Division of Pulmonary and Critical Care Medicine, East Carolina University, Greenville, NC, USA.
Division of Pulmonary and Critical Care Medicine, University of Michigan, 300 N Ingalls St Ste 2C40, Ann Arbor, MI, 48109, USA.
Curr Allergy Asthma Rep. 2019 Sep 10;19(10):49. doi: 10.1007/s11882-019-0877-z.
Rising costs and increasing morbidity makes the identification and treatment of high-risk asthma phenotypes important. In this review, we outline the complex relationship between obesity and asthma.
Studies have confirmed a bi-directional relationship between obesity and asthma. Pathophysiological factors implicated include genetic risk, the effect of diet and microbiome, and obesity-related cytokines. There have been robust, albeit derived, efforts to phenotype this group with distinct clinical presentations based on age of onset of asthma. Unfortunately, the poor performance of biomarkers and traditional lung function testing has impeded diagnosis, phenotyping, and management of the obese asthma patient. There is also a lack of targeted interventions with weight loss showing some benefits. Obesity increases the prevalence of asthma and is associated with worse outcomes. There are unique research and clinical challenges while managing this group of patients.
不断上涨的医疗成本和日益增加的发病率使得识别和治疗高危哮喘表型变得非常重要。在这篇综述中,我们概述了肥胖和哮喘之间复杂的关系。
研究已经证实肥胖和哮喘之间存在双向关系。涉及的病理生理因素包括遗传风险、饮食和微生物组的影响以及与肥胖相关的细胞因子。尽管是衍生的,但已经有大量的努力根据哮喘发病年龄来对该群体进行表型分析,得出不同的临床表现。不幸的是,生物标志物和传统肺功能检测的性能不佳,阻碍了肥胖哮喘患者的诊断、表型分析和管理。缺乏针对体重减轻的靶向干预措施也显示出一些益处。肥胖增加了哮喘的患病率,并与更差的预后相关。在管理这群患者时存在独特的研究和临床挑战。