Koebnick Corinna, Fischer Heidi, Daley Matthew F, Ferrara Assiamira, Horberg Michael A, Waitzfelder Beth, Young Deborah Rohm, Gould Michael K
Department of Research and Evaluation, Kaiser Permanente Southern California, 100 S. Los Robles, 2nd Floor, Pasadena, CA 91101 USA.
Institute for Health Research, Kaiser Permanente Colorado, 10065 E. Harvard Street Suite 300, Denver, CO 80231 USA.
Allergy Asthma Clin Immunol. 2016 Oct 19;12:50. doi: 10.1186/s13223-016-0155-8. eCollection 2016.
To improve care and control for patients with adult-onset asthma, a better understanding of determinants of their risk and outcomes is important. We investigated how associations between asthma, asthma control and obesity may be modified by patient demographic characteristics.
This retrospective study of adults enrolled in several health plans across the U.S. (n = 2,860,305) examined the interacting effects of obesity, age, race, and sex on adult-onset asthma and asthma control. Multivariable adjusted Cox and logistic regression models estimated hazard ratios (HR), and 95 % confidence intervals (CI) for the associations between body mass index (BMI) and study outcomes, and interactions of BMI with demographic characteristics.
Compared with individuals who had a BMI <25 kg/m, the hazard of adult-onset asthma progressively increased with increasing BMI, from a 12 % increase among persons with a BMI of 25.0-29.9 kg/m (HR 1.12, 95 % CI 1.10, 1.14) to an almost 250 % increase among persons with a BMI ≥50 kg/m (HR 2.49, 95 % CI 2.38, 2.60). The magnitude of the association between obesity and asthma risk was greater for women (compared with men) and lower for Blacks (compared with non-Hispanic Whites). Among individuals with asthma, obesity was associated with poorly controlled and high-risk asthma.
The present study demonstrates that the magnitude of the associations between obesity and adult-onset asthma incidence and control are modified by race, age, and sex. Understanding the role of obesity in the development of adult-onset asthma will help to improve asthma treatment algorithms and to develop targeted interventions.
为改善成人哮喘患者的护理与控制，更好地了解其风险及预后的决定因素至关重要。我们研究了哮喘、哮喘控制与肥胖之间的关联如何因患者人口统计学特征而改变。
这项对美国多个健康计划中登记的成年人进行的回顾性研究（n = 2,860,305），考察了肥胖、年龄、种族和性别对成人哮喘及哮喘控制的交互作用。多变量调整后的Cox和逻辑回归模型估计了体重指数（BMI）与研究结局之间关联的风险比（HR）及95%置信区间（CI），以及BMI与人口统计学特征的交互作用。
与BMI<25kg/m²的个体相比，成人哮喘风险随BMI升高而逐渐增加，BMI为25.0 - 29.9kg/m²的人群风险增加12%（HR 1.12，95%CI 1.10, 1.14），而BMI≥50kg/m²的人群风险几乎增加250%（HR 2.49，95%CI 2.38, 2.60）。肥胖与哮喘风险之间的关联程度女性（与男性相比）更大，黑人（与非西班牙裔白人相比）更低。在哮喘患者中，肥胖与哮喘控制不佳及高风险哮喘相关。
本研究表明，肥胖与成人哮喘发病率及控制之间关联的程度因种族、年龄和性别而改变。了解肥胖在成人哮喘发病中的作用将有助于改进哮喘治疗方案并制定针对性干预措施。
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