Yildiz Fusun, Mungan Dilsad, Gemicioglu Bilun, Yorgancioglu Arzu, Dursun Berna, Oner Erkekol Ferda, Ogus Candan, Turktas Haluk, Bogatekin Gunhan, Topcu Fusun, Deveci Figen, Bayram Hasan, Tor Meltem, Kalyoncu A Fuat
Pulmonary Diseases Department, Kocaeli University School of Medicine, Kocaeli, Turkey.
Department of Allergy, Ankara University School of Medicine, Ankara, Turkey.
Clin Respir J. 2017 Mar;11(2):210-223. doi: 10.1111/crj.12326. Epub 2015 Jul 7.
To evaluate asthma phenotypes in patients with asthma from different regions of Turkey.
A total of 1400 adult asthmatic patients (mean (SD) age: 44.0 (13.9) years, 75% females) from 14 centers across Turkey were included in this study and a standard questionnaire was applied between the time period of February 2011-January 2012.
The disease onset ≥ 40 years of age was higher percentage in obese vs. normal/overweight patients and nonallergic vs. allergic patients (P < 0.01). The percentage of patients who had FEV1 values over 80% was higher in allergic than nonallergic and normal/overweight than obese patients (P < 0.01). Uncontrolled asthmatics have more severe disease (P < 0.01). There were more frequent hospital admissions in nonallergic and uncontrolled asthmatics (P < 0.01). Chronic rhino-sinusitis was the leading comorbid disorder in normal/overweight and allergic asthma, while gastroesophageal reflux disorder was more frequent in nonallergic and uncontrolled asthma (P < 0.01). Asthma control rate was the highest (39.0%) in patients from Marmara region among all geographical regions (P < 0.05).
In conclusion, our findings revealed existence of clinical/trigger related phenotypes based on BMI, allergic status, control level and geographical region with more frequent respiratory dysfunction and/or adverse health outcomes in uncontrolled, obese and nonallergic phenotypes.
评估来自土耳其不同地区哮喘患者的哮喘表型。
本研究纳入了来自土耳其14个中心的1400例成年哮喘患者(平均(标准差)年龄:44.0(13.9)岁,75%为女性),并于2011年2月至2012年1月期间应用了标准问卷。
肥胖患者与正常/超重患者相比,非过敏患者与过敏患者相比,疾病发病年龄≥40岁的比例更高(P<0.01)。过敏患者中FEV1值超过80%的患者比例高于非过敏患者,正常/超重患者高于肥胖患者(P<0.01)。未控制的哮喘患者病情更严重(P<0.01)。非过敏和未控制的哮喘患者住院次数更频繁(P<0.01)。慢性鼻-鼻窦炎是正常/超重和过敏性哮喘中最主要的合并症,而非过敏性和未控制的哮喘中胃食管反流病更常见(P<0.01)。在所有地理区域中,马尔马拉地区患者的哮喘控制率最高(39.0%)(P<0.05)。
总之,我们的研究结果显示,基于体重指数、过敏状态、控制水平和地理区域存在临床/触发因素相关的表型,未控制、肥胖和非过敏表型的呼吸功能障碍和/或不良健康结局更为常见。