Selge Charlotte, Thomas Silke, Nowak Dennis, Radon Katja, Wolfarth Bernd
Department of Neurology, University Hospital Munich (LMU), Munich, Germany.
Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, University Hospital Munich (LMU), Munich, Germany.
Respir Med. 2016 Sep;118:15-21. doi: 10.1016/j.rmed.2016.07.008. Epub 2016 Jul 14.
Prevalence of asthma in elite athletes shows very wide ranges. It remains unclear to what extent this is influenced by the competition season (winter vs. summer) or the ventilation rate achieved during competition. The aim of this study was to evaluate prevalence of asthma in German elite winter and summer athletes from a wide range of sport disciplines and to identify high risk groups.
In total, 265 German elite winter athletes (response 77%) and 283 German elite summer athletes (response 64%) answered validated respiratory questionnaires. Using logistic regression, the asthma risks associated with competition season and ventilation rate during competition, respectively, were investigated. A subset of winter athletes was also examined for their FENO-levels and lung function.
With respect to all asthma outcomes, no association was found with the competition season. Regarding the ventilation rate, athletes in high ventilation sports were at increased risk of asthma, as compared to athletes in low ventilation sports (doctors' diagnosed asthma: OR 2.32, 95% CI 1.19-4.53; use of asthma medication: OR 4.46, 95% CI 1.52-13.10; current wheeze or use of asthma medication: OR 2.78, 95% CI 1.34-5.76). Athletes with doctors' diagnosed asthma were at an approximate four-fold risk of elevated FENO-values.
The clinically relevant finding of this study is that athletes' asthma seems to be more common in sports with high ventilation during competition, whereas the summer or winter season had no impact on the frequency of the disease. Among winter athletes, elevated FENO suggested suboptimal control of asthma.
精英运动员中哮喘的患病率范围很广。目前尚不清楚这在多大程度上受比赛季节(冬季与夏季)或比赛期间达到的通气率影响。本研究的目的是评估来自广泛体育项目的德国精英冬季和夏季运动员中哮喘的患病率,并确定高危人群。
共有265名德国精英冬季运动员(应答率77%)和283名德国精英夏季运动员(应答率64%)回答了经过验证的呼吸问卷。使用逻辑回归分别研究与比赛季节和比赛期间通气率相关的哮喘风险。还对一部分冬季运动员进行了呼出气一氧化氮(FENO)水平和肺功能检查。
就所有哮喘结局而言,未发现与比赛季节有关联。关于通气率,与低通气运动项目的运动员相比,高通气运动项目的运动员患哮喘的风险增加(医生诊断的哮喘:比值比[OR]2.32,95%置信区间[CI]1.19 - 4.53;使用哮喘药物:OR 4.46,95% CI 1.52 - 13.10;当前喘息或使用哮喘药物:OR 2.78,95% CI 1.34 - 5.76)。医生诊断为哮喘的运动员FENO值升高的风险约为四倍。
本研究具有临床意义的发现是,运动员哮喘在比赛期间通气量高的运动项目中似乎更常见,而夏季或冬季季节对该病的发生频率没有影响。在冬季运动员中,FENO升高提示哮喘控制欠佳。