Scott Hayley A, Wood Lisa G, Gibson Peter G
Priority Research Centre for Healthy Lungs, Hunter Medical Research Institute, The University of Newcastle, New Lambton Heights, NSW, 2305, Australia.
School of Biomedical Sciences and Pharmacy, The University of Newcastle, Callaghan, NSW, 2308, Australia.
Curr Allergy Asthma Rep. 2017 Aug;17(8):53. doi: 10.1007/s11882-017-0719-9.
Obesity is a commonly reported comorbidity in asthma, particularly in severe asthma. Obese asthmatics are highly symptomatic with a poor quality of life, despite using high-dose inhaled corticosteroids. While the clinical manifestations have been documented, the aetiologies of obese-asthma remain unclear.
Several potential mechanisms have been proposed, including poor diet quality, physical inactivity and consequent accrual of excess adipose tissue. Each of these factors independently activates inflammatory pathways, potentially exerting effects in the airways. Because the origins of obesity are multifactorial, it is now believed there are multiple obese-asthma phenotypes, with varied aetiologies and clinical consequences. In this review, we will describe the clinical implications of obesity in people with asthma, our current understanding of the mechanisms driving this association and describe recently proposed obese-asthma phenotypes. We will then discuss how asthma management is complicated by obesity, and provide graded recommendations for the management of obesity in this population.
肥胖是哮喘中常见的共病，尤其是在重度哮喘中。尽管使用了高剂量吸入性糖皮质激素，但肥胖哮喘患者症状严重，生活质量较差。虽然临床表现已有记录，但肥胖相关性哮喘的病因仍不清楚。
已经提出了几种潜在机制，包括饮食质量差、缺乏身体活动以及随之而来的过多脂肪组织堆积。这些因素中的每一个都独立激活炎症途径，可能在气道中发挥作用。由于肥胖的起源是多因素的，现在认为存在多种肥胖相关性哮喘表型，其病因和临床后果各不相同。在本综述中，我们将描述肥胖对哮喘患者的临床影响，我们目前对驱动这种关联的机制的理解，并描述最近提出的肥胖相关性哮喘表型。然后，我们将讨论肥胖如何使哮喘管理复杂化，并为该人群的肥胖管理提供分级建议。
