma risk increased with increasing WC independently of BMI and other confounders (adjusted odds ratio (ORa), 95% confidence interval (CI): 1.30, 1.02-1.65 and ORa: 1.76, 1.31-2.36 for abdominal overweight and obesity, respectively). Asthma incidence was related to WC (hazard ratio (HRa), 95% CI: 2.69, 1.21-5.98 and HRa: 3.84, 1.55-9.49, for abdominal overweight and obesity, respectively). Estimates were similar in both sexes. In the elderly, abdominal adiposity was independently associated with increased prevalence and incidence of asthma. Studies aiming to understand the mechanisms involved in the adiposity-asthma link are needed.
虽然 BMI 评估的全球肥胖与哮喘风险有关，但关于腹部肥胖在这种关系中的潜在影响知之甚少。在老年人中，哮喘研究仍不充分，腹部脂肪往往会增加，而肌肉量则会减少。本研究旨在调查腹部肥胖（通过腰围 [WC] 评估）与一个大型老年队列中哮喘的患病率和发病率之间的关联。横断面分析基于包括 592 名（7.7%）终身被医生诊断为哮喘的患者在内的 7643 名年龄≥65 岁的参与者。纵向分析涉及 6267 名基线非哮喘患者，随访时间为 4 年，其中 67 名出现了新的哮喘。根据性别特异性标准（男性/女性）对基线 WC 进行分类：<94/80cm（参考）、[94-102cm/[80-88cm[（腹部超重）和≥102/88cm（腹部肥胖）。在调整年龄、性别、教育程度、吸烟状况、BMI、身体能力、呼吸困难、慢性支气管炎症状和心血管疾病史后，逻辑回归和 Cox 回归模型估计了与 WC 相关的哮喘风险。在基线时，哮喘风险随着 WC 的增加而增加，独立于 BMI 和其他混杂因素（调整后的比值比 [ORa]，95%置信区间 [CI]：1.30，1.02-1.65 和 ORa：1.76，1.31-2.36 用于腹部超重和肥胖）。哮喘发病率与 WC 相关（风险比 [HRa]，95%CI：2.69，1.21-5.98 和 HRa：3.84，1.55-9.49，用于腹部超重和肥胖）。在两性中估计值相似。在老年人中，腹部肥胖与哮喘的患病率和发病率增加独立相关。需要进行旨在了解肥胖与哮喘之间关联的机制的研究。
