Capelo Albertina Varandas, de Fonseca Vania Matos, Peixoto Maria Virgínia Marques, de Carvalho Sonia Regina, Guerino Larissa Garcia
Gaffrée and Guinle University Hospital of Federal University of the State of Rio de Janeiro, Rio de Janeiro, Brazil.
Institute of women, children and adolescents Health Fernandes Figueira - IFF-FIOCRUZ, Rio de Janeiro, Brazil.
Allergy Asthma Clin Immunol. 2015 Mar 31;11(1):12. doi: 10.1186/s13223-015-0076-y. eCollection 2015.
Asthma remains an uncontrolled disease. The Comorbidities, particularly obesity, and several other factors have been identified as being individually associated with asthma control, and these factors vary among different countries and between sexes. Studies have suggested that the harmful effects of these factors are greatest among women. The aim of the present study was to identify associated factors with uncontrolled asthma in women at the outpatient clinic of a Federal University Hospital in Rio de Janeiro, Brazil.
Cross-sectional study with asthmatic women, older than 18 years old. All subjects were included according to stringent criteria. The study used a structured questionnaire with data about demographic variables, education level, comorbid conditions, and disease history. Anthropometric and spirometric measurements were obtained. Asthma control was assessed by three different tools: the Asthma Control Test (ACT), the Asthma Control Questionnaire (ACQ) and the Global Initiative for Asthma (GINA) criteria.
A total of 124 women were included, and 57%, 38% and 21% were totally controlled according to ACT, ACQ and GINA criteria, respectively. A total of 31.5% were obese. According to the CI (Conicity Index) and WC (waist circumference) respectively, 84% and 68% were centrally obese. There was no association between asthma control and age, education, duration of the disease or BMI (Body Mass Index) in the three models, but there was a significant association between central obesity and asthma control with the ACQ and GINA assessment tools, controlling for explanatory variables such as GERD (gastroesophageal reflux disease). Pre-bronchodilator percent predicted forced expiratory volume in one second (FEV1) and forced vital capacity (FVC) were significantly associated with age and FVC was also associated with central obesity.
Asthma remains uncontrolled in women despite treatment, and central obesity seems to have a negative influence on the control of the disease. We believe that women should be studied as a separate group and suggest prospective studies with assessment of fat distribution and biomarkers, controlling for possible comorbidities associated with asthma control.
哮喘仍是一种未得到有效控制的疾病。已确定合并症，尤其是肥胖症，以及其他几个因素分别与哮喘控制相关，且这些因素在不同国家和不同性别之间存在差异。研究表明，这些因素对女性的有害影响最大。本研究的目的是在巴西里约热内卢一家联邦大学医院的门诊中，确定未控制哮喘的女性的相关因素。
对年龄超过18岁的哮喘女性进行横断面研究。所有受试者均根据严格标准纳入。该研究使用了一份结构化问卷，其中包含有关人口统计学变量、教育水平、合并症和疾病史的数据。进行了人体测量和肺功能测量。通过三种不同工具评估哮喘控制情况：哮喘控制测试（ACT）、哮喘控制问卷（ACQ）和全球哮喘防治创议（GINA）标准。
共纳入124名女性，根据ACT、ACQ和GINA标准，分别有57%、38%和21%的女性得到完全控制。共有31.5%的女性肥胖。根据锥度指数（CI）和腰围（WC），分别有84%和68%的女性为中心性肥胖。在三种模型中，哮喘控制与年龄、教育程度、病程或体重指数（BMI）之间均无关联，但在控制诸如胃食管反流病（GERD）等解释变量后，中心性肥胖与使用ACQ和GINA评估工具的哮喘控制之间存在显著关联。支气管扩张剂使用前一秒用力呼气量（FEV1）占预计值百分比和用力肺活量（FVC）与年龄显著相关，FVC也与中心性肥胖相关。
尽管接受了治疗，但女性哮喘仍未得到有效控制，中心性肥胖似乎对疾病控制有负面影响。我们认为应将女性作为一个单独的群体进行研究，并建议进行前瞻性研究，评估脂肪分布和生物标志物，同时控制与哮喘控制相关的可能合并症。
