Reyes Noriega Nayely, Del-Río-Navarro Blanca E, Berber Arturo, de Jesús Romero Tapia Sergio, Molina Díaz Darío Jorge Mario
Allergy and Immunology Pediatric Department, Hospital Infantil de México Federico Gómez, Ciudad de México 06720, Mexico.
División Académica de Ciencias de la Salud, Universidad Juárez Autónoma de Tabasco, Villahermosa 86280, Mexico.
J Clin Med. 2023 Aug 19;12(16):5385. doi: 10.3390/jcm12165385.
Obesity and asthma are major global health concerns, particularly in industrialized nations. Obesity has been shown to have detrimental effects on the respiratory system and lung function owing to metabolic issues and immunological consequences. Research has indicated that obese patients with asthma (atopic or T2-high and non-atopic or T2-low) have diminished lung function in terms of functional residual capacity (FRC), residual volume (RV), expiratory reserve volume (ERV), the FEV1/FVC ratio, and FEF 25-75% due to mechanical fat loading on the diaphragm and central adiposity when compared to non-obese asthmatic patients. Therefore, it is plausible that changes in lung function are the result of a combination of mechanical (fat loading on the diaphragm, central adiposity, bronchial hyper-reactivity, and an increase in cholinergic tone), environmental (diet and exercise), and inflammatory factors (local and systemic), which can lead to the obesity-related asthma phenotype characterized by severe asthma symptoms, poor response to corticosteroid treatment, loss of lung function, and poor quality of life from an early age.
肥胖和哮喘是全球主要的健康问题，在工业化国家尤为如此。由于代谢问题和免疫后果，肥胖已被证明会对呼吸系统和肺功能产生不利影响。研究表明，与非肥胖哮喘患者相比，肥胖哮喘患者（特应性或T2高和非特应性或T2低）由于膈肌上的机械性脂肪负荷和中心性肥胖，在功能残气量（FRC）、残气量（RV）、呼气储备量（ERV）、FEV1/FVC比值和FEF 25-75%方面的肺功能下降。因此，肺功能的变化可能是机械因素（膈肌上的脂肪负荷、中心性肥胖、支气管高反应性和胆碱能张力增加）、环境因素（饮食和运动）和炎症因素（局部和全身）共同作用的结果，这些因素可导致以严重哮喘症状、对皮质类固醇治疗反应不佳、肺功能丧失和早年生活质量差为特征的肥胖相关哮喘表型。
