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肥胖与结节病:是后果还是促成因素?

Obesity and sarcoidosis: consequence or contributor?

机构信息

Slone Epidemiology Center at Boston University.

Department of Medicine, Pulmonary, Allergy, Sleep & Critical Care Medicine, Boston University School of Medicine.

出版信息

Curr Opin Pulm Med. 2018 Sep;24(5):487-494. doi: 10.1097/MCP.0000000000000503.

Abstract

PURPOSE OF REVIEW

Sarcoidosis is a multisystem disease of unknown cause. Obesity can affect many physiological factors. The relationship between obesity and sarcoidosis is unclear, and can been described as posing a 'chicken and egg' scenario for the patient as it is not always clear whether it is a consequence of, or a risk factor for any disease. The purpose of this review is to examine the dual roles of obesity on sarcoidosis morbidity and the incidence.

RECENT FINDINGS

Obesity magnifies the symptoms of sarcoidosis and corticosteroid therapy increases BMI. Prospective epidemiologic studies started to explore the role of obesity as a potential risk factor for sarcoidosis. Three studies in the United States, and one study in Denmark, have demonstrated significantly increased risks of sarcoidosis among obese compared with nonobese patients; risk estimates ranged from 1.42 [95% confidence interval (CI), 1.07-1.89] to 3.59 (95% CI, 2.31-5.57).

SUMMARY

Obesity can be both a consequence of sarcoidosis treatment, and a contributor to disease risk likely through the pro-inflammatory environment of obesity. Prospective epidemiologic cohort studies are needed to explore the cause of sarcoidosis and insight into possible avenues of treatment development and prevention.

摘要

目的综述

结节病是一种病因不明的多系统疾病。肥胖会影响许多生理因素。肥胖与结节病之间的关系尚不清楚,可以用“先有鸡还是先有蛋”的情景来描述患者,因为尚不清楚肥胖是疾病的结果还是危险因素。本文的目的是探讨肥胖对结节病发病率和发病的双重作用。

最近的发现

肥胖症会加重结节病的症状,皮质类固醇治疗会增加 BMI。前瞻性的流行病学研究开始探讨肥胖作为潜在的结节病危险因素的作用。美国的三项研究和丹麦的一项研究表明,与非肥胖患者相比,肥胖患者患结节病的风险显著增加;风险估计值范围从 1.42(95%置信区间[CI],1.07-1.89)到 3.59(95%CI,2.31-5.57)。

总结

肥胖可能是结节病治疗的结果,也可能是通过肥胖的促炎环境导致疾病风险的因素。需要进行前瞻性的流行病学队列研究,以探讨结节病的病因,并深入了解可能的治疗开发和预防途径。

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