Barros R, Moreira P, Padrão P, Teixeira V H, Carvalho P, Delgado L, Moreira A
Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal.
Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal; Research Centre on Physical Activity and Health, University of Porto, Porto, Portugal; EPI Unit, Public Health Institute, University of Porto, Porto, Portugal.
Clin Nutr. 2017 Aug;36(4):1068-1074. doi: 10.1016/j.clnu.2016.06.023. Epub 2016 Jul 9.
BACKGROUND & AIMS: We aimed to explore the association between obesity and asthma prevalence, incidence and severity.
The study included 32,644 adults, 52.6% female, from a representative sample of the 4th Portuguese National Health Survey. The following asthma definitions were used: ever asthma (ever medical doctor asthma diagnosis), current asthma (asthma within the last 12 months), current persistent asthma (required asthma medication within the last 12 months), current severe asthma (attending an emergency department because of asthma within the last 12 months), and incident asthma (asthma diagnosis within the last 12 months). Body mass index was calculated based on self-reported weight and height and categorised according to WHO classification. Logistic regression models adjusted for confounders were performed.
Prevalence of ever asthma was 5.3%, current asthma 3.5%, current persistent asthma 3.0%, current severe asthma 1.4%, and incident asthma 0.2%. Prevalence of obesity was 16%, overweight 37.6%, normal weight 44.6% and underweight 0.2%. Being overweight, obesity class I and II, and obesity class III were associated with an OR (95% CI) with ever asthma 1.22 (1.21-1.24), 1.39 (1.36-1.41), 3.24 (3.08-3.40) respectively; current asthma 1.16 (1.14-1.18), 1.86 (1.82-1.90), 4.73 (4.49-4.98) respectively; current persistent asthma 1.08 (1.06-1.10), 2.06 (2.01-2.10), 5.24 (4.96-5.53), and current severe asthma 1.36 (1.32-1.40), 1.50 (1.45-1.55) and 3.70 (3.46-3.95), respectively. Considering the incidence of asthma, obesity more than quadrupled the odds (OR = 4.46, 95% CI 4.30, 4.62).
Obesity is associated in a dose dependent way with an increase of prevalent and incident asthma, and it seems to increase the odds of a more persistent and severe asthma phenotype independently of socio-demographic determinants, physical activity, and dietary patterns. Our results provide rational for future lifestyle intervention studies for weight reduction in the obesity-asthma phenotype.
我们旨在探究肥胖与哮喘患病率、发病率及严重程度之间的关联。
该研究纳入了来自葡萄牙第四次全国健康调查代表性样本的32644名成年人，其中52.6%为女性。采用了以下哮喘定义：曾患哮喘（曾被医生诊断为哮喘）、现患哮喘（过去12个月内患哮喘）、现患持续性哮喘（过去12个月内需要使用哮喘药物）、现患重度哮喘（过去12个月内因哮喘前往急诊科就诊）以及新发哮喘（过去12个月内被诊断为哮喘）。根据自我报告的体重和身高计算体重指数，并按照世界卫生组织的分类进行归类。进行了调整混杂因素的逻辑回归模型分析。
曾患哮喘的患病率为5.3%，现患哮喘为3.5%，现患持续性哮喘为3.0%，现患重度哮喘为1.4%，新发哮喘为0.2%。肥胖患病率为16%，超重为37.6%，正常体重为44.6%，体重过轻为0.2%。超重、I级肥胖、II级肥胖和III级肥胖与曾患哮喘的比值比（95%置信区间）分别为1.22（1.21 - 1.24）、1.39（1.36 - 1.41）、3.24（3.08 - 3.40）；与现患哮喘的比值比分别为1.16（1.14 - 1.18）、1.86（1.82 - 1.90）、4.73（4.49 - 4.98）；与现患持续性哮喘的比值比分别为1.08（1.06 - 1.10）、2.06（2.01 - 2.10）、5.24（4.96 - 5.53）；与现患重度哮喘的比值比分别为1.36（1.32 - 1.40）、1.50（1.45 - 1.55）、3.70（3.46 - 3.95）。就哮喘发病率而言，肥胖使患病几率增加了四倍多（比值比 = 4.46，95%置信区间4.30，4.62）。
肥胖与哮喘患病率和发病率的增加呈剂量依赖性关联，并且似乎独立于社会人口学决定因素、身体活动和饮食模式增加了更持续性和重度哮喘表型的患病几率。我们的结果为未来针对肥胖 - 哮喘表型进行减重的生活方式干预研究提供了依据。
