Çelebi Sözener Zeynep, Çiftci Fatma, Aydın Ömür, Mungan Dilşad
Division of Immunology and Allergy Diseases, Department of Chest Diseases, Faculty of Medicine, Ankara University, Ankara, Turkey.
Department of Chest Diseases, Faculty of Medicine, Ankara University, Ankara, Turkey.
Tuberk Toraks. 2018 Dec;66(4):288-296. doi: 10.5578/tt.67629.
Asthma is a heterogeneous and chronic inflamatory disease that can accompany many comorbidities during the course. It is thought that different comorbidities are seen in different phenotypes of asthma. Our aim is to establish the relationship between systemic comorbidities seen in asthmatic patients and asthma control, severity and phenotypes.
Patients who were followed up with asthma diagnosis in Polyclinics of Ankara University Faculty of Medicine Department of Immunology and Allergy Diseases were questioned about demographic characteristics. Their control status and disease severity were determined. They were classified whether r atopic, eosinophilic or obese. Systemic comorbidities were questioned and Charlson comorbidity indices (CCI) were calculated. The difference between the groups in the terms of CCI was evaluated.
Two hundred and twenty-nine patients (29E/200K, 12.7%/87.3%) with a mean age of 51.25 ± 12.02 were included in the study. CCI was significantly higher in patients without asthma control than in those with partial control and well control (CCI: 2.22, 1.69, 1.50, respectively) (p= 0.03). There was also a linear correlation between asthma severity and CCI (CC: 0.22, p= 0.001). Allergic comorbidities were more frequent in the eosinophilic phenotype (p= 0.01) (OR: 2.20, 95% CI: 1.2-3.8) but did not increase the likelihood of accompanying systemic comorbidity (OR: 1.05, 95% CI: 0.8-1.2) (p> 0.05). The likelihood of systemic comorbidity, especially HT, coroner artery diseases, depression, was higher in nonatopics than in atopic patients (OR: 2.039 95% CI: 1.04.11) (p= 0.03). Obesity was found to be a risk factor for systemic comorbidities (OR: 1.36 %95 C1: 1.09-1.84) (p= 0.04).
Severe, uncontrolled, obese or nonatopic asthma patients should be examined for systemic comorbidities. There is a need for further study to assess the relationship between treatment of established comorbidities and asthma course.
哮喘是一种异质性慢性炎症性疾病,在病程中可伴有多种合并症。人们认为,不同的哮喘表型会出现不同的合并症。我们的目的是确定哮喘患者出现的全身性合并症与哮喘控制、严重程度及表型之间的关系。
对在安卡拉大学医学院免疫学与过敏疾病科门诊接受哮喘诊断随访的患者进行人口统计学特征询问。确定他们的控制状态和疾病严重程度。将他们分类为是否为特应性、嗜酸性粒细胞性或肥胖型。询问全身性合并症情况并计算查尔森合并症指数(CCI)。评估各亚组在CCI方面的差异。
229例患者(29例嗜酸性粒细胞性/200例非嗜酸性粒细胞性,12.7%/87.3%)纳入研究,平均年龄为51.25±12.02岁。未控制哮喘的患者CCI显著高于部分控制和良好控制的患者(CCI分别为:2.22、1.69、1.50)(p=0.03)。哮喘严重程度与CCI之间也存在线性相关性(CC:0.22,p=0.001)。嗜酸性粒细胞表型的患者过敏性合并症更常见(p=0.01)(OR:2.20,95%CI:1.2 - 3.8),但并未增加全身性合并症的发生可能性(OR:1.05,95%CI:0.8 - 1.2)(p>0.05)。非特应性患者发生全身性合并症的可能性,尤其是高血压、冠状动脉疾病、抑郁症,高于特应性患者(OR:2.039,95%CI:1.04 - 1.1)(p=0.03)。肥胖被发现是全身性合并症的一个危险因素(OR:1.36,95%CI:1.09 - 1.