Health Sciences Post-graduation Program, Universidade Federal de Pernambuco, Recife, Pernambuco, Brazil.
Center for Allergy and Clinical Immunology Research at Hospital das Clínicas, Universidade Federal de Pernambuco, Recife, Pernambuco, Brazil.
Pediatr Pulmonol. 2020 Aug;55(8):1916-1923. doi: 10.1002/ppul.24875. Epub 2020 Jun 7.
Exercise-induced bronchospasm (EIB) is common in young asthmatics and obesity is becoming an epidemic in this population. Both conditions can give rise to or worsen respiratory symptoms upon exercise and may interfere with recreational and sports activities.
To investigate the association between obesity and the risk and severity of EIB in asthmatic children and adolescents.
This study included data from asthmatic patients aged between 7 and 19 years undergoing treadmill running tests to evaluate EIB, defined as a reduction greater than or equal to 10% in forced expiratory volume in the first second (FEV ) compared to baseline. Eutrophic, obese, and overweight individuals were categorized according to body mass index z-score (eutrophic, -0.5 < z ≤ 1; overweight, 1 < z < 2; and obese, z ≥ 2).
Of the 156 individuals studied (42% female), 58% were eutrophic, 22% overweight, and 19% obese. Seventy-three individuals (47%) presented with EIB, with higher risk among obese (OR, 2.86; 95% CI, 1.00-8.14; P = .05). Asthma severity was another independent risk factor for EIB (OR, 2.95; 95% CI, 1.36-6.42; P = .006). The number of patients in whom FEV returned to baseline values (difference less than 10% from baseline) at the 13th minute after challenge was lower in obese individuals compared to eutrophic and overweight ones (P = .04). Baseline FEV , gender, or age were not found to be risk factors for EIB in any of the groups.
Obese youngsters with asthma present a greater risk for EIB with slower recovery than their nonobese peers. Clinicians should be aware of this association, especially in those with more severe disease, for adequate recognition and treatment.
运动诱发性支气管痉挛（EIB）在年轻哮喘患者中很常见，而肥胖在该人群中正成为一种流行疾病。这两种情况都可能在运动时引发或加重呼吸道症状，并可能影响到他们的娱乐和体育活动。
调查肥胖与哮喘患儿和青少年 EIB 风险和严重程度之间的关系。
这项研究纳入了年龄在 7 至 19 岁之间、接受跑步机跑步测试以评估 EIB 的哮喘患者的数据。EIB 定义为与基线相比，用力呼气第一秒容积（FEV ）下降≥ 10%。根据体重指数 z 分数（体健，-0.5<z≤1；超重，1<z<2；肥胖，z≥2），将营养良好、肥胖和超重的个体分类。
在所研究的 156 名个体中（42%为女性），58%为体健，22%为超重，19%为肥胖。73 名（47%）个体出现 EIB，肥胖个体的风险更高（比值比，2.86；95%置信区间，1.00-8.14；P=0.05）。哮喘严重程度也是 EIB 的另一个独立危险因素（比值比，2.95；95%置信区间，1.36-6.42；P=0.006）。与体健和超重个体相比，肥胖个体在挑战后 13 分钟时，FEV 恢复至基线值（与基线相比差异小于 10%）的患者人数更少（P=0.04）。在任何一组中，FEV 基线值、性别或年龄均不是 EIB 的危险因素。
与非肥胖同龄人相比，肥胖的哮喘青少年出现 EIB 的风险更高，且恢复速度更慢。临床医生应意识到这种关联，尤其是在疾病更严重的患者中，以便进行充分的识别和治疗。
