Division of Pulmonary Medicine, Department of Pediatrics, University of Pittsburgh, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania.
Division of Pulmonary Medicine, Department of Pediatrics, University of Pittsburgh, UPMC Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania.
Ann Allergy Asthma Immunol. 2022 Sep;129(3):301-306. doi: 10.1016/j.anai.2022.04.029. Epub 2022 Apr 30.
To review and critically discuss published evidence on interactions between obesity and selected risk factors on asthma in children and adults, and to discuss potential future directions in this field.
National Library of Medicine (via PubMed) STUDY SELECTION: A literature search was conducted for human studies on obesity and selected interactions (with sex, race and ethnicity, socioeconomic status, indoor and outdoor pollutants, depression, anxiety, and diet) on asthma. Studies that were published in English and contained a full text were considered for inclusion in this review.
Current evidence supports interactions between obesity and outdoor and indoor air pollutants (including second-hand smoke [SHS]) on enhancing asthma risk, although there are sparse data on the specific pollutants underlying such interactions. Limited evidence also suggests that obesity may modify the effects of depression or anxiety on asthma, whereas little is known about potential interactions between obesity and sex-hormone levels or dietary patterns.
Well-designed observational prospective studies (eg, for pollutants and sex hormones) and randomized clinical trials (eg, for the treatment of depression) should help establish the impact of modifying coexisting exposures to reduce the harmful effects of obesity on asthma. Such studies should be designed to have a sample size that is large enough to allow adequate testing of interactions between obesity and risk factors that are identified a priori and thus, well characterized, using objective measures and biomarkers (eg, urinary or serum cotinine for SHS, epigenetic marks of specific environmental exposures).
回顾和批判性地讨论已发表的关于肥胖与儿童和成人哮喘相关选定风险因素之间相互作用的证据，并讨论该领域未来的潜在方向。
国家医学图书馆（通过 PubMed）
对肥胖与选定相互作用（性别、种族和民族、社会经济地位、室内外污染物、抑郁、焦虑和饮食）对哮喘影响的人类研究进行了文献检索。只有发表英文全文的研究才被考虑纳入本综述。
目前的证据支持肥胖与室外和室内空气污染物（包括二手烟[SHS]）之间的相互作用会增加哮喘风险，尽管关于这些相互作用背后的特定污染物的数据很少。有限的证据还表明，肥胖可能会改变抑郁或焦虑对哮喘的影响，而肥胖与性激素水平或饮食模式之间的潜在相互作用知之甚少。
精心设计的观察性前瞻性研究（例如，针对污染物和性激素）和随机临床试验（例如，针对抑郁的治疗）应有助于确定减轻共存暴露的影响，以减少肥胖对哮喘的有害影响。这些研究应设计成具有足够大的样本量，以便能够充分测试预先确定的肥胖与风险因素之间的相互作用，并使用客观测量和生物标志物（例如，SHS 的尿液或血清可替宁、特定环境暴露的表观遗传标记）对其进行很好的特征描述。
