Universidade Estadual do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
Rev Paul Pediatr. 2020 Nov 6;39:e2019405. doi: 10.1590/1984-0462/2021/39/2019405. eCollection 2020.
Asthma and obesity are prevalent and interrelated diseases. In the pediatric population, the effect of systemic inflammation associated to obesity, leading to inflammation of the airways, is currently controversial. Our aim was to compare inflammatory, clinical and spirometric patterns between children with asthma and obesity and those within the normal weight status range.
A total of 79 boys and girls from 6 to 10 years old were selected and divided into four groups: obese asthmatics, non-obese asthmatics, obese non-asthmatics, and non-obese non-asthmatics. In addition to collecting clinical and anthropometric data, all children underwent spirometry and skin prick tests for inhalant allergens. Blood samples for measurement of cytokines and adipokines were also collected.
Obese asthmatics had significantly worse control of asthma than non-obese asthmatics (OR 4.9; 95%CI 1.1‒22.1), regardless of sex, physical activity and atopy. No differences in spirometry, Th1 and Th2 cytokines and adipokines levels were observed among the four groups. The prick tests were positive in 81.8 and 80% of non-obese asthmatics and obese asthmatics, respectively.
The degree of control of asthma was significantly lower in the obese group, regardless of the findings of no differences in spirometry. Extra-pulmonary factors could be responsible for this symptomatic profile. High positivity of skin test in both groups, which is considered a good marker of atopy, shows a preponderant atopic component in the genesis of asthma, both in children with obesity and in those within the normal weight status.
哮喘和肥胖是常见且相互关联的疾病。在儿科人群中,与肥胖相关的系统性炎症对气道炎症的影响目前仍存在争议。我们的目的是比较肥胖哮喘儿童与正常体重儿童在炎症、临床和肺功能方面的差异。
共纳入 79 名 6 至 10 岁的男孩和女孩,分为四组:肥胖哮喘组、非肥胖哮喘组、肥胖非哮喘组和非肥胖非哮喘组。除收集临床和人体测量数据外,所有儿童均进行肺功能检查和吸入性过敏原皮肤点刺试验。还采集血液样本以测量细胞因子和脂肪因子。
肥胖哮喘患者的哮喘控制情况明显差于非肥胖哮喘患者(OR 4.9;95%CI 1.1‒22.1),无论性别、体力活动和特应性如何。四组间肺功能、Th1 和 Th2 细胞因子及脂肪因子水平无差异。非肥胖哮喘组和肥胖哮喘组的皮肤点刺试验阳性率分别为 81.8%和 80%。
无论肺功能是否存在差异,肥胖组的哮喘控制程度明显较低。肺外因素可能是导致这种症状表现的原因。两组的皮肤试验阳性率均较高(被认为是特应性的良好标志物),表明肥胖和正常体重儿童的哮喘发病机制中均存在特应性成分。