Ballantyne D, Scott H, MacDonald-Wicks L, Gibson P G, Wood L G
Centre for Asthma and Respiratory Diseases, Hunter Medical Research Institute, University of Newcastle, Newcastle, NSW, Australia.
Discipline of Nutrition and Dietetics, School of Health Sciences, University of Newcastle, Newcastle, NSW, Australia.
Clin Exp Allergy. 2016 Aug;46(8):1056-65. doi: 10.1111/cea.12742. Epub 2016 May 27.
Adipokines, such as resistin and adiponectin, modify inflammation and may contribute to increased asthma risk and severity in obese people.
To examine plasma resistin and resistin:adiponectin ratio (i) in asthmatics compared to healthy controls, (ii) according to asthma severity, obesity and gender (iii) following weight loss in obese asthmatics.
In a cross-sectional observational study of asthmatic adults (n = 96) and healthy controls (n = 46), plasma resistin and adiponectin were measured. In a separate intervention study, obese asthmatic adults (n = 27) completed a 10-week weight loss intervention and plasma resistin and adiponectin concentrations were analysed.
Plasma resistin and resistin:adiponectin ratio were higher in asthma compared to controls and were higher again in subjects with a severe vs. mild-to-moderate asthma pattern. Amongst asthmatic subjects, resistin was not modified by gender or obesity, while adiponectin was lower in males and obese subjects. As a result, resistin:adiponectin ratio was higher in obese males, non-obese males and obese females, compared to non-obese females. In a logistic regression model, plasma resistin concentration was a predictor of asthma risk. In a multiple linear regression model, plasma resistin:adiponectin ratio was a negative predictor of FEV1 in asthma. Following weight loss, neither resistin, adiponectin nor resistin:adiponectin ratio was changed. However, the change (∆) in %body fat was associated with ∆ resistin:adiponectin ratio. Post-intervention ∆ resistin was negatively correlated with both ∆FRC and ∆RV.
This study demonstrates that resistin and resistin:adiponectin ratio are higher in asthma and are higher again in subjects who have more severe disease. Resistin:adiponectin ratio is highest in obese male asthmatics. As resistin is a predictor of asthma risk and resistin:adiponectin is a predictor of FEV1 in asthma, these adipokines may be contributing to the obese asthma phenotype, thus providing a potential therapeutic target for obese asthma.
抵抗素和脂联素等脂肪因子可调节炎症，可能会增加肥胖人群患哮喘的风险并加重哮喘病情。
研究哮喘患者与健康对照者血浆中抵抗素及抵抗素与脂联素的比值，（i）比较哮喘患者与健康对照者；（ii）根据哮喘严重程度、肥胖情况和性别进行比较；（iii）观察肥胖哮喘患者体重减轻后的变化。
在一项对成年哮喘患者（n = 96）和健康对照者（n = 46）的横断面观察研究中，检测血浆抵抗素和脂联素水平。在另一项干预研究中，肥胖哮喘成年患者（n = 27）完成了为期10周的体重减轻干预，并分析了血浆抵抗素和脂联素浓度。
与对照组相比，哮喘患者的血浆抵抗素及抵抗素与脂联素的比值更高，且重度哮喘患者高于轻度至中度哮喘患者。在哮喘患者中，抵抗素不受性别或肥胖的影响，而脂联素在男性和肥胖患者中较低。因此，与非肥胖女性相比，肥胖男性、非肥胖男性和肥胖女性的抵抗素与脂联素比值更高。在逻辑回归模型中，血浆抵抗素浓度是哮喘风险的预测指标。在多元线性回归模型中，血浆抵抗素与脂联素的比值是哮喘患者第一秒用力呼气容积（FEV1） 的负性预测指标。体重减轻后，抵抗素、脂联素及抵抗素与脂联素的比值均未改变。然而，体脂百分比的变化（∆）与抵抗素与脂联素比值的变化相关。干预后，∆抵抗素与∆功能残气量（FRC）和∆残气量（RV）均呈负相关。
本研究表明，哮喘患者的抵抗素及抵抗素与脂联素的比值更高，病情越严重者该比值越高。肥胖男性哮喘患者的抵抗素与脂联素比值最高。由于抵抗素是哮喘风险的预测指标，而抵抗素与脂联素的比值是哮喘患者FEV1的预测指标，这些脂肪因子可能与肥胖哮喘表型有关，从而为肥胖哮喘提供了一个潜在的治疗靶点。
