de Boer Geertje M, Tramper-Stranders Gerdien A, Houweling Laura, van Zelst Cathelijne M, Pouw Nadine, Verhoeven Gert T, Boxma-de Klerk Bianca M, In 't Veen Johannes C C M, van Rossum Elisabeth F C, Hendriks Rudi W, Braunstahl Gert-Jan
Department of Pulmonary Medicine, Franciscus Gasthuis & Vlietland, Rotterdam, the Netherlands; Department of Pulmonary Medicine, Erasmus MC, Rotterdam, the Netherlands.
Department of Pediatrics, Franciscus Gasthuis & Vlietland, Rotterdam, the Netherlands.
Respir Med. 2021 Nov;188:106603. doi: 10.1016/j.rmed.2021.106603. Epub 2021 Sep 10.
Adult-onset asthma (AOA) is usually more severe compared to childhood onset asthma (CoA). Given the increasing evidence that AoA is associated with obesity, we investigated the relationship of other related metabolic comorbid conditions with AoA compared to CoA.
This cross-sectional study compared the metabolic syndrome and lipid derived inflammatory markers in patients with AoA, CoA and age- and sex-matched control subjects without asthma. Participants were asthma patients visiting the outpatient clinic of two teaching hospitals in Rotterdam, The Netherlands. All participants underwent lung function tests, blood tests and physical activity tracking. AoA was defined as asthma age of onset after the age of 18 years. Metabolic syndrome was defined according to the international joint interim statement criteria.
Eighty-one participants were included (27 AoA, 25 CoA, 29 controls). AoA was associated with the metabolic syndrome (Odds Ratio = 3.64 95% CI (1.16-11.42) p = 0.03, Nagelkerke R = 0.26), adjusted for age, sex, body mass index and smoking habits. AoA patients had higher median serum IL-6 and leptin-adiponectin (LA) ratio compared to controls (IL-6 (pg/mL): 3.10 [1.11-4.30] vs. 1.13 [0.72-1.58], p = 0.002 and LA ratio (pg/mL): 6.21 [2.45-14.11] vs. 2.24 [0.67-4.71], p = 0.0390). This was not observed in CoA and controls.
AoA was associated with the metabolic syndrome and its related pro-inflammatory endocrine and cytokine status. This may suggest adipose tissue derived inflammatory markers play a role in the pathophysiology of AoA.
与儿童期哮喘（CoA）相比，成人起病型哮喘（AOA）通常更为严重。鉴于越来越多的证据表明AOA与肥胖有关，我们研究了与CoA相比，其他相关代谢合并症与AOA之间的关系。
这项横断面研究比较了AOA患者、CoA患者以及年龄和性别匹配的无哮喘对照受试者的代谢综合征和脂质衍生的炎症标志物。参与者是在荷兰鹿特丹的两家教学医院门诊就诊的哮喘患者。所有参与者均接受了肺功能测试、血液测试和身体活动追踪。AOA定义为18岁以后发病的哮喘。代谢综合征根据国际联合临时声明标准定义。
纳入了81名参与者（27名AOA患者、25名CoA患者、29名对照）。在对年龄、性别、体重指数和吸烟习惯进行调整后，AOA与代谢综合征相关（优势比=3.64，95%置信区间[1.16 - 11.42]，p = 0.03，Nagelkerke R = 0.26）。与对照组相比，AOA患者的血清白细胞介素-6（IL-6）中位数和瘦素-脂联素（LA）比值更高（IL-6（pg/mL）：3.10 [1.11 - 4.30] 对 与1.13 [0.72 - 1.58]，p = 0.）。在CoA患者和对照组中未观察到这种情况。
AOA与代谢综合征及其相关的促炎内分泌和细胞因子状态有关。这可能表明脂肪组织衍生的炎症标志物在AOA的病理生理学中起作用。
