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中年普通人群中的哮喘及肺外合并症:SCAPIS研究结果

Asthma and extrapulmonary comorbidities in a middle-aged general population: results from the SCAPIS study.

作者信息

Wang Juan, Blomberg Anders, Ekström Magnus, Persson Hans Lennart, Sköld Magnus, Torén Kjell, Zhou Xingwu, Malinovschi Andrei, Janson Christer

机构信息

Department of Medical Sciences, Respiratory-, Allergy- and Sleep Research, Uppsala University, Uppsala, Sweden

Department of Medical Sciences, Clinical Physiology, Uppsala University, Uppsala, Sweden.

出版信息

BMJ Open Respir Res. 2025 Jun 19;12(1):e003020. doi: 10.1136/bmjresp-2024-003020.

Abstract

INTRODUCTION

Asthma may increase the risk of comorbidities and systemic inflammation, but population data are scarce. This study aimed to compare comorbidities and systemic inflammation between those with and without current asthma and to identify characteristics linked to comorbidities and biomarkers.

METHODS

In a cross-sectional analysis of 28 828 people aged 50-64 in the Swedish CArdioPulmonary bioImage Study, assessments included postbronchodilator forced expiratory volume in 1 s (FEV), forced vital capacity (FVC), serum levels of C reactive protein (CRP) and haemoglobin A1c (HbA1c). Data on current physician-diagnosed asthma, respiratory symptoms and comorbidities were obtained via a questionnaire.

RESULTS

The prevalence of current asthma was 6.3%. Current asthma was independently associated with a higher prevalence of hypertension (OR=1.30; 95% CI 1.16 to 1.46), hyperlipidaemia (OR=1.20; 95% CI 1.04 to 1.39), diabetes (OR=1.42; 95% CI 1.16 to 1.75), coeliac disease (OR=2.52; 95% CI 1.61 to 3.95) and rheumatic disease (OR=1.43; 95% CI 1.16 to 1.78). Asthma was also associated with higher levels of CRP (beta=0.25; 95% CI 0.06 to 0.44) and HbA1c (beta=0.47; 95% CI 0.18 to 0.77). In those with asthma, lower FVC % predicted was associated with a higher likelihood of hypertension (OR=1.10; 95% CI 1.01 to 1.19), diabetes (OR=1.47; 95% CI 1.26 to 1.71) and rheumatic disease (OR=1.22; 95% CI 1.05 to 1.42). Lower FEV % predicted was associated with a higher likelihood of diabetes (OR=1.27; 95% CI 1.12 to 1.44). FVC % and FEV % predicted were negatively associated with CRP and HbA1c.

CONCLUSIONS

Our findings suggest that in middle-aged people, asthma is independently associated with common comorbidities such as hypertension, diabetes and rheumatic disease, as well as elevated CRP and blood glucose. Our data suggest that some associations are connected with lung function impairment in those with asthma.

摘要

引言

哮喘可能会增加合并症和全身炎症的风险,但相关人群数据较少。本研究旨在比较当前患有哮喘和未患哮喘人群的合并症及全身炎症情况,并确定与合并症和生物标志物相关的特征。

方法

在瑞典心肺生物图像研究中,对28828名年龄在50 - 64岁的人群进行横断面分析,评估指标包括支气管扩张剂后1秒用力呼气容积(FEV)、用力肺活量(FVC)、血清C反应蛋白(CRP)水平和糖化血红蛋白(HbA1c)。通过问卷调查获取当前医生诊断的哮喘、呼吸道症状及合并症的数据。

结果

当前哮喘的患病率为6.3%。当前哮喘与高血压患病率较高独立相关(比值比[OR]=1.30;95%置信区间[CI]为1.16至1.46)、高脂血症(OR=1.20;95% CI为1.04至1.39)、糖尿病(OR=1.42;95% CI为1.16至1.75)、乳糜泻(OR=2.52;95% CI为1.61至3.95)和风湿性疾病(OR=1.43;95% CI为1.16至1.78)。哮喘还与较高水平的CRP(β=0.25;95% CI为0.06至0.44)和HbA1c(β=0.47;95% CI为0.18至0.77)相关。在患有哮喘的人群中,预测的较低FVC%与高血压(OR=1.10;95% CI为1.01至1.19)、糖尿病(OR=1.47;95% CI为1.26至1.71)和风湿性疾病(OR=1.22;95% CI为1.05至1.42)的较高可能性相关。预测的较低FEV%与糖尿病的较高可能性相关(OR=1.27;95% CI为1.12至1.44)。预测的FVC%和FEV%与CRP和HbA1c呈负相关。

结论

我们的研究结果表明,在中年人中,哮喘与高血压、糖尿病和风湿性疾病等常见合并症以及CRP升高和血糖升高独立相关。我们的数据表明,哮喘患者中的一些关联与肺功能损害有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7717/12182154/a936b728cf5b/bmjresp-12-1-g001.jpg

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