van Veen Wilma J, Driessen Jean M M, Kersten Elin T G, van Leeuwen Janneke C, Brusse-Keizer Marjolein G J, van Aalderen Wim M C, Thio Bernard J
Department of Pediatrics, Medisch Spectrum Twente, Enschede, The Netherlands.
University of Groningen, University Medical Center Groningen, Beatrix Children's Hospital, Groningen, The Netherlands.
Pediatr Pulmonol. 2017 Sep;52(9):1130-1134. doi: 10.1002/ppul.23758. Epub 2017 Jul 11.
Exercise induced bronchoconstriction (EIB) is a frustrating morbidity of asthma in children. Obesity has been associated with asthma and with more severe EIB in asthmatic children.
To quantify the effect of BMI on the risk of the occurrence of EIB in children with asthma.
Data were collected from six studies in which exercise challenge tests were performed according to international guidelines. We included 212 Children aged 7-18 years, with a pediatrician-diagnosed mild-to-moderate asthma.
A total of 103 of 212 children (49%) had a positive exercise challenge (fall of FEV ≥ 13%). The severity of EIB, as measured by the maximum fall in FEV , was significantly greater in overweight and obese children compared to normal weight children (respectively 23.9% vs 17.9%; P = 0.045). Asthmatic children with a BMI z-score around +1 had a 2.9-fold higher risk of the prevalence of EIB compared to children with a BMI z-score around the mean (OR 2.9; 95%CI: 1.3-6.1; P < 0.01). An increase in BMI z-score of 0.1 in boys led to a 1.4-fold increased risk of EIB (OR 1.4; 95%CI: 1.0-1.9; P = 0.03). A reduction in pre-exercise FEV was associated with a higher risk of EIB (last quartile six times higher risk compared to highest quartile (OR 6.1 [95%CI 2.5-14.5]).
The severity of EIB is significantly greater in children with overweight and obesity compared to non-overweight asthmatic children. Furthermore, this study shows that the BMI-z-score, even with a normal weight, is strongly associated with the incidence of EIB in asthmatic boys.
运动诱发性支气管收缩（EIB）是儿童哮喘中令人沮丧的一种发病情况。肥胖与哮喘以及哮喘儿童中更严重的EIB有关。
量化体重指数（BMI）对哮喘儿童发生EIB风险的影响。
从六项根据国际指南进行运动激发试验的研究中收集数据。我们纳入了212名7至18岁、经儿科医生诊断为轻度至中度哮喘的儿童。
212名儿童中有103名（49%）运动激发试验呈阳性（第一秒用力呼气容积（FEV）下降≥13%）。与正常体重儿童相比，超重和肥胖儿童中以FEV最大下降幅度衡量的EIB严重程度明显更高（分别为23.9%对17.9%；P = 0.045）。BMI z评分约为+1的哮喘儿童发生EIB的患病率风险比BMI z评分约为平均值的儿童高2.9倍（比值比[OR]2.9；95%置信区间[CI]：1.3 - 6.1；P < 0.01）。男孩的BMI z评分每增加0.1，EIB风险增加1.4倍（OR 1.4；95%CI：1.0 - 1.9；P = 0.03）。运动前FEV的降低与EIB风险较高相关（最后四分位数的风险是最高四分位数的六倍[OR 6.1[95%CI 2.5 - 14.5]）。
与非超重哮喘儿童相比，超重和肥胖儿童的EIB严重程度明显更高。此外，本研究表明，即使体重正常，BMI - z评分也与哮喘男孩中EIB的发生率密切相关。
