Leung Sharon S Y, Tsang Helen S L, Chan Jasmine, Kui Oliver Y H, Zeng Ping, Cheung Yin Ting, Cheng James-Wesley, Chan Kate C C, Yu Michelle, Tang Patricia, Brannan John D, Lam Jenny K W, Chan Hak-Kim, Li Albert M
School of Pharmacy, The Chinese University of Hong Kong, Hong Kong SAR, China.
Department of Paediatrics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China.
Ann Med. 2025 Dec;57(1):2468262. doi: 10.1080/07853890.2025.2468262. Epub 2025 Feb 20.
Increasing epidemiological studies reported that overweight/obese asthma patients had more frequent and severe symptoms and exacerbations, indicating their asthma management may not be sufficient. Airway hyperresponsiveness (AHR), a significant feature of asthma, was found to link with the body mass index (BMI) with mixed findings using the "direct" methacholine challenge test. The objective was to examine the association between BMI and asthma control, as reflected by the "indirect" AHR with the mannitol challenge test in a paediatric asthmatic population.
A total of 80 subjects with physician-diagnosed asthma, aged 6-18 years were enrolled in this cross-sectional study. Patients were first asked to complete the Asthma Control Test (ACT) questionnaire to self-evaluate their disease status. A mannitol challenge test was then performed to assess their AHR severity.
Seventy-six patients (96%) rated their asthma as well-controlled with an ACT score ≥ 20, but 42 patients (53%) were tested positive in the mannitol challenge test with mild and moderate AHR. While patients with mild AHR had comparable lung functions to those without AHR, patients with moderate AHR showed slightly but significantly lower FEV and FEV/FVC values. Although no significant difference in the BMI values was noted for patients with different levels of AHR, the trend of increasing BMI with age was steeper for patients with moderate AHR.
A high prevalence of AHR (>50%) was found in asthmatic children who self-evaluated with good asthma control. No significant influence of the BMI on the AHR severity could be demonstrated in this population with the "indirect" mannitol challenge test. Since only a small number of overweight/obese subjects were recruited in the present study, further verification of the results with a larger sample size of obese subjects is required.
越来越多的流行病学研究报告称，超重/肥胖的哮喘患者症状更频繁、更严重，且病情加重情况更多，这表明他们的哮喘管理可能并不充分。气道高反应性（AHR）是哮喘的一个显著特征，通过“直接”乙酰甲胆碱激发试验发现其与体重指数（BMI）之间的关联存在混合结果。本研究的目的是在儿科哮喘患者群体中，通过甘露醇激发试验这一“间接”AHR来检验BMI与哮喘控制之间的关联。
本横断面研究共纳入80名经医生诊断为哮喘的6至18岁受试者。首先要求患者完成哮喘控制测试（ACT）问卷以自我评估其疾病状态。然后进行甘露醇激发试验以评估其AHR严重程度。
76名患者（96%）将其哮喘评定为控制良好，ACT评分≥20，但42名患者（53%）在甘露醇激发试验中呈阳性，具有轻度和中度AHR。轻度AHR患者的肺功能与无AHR患者相当，而中度AHR患者的第一秒用力呼气容积（FEV）和FEV/用力肺活量（FVC）值略低但有显著差异。尽管不同AHR水平的患者BMI值无显著差异，但中度AHR患者的BMI随年龄增长的趋势更为陡峭。
在自我评估哮喘控制良好的哮喘儿童中发现AHR的高患病率（>50%）。通过“间接”甘露醇激发试验，在该人群中未发现BMI对AHR严重程度有显著影响。由于本研究仅招募了少数超重/肥胖受试者，因此需要用更大样本量的肥胖受试者进一步验证结果。
