Zhou Meicen, Zhang Ting, Zeng Ziyi, Zeng Shuqin, Wang Shaopu, Wang Hua
Department of Pediatrics, West China Second University Hospital, Sichuan University, No. 20, Section 3, South Renmin Road, Chengdu, Sichuan Province, 610041, China.
Key Laboratory of Birth Defects and Related Diseases of Women and Children, Ministry of Education, Sichuan University, Chengdu, Sichuan Province, 610041, China.
Lipids Health Dis. 2025 Jan 14;24(1):13. doi: 10.1186/s12944-024-02428-y.
This study aimed to investigate the association between relative fat mass (RFM) and asthma, as well as to explore the mediating role of Systemic Immune-Inflammation Index (SII) and Systemic Inflammation Response Index (SIRI).
This cross-sectional study utilized data from the National Health and Nutrition Examination Survey from 2007 to 2018. Associations between RFM and asthma were tested using multivariable logistic regressions, restricted cubic splines, subgroup analyses, and interaction tests, with mediation analysis for SII and SIRI. The inflection point was determined by the two-piecewise linear regression. Sensitivity analysis and propensity score matching (PSM) was applied to validate the stability of the associations.
Higher RFM was positively associated with asthma, with an inflection point at 34.08. Below this threshold, each unit increase in RFM was positively associated with a 2% increase in the odds of asthma (Odds ratio (OR) 1.02, 95% Confidence interval (CI): 1.00-1.03), while above it, the association strengthened, with a 5% increase in the odds per unit (OR 1.05, 95% CI: 1.04-1.07). The association was consistent across subgroups. The association between RFM and asthma is stronger in current asthma patients than in ever had asthma ones. Mediation analyses showed that SII and SIRI partially mediated 7.48% and 3.88% of the RFM-asthma association, respectively. The findings remained robust after sensitivity analyses and adjusting for confounding bias using PSM.
RFM is positively associated with the prevalence of asthma in the U.S., particularly among individuals with current asthma, with systemic inflammation partially mediating this relationship.
本研究旨在调查相对脂肪量（RFM）与哮喘之间的关联，并探讨全身免疫炎症指数（SII）和全身炎症反应指数（SIRI）的中介作用。
这项横断面研究利用了2007年至2018年美国国家健康与营养检查调查的数据。使用多变量逻辑回归、受限立方样条、亚组分析和交互作用检验来测试RFM与哮喘之间的关联，并对SII和SIRI进行中介分析。通过两段式线性回归确定拐点。应用敏感性分析和倾向得分匹配（PSM）来验证关联的稳定性。
较高的RFM与哮喘呈正相关，拐点为34.08。低于此阈值时，RFM每增加一个单位与哮喘患病几率增加2%呈正相关（优势比（OR）1.02，95%置信区间（CI）：1.00 - 1.03），而高于该阈值时，关联增强，每单位优势增加5%（OR 1.05，95% CI：1.04 - 1.07）。该关联在各亚组中一致。RFM与哮喘之间的关联在当前哮喘患者中比曾经患过哮喘的患者更强。中介分析表明，SII和SIRI分别部分介导了RFM与哮喘关联的7.48%和3.88%。经过敏感性分析和使用PSM调整混杂偏倚后，研究结果仍然稳健。
在美国，RFM与哮喘患病率呈正相关，尤其是在当前患有哮喘的个体中，全身炎症部分介导了这种关系。
