From the Department of Pulmonology, Franciscus Gasthuis en Vlietland, Rotterdam, the Netherlands.
Department of Pulmonology, Northwest Hospital Group, Alkmaar, the Netherlands.
Allergy Asthma Proc. 2021 May 1;42(3):e71-e76. doi: 10.2500/aap.2021.42.210020.
Adults with a high body mass index (BMI) have an increased risk of developing asthma. To explore the impact of increased lipids on the presence of asthma, this study investigated the relationship between lipid levels and inflammatory markers in patients with asthma and controls with obesity. We hypothesized that higher lipid levels are more prevalent in patients with obesity and asthma. In this explorative cohort study, 96 patients with asthma and 45 controls were included. All the patients participated in one of three asthma studies; two of these studies included only patients with obesity. An asthma diagnosis was defined by the presence of typical clinical symptoms, reversible airway obstruction (+12% improvement in forced expiratory volume in the first second of expiration after bronchodilator), or bronchial hyperreactivity (Histamine PC20 < 8 mg/mL), or a fractional exhaled nitric oxide of > 50 ppb. We compared lipid levels and neutrophils and eosinophils in patients with asthma and the controls with a wide BMI range (17.8-63.8 kg/m²). Multivariable logistic regression was used to analyze the data. Serum triglycerides were statistically significantly higher in patients with obesity and asthma adjusted for BMI, blood eosinophils, and statin use (odds ratio [OR] 2.56 [95% confidence interval, 1.34-4.88]; p = 0.004). Inclusion or exclusion of those who used long-acting β2-agonists and inhaled corticosteroids led to comparable adjusted ORs for blood triglyceride and blood eosinophils levels. Elevated serum triglycerides were associated with the presence of asthma in patients with obesity. This indicated that elevated triglycerides might be a yet unrecognized trait that contributed to the development of asthma. The precise cause and effect of these high triglyceride levels in the patients with asthma and with obesity were not determined in this study.Clinical trial Trial registration NCT03278561,
成年人的身体质量指数（BMI）较高，患哮喘的风险增加。为了探究脂质增加对哮喘存在的影响，本研究调查了哮喘患者和肥胖对照组中脂质水平与炎症标志物之间的关系。我们假设肥胖和哮喘患者中脂质水平升高更为普遍。在这项探索性队列研究中，纳入了 96 名哮喘患者和 45 名对照组。所有患者均参加了三项哮喘研究中的一项；其中两项研究仅纳入了肥胖患者。哮喘的诊断定义为存在典型的临床症状、气道可逆性阻塞（支气管扩张剂后第一秒用力呼气量增加 12%）或支气管高反应性（组胺 PC20＜8mg/mL）或呼气一氧化氮分数＞50ppb。我们比较了哮喘患者和 BMI 范围较宽（17.8-63.8kg/m²）的对照组之间的脂质水平和中性粒细胞及嗜酸性粒细胞。采用多变量逻辑回归分析数据。在校正 BMI、血嗜酸性粒细胞和他汀类药物使用后，肥胖合并哮喘患者的血清甘油三酯显著高于对照组（比值比[OR] 2.56[95%置信区间，1.34-4.88]；p=0.004）。纳入或排除长期使用β2-受体激动剂和吸入皮质激素的患者，对血甘油三酯和血嗜酸性粒细胞水平的校正 OR 相似。血清甘油三酯升高与肥胖患者哮喘的存在相关。这表明，升高的甘油三酯可能是一种尚未被认识的特征，有助于哮喘的发生。本研究未确定哮喘和肥胖患者中这些高甘油三酯水平的确切原因和影响。
