Vo Phuong, Bair-Merritt Megan, Camargo Carlos A
Division of Pediatric Pulmonary and Allergy, Boston Medical Center, Boston, MA 02118, USA.
Expert Rev Respir Med. 2015 Jun;9(3):309-25. doi: 10.1586/17476348.2015.1042457. Epub 2015 May 6.
Childhood obesity and asthma are major public health problems. Obesity is not only associated with increased risk of incident asthma, but it may worsen asthma severity/control. Although the mechanisms linking obesity with asthma expression have not been completely elucidated, evidence suggests that increased frequency of acute respiratory infection (ARI) and decreased corticosteroid responsiveness may help to explain how obesity worsens asthma expression. In addition, obese individuals have low vitamin D status, and emerging evidence suggests vitamin D affects risk of ARI and corticosteroid responsiveness in individuals with asthma. In this review, we summarize the association between obesity and asthma severity/control in children and discuss ARI and corticosteroid responsiveness as potential mediators in the obesity-asthma pathway. We also discuss the potential role of vitamin D, including a brief summary of recent randomized controlled trials of vitamin D supplementation.
儿童肥胖和哮喘是主要的公共卫生问题。肥胖不仅与哮喘发病风险增加有关，还可能使哮喘严重程度/控制情况恶化。尽管肥胖与哮喘表现之间的关联机制尚未完全阐明，但有证据表明，急性呼吸道感染（ARI）频率增加和皮质类固醇反应性降低可能有助于解释肥胖如何使哮喘表现恶化。此外，肥胖个体的维生素D水平较低，新出现的证据表明维生素D会影响哮喘患者发生ARI的风险和皮质类固醇反应性。在本综述中，我们总结了儿童肥胖与哮喘严重程度/控制情况之间的关联，并讨论了ARI和皮质类固醇反应性作为肥胖-哮喘途径中的潜在介导因素。我们还讨论了维生素D的潜在作用，包括对近期维生素D补充剂随机对照试验的简要总结。
