Division of Allergy and Immunology, Department of Internal Medicine, University of South Florida, Morsani College of Medicine, Tampa, Fla.
Division of Allergy and Immunology, Department of Internal Medicine, University of South Florida, Morsani College of Medicine, Tampa, Fla; Department of Internal Medicine, College of Medicine, Umm Al Qura University, Makkah, Saudi Arabia.
J Allergy Clin Immunol Pract. 2021 Nov;9(11):3887-3897. doi: 10.1016/j.jaip.2021.08.027. Epub 2021 Sep 4.
Asthma is a chronic heterogeneous airway disease. Common comorbid conditions are often disproportionately present in severe asthma. Optimal care of patients with asthma requires the recognition and treatment of these comorbid conditions. This review outlines the pathophysiological mechanisms between nonrespiratory comorbid conditions and asthma and their effect on asthma outcomes. They include: type 2 diabetes mellitus, hypertension, atherosclerotic cardiovascular disease, adrenal and thyroid gland diseases, pregnancy, osteoporosis, adverse effects from medications, and mental health disorders. Studies indicate how poor glycemic control of type 2 diabetes mellitus is associated with not only greater health care utilization but poorer asthma outcomes. Also, a large health care claims database indicates that a substantial proportion of pregnant women have uncontrolled asthma and are prescribed suboptimal controller therapy. Additional data about these nonrespiratory comorbidities and medications known to benefit both nonrespiratory comorbidities and asthma are necessary.
哮喘是一种慢性异质性气道疾病。常见的合并症在重度哮喘中常常不成比例地存在。哮喘患者的最佳治疗需要识别和治疗这些合并症。这篇综述概述了非呼吸系统合并症与哮喘之间的病理生理机制及其对哮喘结局的影响。它们包括：2 型糖尿病、高血压、动脉粥样硬化性心血管疾病、肾上腺和甲状腺疾病、妊娠、骨质疏松症、药物的不良反应和精神健康障碍。研究表明，2 型糖尿病患者血糖控制不佳不仅与更高的医疗保健利用率有关，而且与更差的哮喘结局有关。此外，一项大型医疗保健索赔数据库表明，相当一部分孕妇患有未控制的哮喘，并接受了不理想的控制治疗。需要更多关于这些非呼吸系统合并症和已知对非呼吸系统合并症和哮喘都有益的药物的数据。
