University of Groningen, University Medical Center Groningen, Groninger Research Institute for Asthma and COPD, Groningen, The Netherlands.
Eur Respir J. 2013 Apr;41(4):846-52. doi: 10.1183/09031936.00021212. Epub 2012 Jul 12.
We examined the association between: 1) cortisol levels and asthma or asthma development; 2) cortisol levels upon stress and asthma. In addition, we performed a post hoc meta-analysis on results from the literature. Cortisol, cortisol upon stress, asthma (doctor diagnosis of asthma and/or symptoms and/or treatment in the past 12 months) and asthma development (asthma at a specific survey while not having asthma at the previous survey(s)) were assessed in the TRAILS study (n=2230, mean age at survey 1 11 years, survey 2 14 years and survey 3 16 years). Logistic regression models were used to study associations between: 1) cortisol (cortisol awakening response, area under the curve (AUC) with respect to the ground (AUCg) or with respect to the increase (AUCi), and evening cortisol) and asthma or asthma development; 2) cortisol upon stress (AUCg or AUCi) and asthma. The meta-analyses included nine case-control articles on basal cortisol in asthma. No significant association was found between: 1) cortisol and asthma (age 11 years) or asthma development (age 14 or 16 years); 2) cortisol upon stress and asthma (age 16 years). The meta-analysis found lower morning and evening cortisol levels in asthmatics compared to non-asthmatics; however, the summary estimates were not significant. We found no evidence supporting a role for cortisol in asthma and asthma development.
1)皮质醇水平与哮喘或哮喘发展之间的关联;2)应激时皮质醇水平与哮喘之间的关联。此外,我们对文献中的结果进行了事后荟萃分析。在 TRAILS 研究中评估了皮质醇、应激时的皮质醇、哮喘(过去 12 个月内医生诊断的哮喘和/或症状和/或治疗)和哮喘发展(特定调查时患有哮喘而在前一次调查中未患有哮喘)(n=2230,调查 1 的平均年龄为 11 岁,调查 2 为 14 岁,调查 3 为 16 岁)。使用逻辑回归模型研究了以下因素之间的关联:1)皮质醇(皮质醇觉醒反应、与基础(AUCg)或与增加(AUCi)相关的曲线下面积和傍晚皮质醇)与哮喘或哮喘发展之间的关联;2)应激时的皮质醇(AUCg 或 AUCi)与哮喘之间的关联。荟萃分析包括九项关于哮喘基础皮质醇的病例对照研究。未发现:1)皮质醇与哮喘(11 岁)或哮喘发展(14 或 16 岁)之间存在显著关联;2)应激时的皮质醇与哮喘(16 岁)之间存在显著关联。荟萃分析发现哮喘患者的早晨和傍晚皮质醇水平低于非哮喘患者;然而,汇总估计值没有意义。我们没有发现证据支持皮质醇在哮喘和哮喘发展中的作用。