Lochte Lene, Nielsen Kim G, Petersen Poul Erik, Platts-Mills Thomas A E
Department of Odontology, University of Copenhagen, Copenhagen, 1014, Denmark.
Department of Pediatrics and Adolescent Medicine, Copenhagen University Hospital, Rigshospitalet, Copenhagen, 2100, Denmark.
BMC Pediatr. 2016 Apr 18;16:50. doi: 10.1186/s12887-016-0571-4.
Childhood asthma is a global problem affecting the respiratory health of children. Physical activity (PA) plays a role in the relationship between asthma and respiratory health. We hypothesized that a low level of PA would be associated with asthma in children and adolescents. The objectives of our study were to (1) summarize the evidence available on associations between PA and asthma prevalence in children and adolescents and (2) assess the role of PA in new-onset or incident asthma among children and adolescents.
We searched Medline, the Cochrane Library, and Embase and extracted data from original articles that met the inclusion criteria. Summary odds ratios (ORs) and confidence intervals (CIs) were used to express the results of the meta-analysis (forest plot). We explored heterogeneity using funnel plots and the Graphic Appraisal Tool for Epidemiology (GATE).
We retrieved 1,571 titles and selected 11 articles describing three cohort and eight cross-sectional studies for inclusion. A meta-analysis of the cohort studies revealed a risk of new-onset asthma in children with low PA (OR [95 % CI] 1.32 [0.95; 1.84] [random effects] and 1.35 [1.13; 1.62] [fixed effects]). Three cross-sectional studies identified significant positive associations between childhood asthma or asthma symptoms and low PA.
Children and adolescents with low PA levels had an increased risk of new-onset asthma, and some had a higher risk of current asthma/or wheezing; however, there was some heterogeneity among the studies. This review reveals a critical need for future longitudinal assessments of low PA, its mechanisms, and its implications for incident asthma in children. The systematic review was prospectively registered at PROSPERO (registration number: CRD42014013761; available at: http://www.crd.york.ac.uk/PROSPERO [accessed: 24 March 2016]).
儿童哮喘是一个影响儿童呼吸健康的全球性问题。体育活动（PA）在哮喘与呼吸健康的关系中发挥着作用。我们假设低水平的体育活动与儿童和青少年哮喘有关。我们研究的目的是：（1）总结关于体育活动与儿童和青少年哮喘患病率之间关联的现有证据；（2）评估体育活动在儿童和青少年新发或偶发性哮喘中的作用。
我们检索了医学文献数据库（Medline）、考克兰图书馆（Cochrane Library）和荷兰医学文摘数据库（Embase），并从符合纳入标准的原始文章中提取数据。汇总比值比（OR）和置信区间（CI）用于表达荟萃分析（森林图）的结果。我们使用漏斗图和流行病学图形评估工具（GATE）探索异质性。
我们检索到1571篇文章标题，选择了11篇描述三项队列研究和八项横断面研究的文章纳入分析。对队列研究的荟萃分析显示，体育活动水平低的儿童新发哮喘的风险（随机效应模型的OR[95%CI]为1.32[0.95；1.84]，固定效应模型的OR为1.35[1.13；1.62]）。三项横断面研究确定儿童哮喘或哮喘症状与低水平体育活动之间存在显著正相关。
体育活动水平低的儿童和青少年新发哮喘的风险增加，一些人患当前哮喘/或喘息的风险更高；然而，研究之间存在一些异质性。本综述表明，未来迫切需要对低水平体育活动及其机制以及对儿童偶发性哮喘的影响进行纵向评估。该系统评价已在国际前瞻性系统评价注册库（PROSPERO）进行前瞻性注册（注册号：CRD42014013761；可在http://www.crd.york.ac.uk/PROSPERO获取[访问日期：2016年3月24日]）。
