Kim Jung-Hyun, Park Bo Young, Choi Sun Hee, Kwon Hyouk-Soo, Song Woo-Jung, Yu Jinho, Song Dae Jin, Chang Yoon-Seok, Cho You Sook, Lim Dae Hyun, Cho Young-Joo, Chang Suk-Il, Kim Sae-Hoon, Kim Tae-Bum
Department of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
Division of Allergy and Clinical Immunology, Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.
J Thorac Dis. 2025 Mar 31;17(3):1142-1158. doi: 10.21037/jtd-24-1531. Epub 2025 Mar 27.
Asthma is a heterogenous disease having varied phenotypes. The comorbidities associated with asthma vary with age and disease severity. The well-known asthma related comorbid conditions include rhinitis, gastroesophageal reflux disease (GERD), hypertension, obstructive sleep apnea, hormonal disorders, and psychiatric disorders. However, comprehensive analyses of how asthma severity correlates with the prevalence and type of comorbidities remain limited. Understanding these relationships is essential for developing targeted management strategies. This study aims to analyze the comorbid conditions associated with adult asthma based on severity, using data from the National Health Insurance Sharing Service. By comparing non-severe asthma (NSA) and severe asthma (SA) groups, the study seeks to identify key differences in the prevalence and risks of comorbid diseases, thereby providing valuable insights for clinicians managing asthma patients.
National Health Insurance claim records from July 1, 2014 to June 31, 2016 were analyzed in a retrospective population-based study. We analyzed the frequent comorbidities in adult patients with asthma. Patients were divided into the following groups according to severity of asthma: NSA and SA. Risk of the developing major comorbid diseases conditions were analyzed according to the morbidity and severity of asthma.
Vasomotor and allergic rhinitis, bronchitis, upper respiratory infection, and GERD were common comorbid conditions in all patients with asthma. chronic obstructive pulmonary disease was more common in SA than in NSA. In major comorbid diseases, patients with asthma had more risk in chronic diseases such as diabetes mellitus [odds ratio (OR) =1.13; 95% confidence interval (CI): 1.13, 1,14] and various types of psychiatric disorder (OR =1.49; 95% CI: 1.48, 1.49), as well as rhinitis (OR =1.94; 95% CI: 1.94, 1.95), GERD (OR =1.66; 95% CI: 1.66, 1.67), and osteoporosis (OR =1.40; 95% CI: 1.39, 1.41). Patients with SA experienced more comorbidities and higher incidence of cardiovascular disease, cerebrovascular disease, dementia, and several psychiatric disorders than patients with NSA.
Patients with asthma had a higher risk of chronic diseases than patients without asthma, and there was a tendency of higher risk of major comorbidities in SA. Clinicians should consider the impact of comorbid diseases in the asthma patient care.
哮喘是一种具有多种表型的异质性疾病。与哮喘相关的合并症随年龄和疾病严重程度而异。与哮喘相关的常见合并症包括鼻炎、胃食管反流病（GERD）、高血压、阻塞性睡眠呼吸暂停、激素紊乱和精神疾病。然而，关于哮喘严重程度与合并症患病率及类型之间如何关联的综合分析仍然有限。了解这些关系对于制定有针对性的管理策略至关重要。本研究旨在利用国家健康保险共享服务的数据，基于严重程度分析与成人哮喘相关的合并症。通过比较非重度哮喘（NSA）组和重度哮喘（SA）组，该研究旨在确定合并症患病率和风险的关键差异，从而为管理哮喘患者的临床医生提供有价值的见解。
在一项基于人群的回顾性研究中，分析了2014年7月1日至2016年6月31日的国家健康保险理赔记录。我们分析了成年哮喘患者中常见的合并症。根据哮喘严重程度将患者分为以下几组：NSA和SA。根据哮喘的发病率和严重程度分析发生主要合并症的风险。
血管运动性鼻炎和过敏性鼻炎、支气管炎、上呼吸道感染和GERD是所有哮喘患者常见的合并症。慢性阻塞性肺疾病在SA组比NSA组更常见。在主要合并症方面，哮喘患者患糖尿病等慢性疾病的风险更高[比值比（OR）=1.13；95%置信区间（CI）：1.13，1.14]以及患各种类型精神疾病的风险更高（OR =1.49；95% CI：1.48，1.49），还有患鼻炎的风险更高（OR =1.94；95% CI：1.94，1.95）、患GERD的风险更高（OR =1.66；95% CI：1.66，1.67）以及患骨质疏松症的风险更高（OR =1.40；95% CI：1.39，1.41）。与NSA患者相比，SA患者经历的合并症更多，心血管疾病、脑血管疾病、痴呆和几种精神疾病的发病率更高。
哮喘患者患慢性疾病的风险高于非哮喘患者，并且SA患者发生主要合并症的风险有更高的趋势。临床医生在哮喘患者护理中应考虑合并症的影响。
