Occupational and Environmental Medicine, Telemark Hospital, Skien, Norway
Institute of Clinical Medicine, University of Oslo Faculty of Medicine, Oslo, Norway.
BMJ Open Respir Res. 2021 Sep;8(1). doi: 10.1136/bmjresp-2021-000932.
Although asthma and obesity are each associated with adverse respiratory outcomes, a possible interaction between them is less studied. This study assessed the extent to which asthma and overweight/obese status were independently associated with respiratory symptoms, lung function, Work Ability Score (WAS) and sick leave; and whether there was an interaction between asthma and body mass index (BMI) ≥25 kg/m regarding these outcomes.
In a cross-sectional study, 626 participants with physician-diagnosed asthma and 691 without asthma were examined. All participants completed a questionnaire and performed spirometry. The association of outcome variables with asthma and BMI category were assessed using regression models adjusted for age, sex, smoking status and education.
Asthma was associated with reduced WAS (OR=1.9 (95% CI 1.4 to 2.5)), increased sick leave in the last 12 months (OR=1.4 (95% CI 1.1 to 1.8)) and increased symptom score (OR=7.3 (95% CI 5.5 to 9.7)). Obesity was associated with an increased symptom score (OR=1.7 (95% CI 1.2 to 2.4)). Asthma was associated with reduced prebronchodilator and postbronchodilator forced expiratory volume in 1 s (FEV) (β=-6.6 (95% CI -8.2 to -5.1) and -5.2 (95% CI -6.7 to -3.4), respectively) and prebronchodilator forced vital capacity (FVC) (β=-2.3 (95% CI -3.6 to -0.96)). Obesity was associated with reduced prebronchodilator and postbronchodilator FEV (β=-2.9 (95% CI -5.1 to -0.7) and -2.8 (95% CI -4.9 to -0.7), respectively) and FVC (-5.2 (95% CI -7.0 to -3.4) and -4.2 (95% CI -6.1 to -2.3), respectively). The only significant interaction was between asthma and overweight status for prebronchodilator FVC (β=-3.6 (95% CI -6.6 to -0.6)).
Asthma and obesity had independent associations with increased symptom scores, reduced prebronchodilator and postbronchodilator FEV and reduced prebronchodilator FVC. Reduced WAS and higher odds of sick leave in the last 12 months were associated with asthma, but not with increased BMI. Besides a possible association with reduced FVC, we found no interactions between asthma and increased BMI.
尽管哮喘和肥胖症都与不良的呼吸结果有关，但它们之间的相互作用研究较少。本研究评估了哮喘和超重/肥胖状态与呼吸症状、肺功能、工作能力评分（WAS）和病假之间的独立相关性；并评估了哮喘和 BMI≥25kg/m 之间是否存在交互作用。
在一项横断面研究中，检查了 626 名经医生诊断患有哮喘的参与者和 691 名无哮喘的参与者。所有参与者完成了一份问卷并进行了肺功能检查。使用调整年龄、性别、吸烟状况和教育程度的回归模型评估了与结局变量相关的哮喘和 BMI 类别的相关性。
哮喘与 WAS 降低（OR=1.9（95%CI 1.4 至 2.5））、过去 12 个月病假增加（OR=1.4（95%CI 1.1 至 1.8））和症状评分增加（OR=7.3（95%CI 5.5 至 9.7））有关。肥胖与症状评分增加有关（OR=1.7（95%CI 1.2 至 2.4））。哮喘与支气管扩张前和支气管扩张后用力呼气 1 秒量（FEV1）降低有关（β=-6.6（95%CI-8.2 至-5.1）和-5.2（95%CI-6.7 至-3.4）），支气管扩张前用力肺活量（FVC）降低（β=-2.3（95%CI-3.6 至-0.96））。肥胖与支气管扩张前和支气管扩张后 FEV1 降低有关（β=-2.9（95%CI-5.1 至-0.7）和-2.8（95%CI-4.9 至-0.7）），FVC 降低（β=-5.2（95%CI-7.0 至-3.4）和-4.2（95%CI-6.1 至-2.3））。唯一具有统计学意义的交互作用是哮喘和超重状态对支气管扩张前 FVC 的影响（β=-3.6（95%CI-6.6 至-0.6））。
哮喘和肥胖症与症状评分增加、支气管扩张前和支气管扩张后 FEV1 降低以及支气管扩张前 FVC 降低有关。WAS 降低和过去 12 个月病假较高与哮喘有关，而与 BMI 增加无关。除了与 FVC 降低的可能关联外，我们没有发现哮喘和 BMI 增加之间的相互作用。
