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肥胖儿童肺通气的不均匀性及其在哮喘恶化中的潜在作用。

Inhomogeneity of lung ventilation in children with obesity and its potential role in worsening asthma.

作者信息

Abushahin Ahmed, Abu-Hasan Mutasim, Shailesh Harshita, Antonisamy Belavendra, Hani Yahya, Muhayimana Abidan, Al Theyab Majed, Janahi Ibrahim

机构信息

Department of Pediatric Medicine, Division of Pulmonology, Sidra Medicine, Doha, Qatar.

Clinical Pediatrics, Weill Cornel Medicine-Qatar (WCM-Q), Doha, Qatar.

出版信息

Physiol Rep. 2025 Apr;13(8):e70257. doi: 10.14814/phy2.70257.

Abstract

Asthma is more frequent and severe in individuals with obesity compared to those with normal weight. While inhomogeneity of lung ventilation due to distal airway obstruction is a key feature in asthma, the effect of obesity on ventilation homogeneity is unclear. We conducted a cross-sectional study comparing lung clearance index (LCI) using multiple breath nitrogen washout technique between children with normal weight and asthma (n = 97), overweight/obesity and asthma (n = 100), overweight/obesity and no asthma (n = 100), and children with normal weight and no asthma (n = 67). Spirometry, lung volumes, and fractional exhaled nitric oxide (FeNO) were obtained for comparison. Results showed no significant difference in LCI between overweight/obesity groups and normal weight groups and no significant correlation between LCI and body mass index (BMI). However, LCI was higher in the asthma groups compared to non-asthma groups (p = 0.017, p = 0.003). There was a significant negative correlation between LCI and FEV1% predicted, FEV1/FVC, and FEF25-75% predicted (r = -0.24, p < 0.001; r = -0.26, p < 0.001; r = -0.23, p < 0.001), and a positive correlation with RV/TLC (r = 0.17, p = 0.003) and FeNO (r = 0.29, p < 0.001). These findings indicate that obesity does not affect the homogeneity of lung ventilation. Therefore, alternative mechanisms should be considered to explain the association between asthma and obesity.

摘要

与体重正常的个体相比,肥胖个体患哮喘的频率更高且病情更严重。虽然远端气道阻塞导致的肺通气不均匀是哮喘的一个关键特征,但肥胖对通气均匀性的影响尚不清楚。我们进行了一项横断面研究,使用多次呼吸氮洗脱技术比较了体重正常且患有哮喘的儿童(n = 97)、超重/肥胖且患有哮喘的儿童(n = 100)、超重/肥胖且未患哮喘的儿童(n = 100)以及体重正常且未患哮喘的儿童(n = 67)之间的肺清除指数(LCI)。同时获取了肺活量测定、肺容积和呼出一氧化氮分数(FeNO)用于比较。结果显示,超重/肥胖组与体重正常组之间的LCI无显著差异,且LCI与体重指数(BMI)之间无显著相关性。然而,哮喘组的LCI高于非哮喘组(p = 0.017,p = 0.003)。LCI与预测的第一秒用力呼气容积(FEV1)%、FEV1/FVC以及预测的25%-75%用力呼气流量(FEF25-75%)之间存在显著负相关(r = -0.24,p < 0.001;r = -0.26,p < 0.001;r = -0.23,p < 0.001),与残气量/肺总量(RV/TLC)和FeNO呈正相关(r = 0.17,p = 0.003;r = 0.29, p < 0.001)。这些发现表明,肥胖并不影响肺通气的均匀性。因此,应考虑其他机制来解释哮喘与肥胖之间的关联。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f33f/12004273/e4aa957d880c/PHY2-13-e70257-g003.jpg

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