School of Biomedical Sciences, Faculty of Biological Sciences, University of Leeds, Leeds, UK.
Leeds Institute of Medical Research at St. James's, University of Leeds, Leeds, UK.
Br J Sports Med. 2022 Feb;56(4):213-222. doi: 10.1136/bjsports-2021-104601. Epub 2021 Dec 6.
To report the prevalence of lower airway dysfunction in athletes and highlight risk factors and susceptible groups.
Systematic review and meta-analysis.
PubMed, EBSCOhost and Web of Science (1 January 1990 to 31 July 2020).
Original full-text studies, including male or female athletes/physically active individuals/military personnel (aged 15-65 years) who had a prior asthma diagnosis and/or underwent screening for lower airway dysfunction via self-report (ie, patient recall or questionnaires) or objective testing (ie, direct or indirect bronchial provocation challenge).
In total, 1284 studies were identified. Of these, 64 studies (n=37 643 athletes) from over 21 countries (81.3% European and North America) were included. The prevalence of lower airway dysfunction was 21.8% (95% CI 18.8% to 25.0%) and has remained stable over the past 30 years. The highest prevalence was observed in elite endurance athletes at 25.1% (95% CI 20.0% to 30.5%) (Q=293, I=91%), those participating in aquatic (39.9%) (95% CI 23.4% to 57.1%) and winter-based sports (29.5%) (95% CI 22.5% to 36.8%). In studies that employed objective testing, the highest prevalence was observed in studies using direct bronchial provocation (32.8%) (95% CI 19.3% to 47.2%). A high degree of heterogeneity was observed between studies (I=98%).
Lower airway dysfunction affects approximately one in five athletes, with the highest prevalence observed in those participating in elite endurance, aquatic and winter-based sporting disciplines. Further longitudinal, multicentre studies addressing causality (ie, training status/dose-response relationship) and evaluating preventative strategies to mitigate against the development of lower airway dysfunction remain an important priority for future research.
报告运动员下呼吸道功能障碍的患病率，并强调风险因素和易感人群。
系统评价和荟萃分析。
PubMed、EBSCOhost 和 Web of Science（1990 年 1 月 1 日至 2020 年 7 月 31 日）。
原始全文研究，包括有哮喘既往诊断的男性或女性运动员/体力活动者/军人（年龄 15-65 岁），或通过自我报告（即患者回忆或问卷调查）或客观测试（即直接或间接支气管激发挑战）筛查下呼吸道功能障碍。
共确定了 1284 项研究。其中，来自 21 个以上国家（81.3%为欧洲和北美）的 64 项研究（n=37643 名运动员）被纳入。下呼吸道功能障碍的患病率为 21.8%（95%CI 18.8%至 25.0%），在过去 30 年中保持稳定。在精英耐力运动员中观察到的患病率最高，为 25.1%（95%CI 20.0%至 30.5%）（Q=293，I=91%），参加水上（39.9%）（95%CI 23.4%至 57.1%）和冬季运动（29.5%）（95%CI 22.5%至 36.8%）的运动员患病率最高。在采用客观测试的研究中，使用直接支气管激发的研究中观察到的患病率最高，为 32.8%（95%CI 19.3%至 47.2%）。研究之间存在高度异质性（I=98%）。
下呼吸道功能障碍影响大约五分之一的运动员，在参加精英耐力、水上和冬季运动项目的运动员中患病率最高。进一步的纵向、多中心研究，以确定因果关系（即训练状态/剂量反应关系）并评估预防策略以减轻下呼吸道功能障碍的发展，仍然是未来研究的一个重要优先事项。
