Schleich Florence, Ziant Stéphanie, Louis Sébastien, Moermans Catherine, Deroisy Rita, Louis Renaud, Kaux Jean-François, Bury Thierry
Respiratory Medicine, Exercise Physiology Lab, GIGA I3, University and University Hospital of Liège, Liège, Belgium.
Respiratory Medicine, University Hospital of Liège, Liège, Belgium.
J Asthma Allergy. 2024 Dec 31;17:1369-1382. doi: 10.2147/JAA.S474667. eCollection 2024.
Physical inactivity due to shortness of breath is common among patients with uncontrolled asthma. We evaluated the body mass composition and exercise capacity of patients with poorly controlled asthma, despite maximal inhalation therapy.
We recruited 56 patients from the Asthma Clinic of the University Hospital of Liège between September 2020 and December 2023, and 14 healthy subjects. Patients with asthma underwent detailed investigations, including induced sputum, exercise testing, and Dual-Energy X-ray Absorptiometry (DXA), to determine overall body fat mass and fat-free mass, while healthy subjects only underwent DXA. This study was approved by the Ethics Committee (2019/362).
The mean age of patients with asthma was 45 years ± 12; 58% were female, 10% were active smokers, and mean post-BD Forced Expiratory Volume in one second was 85.7% predicted. Compared to healthy subjects, asthmatics had a higher BMI (28.5±5.1 kg/m2 vs 22.5 ±2.8 kg/m2, p<0.0001) and fat mass index (FMI; 10.3 ± 3.7 vs 5.9 ± 2.8 kg/m2, p=0.0005), lower lean and bone mass (62% vs 71%, p=0.0012), and greater android fat distribution (1.00 ± 0.22 vs 0.80 ± 0.13, p<0.0001). Eosinophilic asthma (sputum eosinophil count of ≥3%) was characterized by a better VO max compared to non-eosinophilic asthma (20.7 [17.8-24.3] vs 17.3 [14.0-18.9], p=0.04). Higher lean mass was correlated with better asthma control and lower depression scores. Lean mass and bone mineral content correlated with maximal expiratory, inspiratory, and maximal aerobic power.
Our study confirmed that patients with uncontrolled asthma were overweight and had decreased exercise capacity.
因呼吸急促导致身体活动不足在哮喘控制不佳的患者中很常见。我们评估了尽管接受了最大剂量吸入治疗但哮喘控制不佳的患者的身体成分和运动能力。
2020年9月至2023年12月期间，我们从列日大学医院哮喘诊所招募了56名患者和14名健康受试者。哮喘患者接受了详细检查，包括诱导痰检查、运动测试和双能X线吸收测定法（DXA），以确定总体脂肪量和去脂体重，而健康受试者仅接受了DXA检查。本研究经伦理委员会批准（2019/362）。
哮喘患者的平均年龄为45岁±12岁；58%为女性，10%为当前吸烟者，一秒钟用力呼气容积（FEV1）预计值的平均支气管扩张后为85.7%。与健康受试者相比，哮喘患者的体重指数（BMI）更高（28.5±5.1kg/m² 对22.5±2.8kg/m²，p<0.0001）和脂肪量指数（FMI；10.3±3.7对5.9±2.8kg/m²，p=0.0005），去脂体重和骨量更低（62%对71%，p=0.0012），腹部脂肪分布更多（1.00±0.22对0.80±0.13，p<0.0001）。嗜酸性粒细胞性哮喘（痰嗜酸性粒细胞计数≥3%）的特点是与非嗜酸性粒细胞性哮喘相比，最大摄氧量更好（20.7[17.8-24.3]对17.3[14.0-18.9]，p=0.04）。更高的去脂体重与更好的哮喘控制和更低的抑郁评分相关。去脂体重和骨矿物质含量与最大呼气、吸气和最大有氧能力相关。
我们的研究证实，哮喘控制不佳的患者超重且运动能力下降。
