Bloodworth Melissa H, Staso Patrick J, Huang Shi, Farber-Eger Eric, Niswender Kevin D, Harrell Frank E, Wells Quinn S, Bacharier Leonard B, Shuey Megan M, Cahill Katherine N
Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee.
Department of Biostatistics, Vanderbilt University School of Medicine, Nashville, Tennessee.
Ann Allergy Asthma Immunol. 2024 Dec;133(6):660-666.e5. doi: 10.1016/j.anai.2024.09.005. Epub 2024 Sep 16.
Obesity and metabolic dysregulation (MetD) have increasing prevalence and adversely affect asthma morbidity and therapeutic response.
To determine the role of weight and MetD on incident asthma in adulthood.
In a retrospective, longitudinal cohort of patients, we performed a time-to-asthma diagnosis analysis after a 3-year landmark period (t-t) during which weight and MetD components were evaluated. We assessed incident asthma risk with MetD components and weight.
In total, 90,081 patients met the inclusion criteria, with 836 cases (0.93%) of incident asthma in our primary cohort. Diabetes present at t, but no other MetD components, was associated with increased risk of asthma (adjusted hazard ratio = 1.85, 95% CI: 1.27-2.71, P = .0002). The effect of weight on asthma risk, independent of other MetD components, identified individuals with overweight or obesity as having a 10-year attributable risk of 15.4%. Metformin was prescribed more frequently, and hemoglobin A1c levels were lower in patients with diabetes in whom asthma did not develop (P < .0001).
Weight and diabetes prevention and management represent modifiable risk factors for adult asthma development.
肥胖和代谢失调（MetD）的患病率不断上升，对哮喘发病率和治疗反应产生不利影响。
确定体重和MetD在成年期新发哮喘中的作用。
在一项回顾性纵向队列研究中，我们在一个为期3年的标志性时期（t-t）后进行了哮喘诊断时间分析，在此期间评估了体重和MetD的组成部分。我们用MetD的组成部分和体重评估了新发哮喘的风险。
共有90,081名患者符合纳入标准，在我们的主要队列中有836例（0.93%）新发哮喘病例。在t时存在糖尿病，但无其他MetD组成部分，与哮喘风险增加相关（调整后的风险比=1.85，95%置信区间：1.27-2.71，P=.0002）。体重对哮喘风险的影响独立于其他MetD组成部分，超重或肥胖个体的10年归因风险为15.4%。在未发生哮喘的糖尿病患者中，二甲双胍的处方频率更高，糖化血红蛋白水平更低（P<.0001）。
体重以及糖尿病的预防和管理是成人哮喘发生的可改变风险因素。
