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应对哮喘控制不佳患者肥胖问题的挑战。

The challenge of addressing obesity in people with poorly controlled asthma.

作者信息

Dixon Anne E, Blake Kathryn V, DiMango Emily A, Dransfield Mark T, Feemster Laura C, Johnson Olivia, Roy Gem, Hazucha Heather, Harvey Jean, McCormack Meredith C, Wise Robert A, Holbrook Janet T

机构信息

University of Vermont Burlington Vermont USA.

Nemours Children's Health Jacksonville Florida USA.

出版信息

Obes Sci Pract. 2021 May 25;7(6):682-689. doi: 10.1002/osp4.533. eCollection 2021 Dec.

Abstract

OBJECTIVE

There is a high prevalence of obesity in people with asthma, and obesity is associated with poorly controlled asthma. Significant weight loss might improve asthma control: the purpose of this study was to investigate patient characteristics and factors that might affect implementation of a weight loss and/or roflumilast intervention, to target both obesity and asthma.

METHODS

A cross-sectional study of people with obesity and poorly controlled asthma performed at 13 sites across the United States.

RESULTS

One hundred and two people participated in this study. Median BMI was 37 (IQR 35-42). The majority, 55%, were African American and 76% were female. Fifty two percent had very poorly controlled asthma. Most participants were quite sedentary (70% reported being inactive or participating only in light-intensity activities according to the Stanford Brief Activity Survey). Participants reported significant impairments related to physical function on the Impact of Weight on Quality of Life-Lite questionnaire (median score 67 [IQR 41-84]). Thirty-five percent of participants reported mild, and 2 % moderate, depressive symptoms as assessed by the Patient Health Questionnaire-9.

CONCLUSIONS

Poorly controlled asthma and obesity often affect minority populations and are associated with significant impairments in health related to physical function and low levels of physical activity that might complicate efforts to lose weight. Interventions targeted at poorly controlled asthma associated with obesity in the United States need to address factors complicating health in underserved communities, such as increasing opportunities for physical activity, while also managing activity limitations related to the combination of asthma and obesity.

摘要

目的

哮喘患者中肥胖的患病率很高,且肥胖与哮喘控制不佳有关。显著的体重减轻可能会改善哮喘控制:本研究的目的是调查可能影响减肥和/或罗氟司特干预措施实施的患者特征和因素,以同时针对肥胖和哮喘。

方法

在美国13个地点对肥胖且哮喘控制不佳的患者进行了一项横断面研究。

结果

102人参与了本研究。BMI中位数为37(四分位间距35 - 42)。大多数人(55%)是非裔美国人,76%为女性。52%的患者哮喘控制非常差。根据斯坦福简短活动调查,大多数参与者久坐不动(70%报告不活动或仅参与轻度活动)。参与者在体重对生活质量 - 简易问卷中报告了与身体功能相关的显著损伤(中位数得分67 [四分位间距41 - 84])。根据患者健康问卷 - 9评估,35%的参与者报告有轻度抑郁症状,2%有中度抑郁症状。

结论

哮喘控制不佳和肥胖常常影响少数族裔人群,并且与身体功能相关的健康显著损伤以及低水平的身体活动有关,这可能会使减肥努力变得复杂。针对美国与肥胖相关的哮喘控制不佳的干预措施需要解决在服务不足社区中使健康状况复杂化的因素,例如增加身体活动的机会,同时还要处理与哮喘和肥胖合并症相关的活动限制。

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本文引用的文献

9
Obesity and asthma.肥胖与哮喘。
J Allergy Clin Immunol. 2018 Apr;141(4):1169-1179. doi: 10.1016/j.jaci.2018.02.004.
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Depression and obesity: evidence of shared biological mechanisms.抑郁和肥胖:存在共同的生物学机制的证据。
Mol Psychiatry. 2019 Jan;24(1):18-33. doi: 10.1038/s41380-018-0017-5. Epub 2018 Feb 16.

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