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儿童哮喘与肥胖的动态关系。

The Dynamic Relationship Between Asthma and Obesity in Schoolchildren.

机构信息

Department of Internal Medicine, Division of Epidemiology, School of Medicine, University of Utah, Salt Lake City, Utah.

Department of Family and Preventive Medicine, School of Medicine, University of Utah, Salt Lake City, Utah.

出版信息

Am J Epidemiol. 2020 Jun 1;189(6):583-591. doi: 10.1093/aje/kwz257.

Abstract

Asthma and obesity are among the most prevalent chronic health conditions in children. Although there has been compelling evidence of co-occurrence of asthma and obesity, it is uncertain whether asthma contributes to the development of obesity or obesity contributes to the onset of asthma or both. In this study, we used a joint transition modeling approach with cross-lagged structure to understand how asthma and obesity influence each other dynamically over time. Subjects for this study included 5,193 kindergarten and first-grade students enrolled from 13 communities in 2002-2003 in the Southern California Children's Health Study, with up to 10 years of follow-up. We found that nonobese children with diagnosed asthma at a study visit were at 37% higher odds of becoming obese by the next annual visit compared with children without asthma (odds ratio = 1.38; 95% credible interval: 1.12, 1.71). However, the presence of obesity at the current visit was not statistically significantly associated with asthma onset in the next visit (odds ratio = 1.25; 95% credible interval: 0.94, 1.62). In conclusion, childhood asthma appears to drive an increase in the onset of obesity among schoolchildren, while the onset of obesity does not necessarily imply the future onset of asthma, at least in the short term.

摘要

哮喘和肥胖是儿童中最常见的慢性健康问题之一。尽管有大量证据表明哮喘和肥胖同时发生,但尚不确定哮喘是否导致肥胖的发展,或者肥胖是否导致哮喘的发生,或者两者都有。在这项研究中,我们使用联合转移建模方法和交叉滞后结构来了解哮喘和肥胖如何随着时间的推移动态地相互影响。本研究的对象包括 2002-2003 年在南加州儿童健康研究中来自 13 个社区的 5193 名幼儿园和一年级学生,随访时间长达 10 年。我们发现,与没有哮喘的儿童相比,在研究就诊时被诊断患有哮喘的非肥胖儿童在下一次年度就诊时肥胖的几率高出 37%(优势比=1.38;95%可信区间:1.12,1.71)。然而,目前就诊时的肥胖与下一次就诊时哮喘的发生没有统计学上的显著相关性(优势比=1.25;95%可信区间:0.94,1.62)。总之,儿童哮喘似乎会导致学龄儿童肥胖的发生增加,而肥胖的发生并不一定意味着未来哮喘的发生,至少在短期内是这样。

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